The COVID-19 Pandemic – Insurer Insights Into Challenges, Implications, and Lessons Learned

The novel coronavirus (COVID-19) pandemic has placed enormous pressure on virtually all facets of U.S. society. Much attention has appropriately been placed on the efforts of health care providers to deliver care to those infected with COVID-19. However, less is known about the experiences of the health insurers who reimburse those health care providers for the care they deliver. In a new report supported by the Robert Wood Johnson Foundation, insurance experts at CHIR and the Urban Institute share findings from interviews with executives at 25 health insurance companies on their impressions of the ongoing ramifications of the pandemic and their response to the crisis. Continue reading

Instead of Encouraging Enrollment in Comprehensive Health Coverage, New Federal Guidance Requires Taxpayers to Subsidize Health Care Sharing Ministries

In the midst of the COVID-19 pandemic, the IRS has published a proposed rule that would grant tax advantages reserved for insurance to individuals’ spending on health care sharing ministries, raising real questions about using federal funds to promote a coverage option that fails to provide consumers with financial protection for health care expenses. JoAnn Volk walks through the proposed rule and its potential implications for consumers.
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A Pledge to Do Better

We at CHIR are reeling and taking stock in the wake of the tragic and callous murder of George Floyd, as well as the unsurprising unrest caused by our nation’s longstanding indifference to the pain of communities of color. At CHIR, we spend our professional lives focused on improving people’s access to affordable, high quality health insurance. The work is an honor and we believe we are helping to advance policies that allow more people to get better health care without facing financial ruin.

However, we know we have privileges we too often take for granted and that, at times, have blinded us to well-documented inequities in our health care system. The fact is that we have not thought deeply enough about the longstanding and structural racism that makes it more likely that Black, Hispanic, and Native American/Alaskan Native people are uninsured, more likely to suffer from high out-of-pocket costs, more likely to lack access to providers, and more likely to get poor quality care. We can and must do more. As researchers and policy analysts, we can study the data to better understand the challenges facing communities of color. We can proactively seek out voices in those communities who are documenting and sharing their lived experiences. We can consciously and carefully assess the disparate impacts of policy choices, and work a lot harder to lift up those policies that lift up people of color. We don’t pretend that our efforts to learn about these issues and integrate them into our work in a deeper and more conscious way will make a big difference, but they could make a small difference. What we realize is that these efforts are essential to our mission and values.

We would love to hear from you. If you know of ways in which we can better integrate these important issues into our work and share them with decision makers, please let us know. Continue reading

During the COVID-19 Crisis, State Health Insurance Marketplaces Are Working to Enroll the Uninsured

As the coronavirus pandemic and economic shutdown continue, the Affordable Care Act’s health insurance marketplaces are an important tool in covering the uninsured. In a new post for the Commonwealth Fund’s To the Point blog, CHIR experts Rachel Schwab, Justin Giovannelli and Kevin Lucia explore how state-based marketplaces have worked to enroll the uninsured during the COVID-19 crisis by creating new opportunities to sign up for coverage and launching outreach campaigns. Continue reading

Idaho Misses Opportunities to Help Consumers Get Affordable, Comprehensive Health Coverage During COVID-19 Pandemic

Since the COVID-19 pandemic began, states have taken charge of responding to the public health emergency. As a state that runs its own health insurance marketplace, Idaho has tools at its disposal to help consumers enroll in comprehensive coverage. But like the federal marketplace, Idaho decided not to wield all of them, leaving large marketplace enrollment barriers and instead promoting alternative and less comprehensive coverage. Continue reading

In the Age of COVID-19, Short-Term Plans Fall Short for Consumers

During February’s State of the Union address, President Trump touted his administration’s efforts to expand access to short-term health plans that do not comply with any of the ACA’s consumer protections. Short-term plans are often cheaper than ACA-compliant plans because they can deny coverage to people and exclude entire categories of services. In a recent post supported by The Commonwealth Fund, we reviewed 12 short-term plans to determine what coverage consumers would have if they needed treatment for COVID-19. We found that consumers in short-term plans are likely to have less financial protections than those enrolled in ACA plans. Continue reading

COVID-19 Response: States That Run Their Own ACA Marketplace Are Better Positioned to Help Consumers Get Covered

During the current public health and financial crises brought by the COVID-19 pandemic, the ACA’s health insurance marketplaces offer a crucial safety net. States that run their own marketplaces have a significant advantage in helping consumers obtain comprehensive, affordable health insurance. CHIR’s Rachel Schwab looks at some opportunities for state-based marketplaces that don’t exist for states relying on the federal marketplace. Continue reading

State-Based Marketplaces Find Value, Potential Opportunity for Growth in Small-Business Offering

Small businesses have historically struggled to provide coverage to their workers. The ACA sought to address these issues through the Small Business Health Options Program (SHOP), creating marketplaces for small employers to offer coverage to their employees. In a new post for the Commonwealth Fund’s To the Point blog, CHIR experts take a look at ways that state-based marketplaces are investing in their SHOPs, and how some are seeing enrollment growth and savings for small businesses. Continue reading

Coronavirus Exposes Big Gaps in the U.S. System Of Coverage: What Can States Do to Help?

The cost of medical care associated with the novel coronavirus can be a barrier for many people who should get tested, raising a public health risk. Given our patchwork quilt system of health insurance coverage and the lack of a timely and comprehensive federal response, CHIR’s Sabrina Corlette and Kevin Lucia consider actions states can take to encourage people to get the care they need. Continue reading

A Placeholder Won’t Protect People with Pre-Existing Conditions

President Donald Trump has voiced an “ironclad pledge” to protect patients with pre-existing conditions, but his 2021 budget proposal, which repeats this promise, is silent on how he would do that. At the same time, the Trump administration has taken numerous actions that undermine the Affordable Care Act, including its support of a lawsuit to overturn the ACA and its key protections for people with pre-existing conditions. Continue reading