New Resource for Consumer Advocates on Out-of-Network Payment Disputes in Balance Billing Legislation

State lawmakers across the country are are gearing up for a new legislative session. Many will be considering state-level protections for consumers to prevent surprise out-of-network medical bills. Just as with the federal legislation, however, one of the key sticking points for state policymakers will be how to approach out-of-network provider reimbursement. To aid stakeholders in these efforts, Community Catalyst teamed up with CHIR experts to create a guide for its health insurance reform toolkit: The Advocate’s Guide to Addressing Out-Of-Network Payment in Surprise Balance Billing Legislation. Continue reading

Insurers Report on Their Q3 Financial Earnings: Marketplace Profitability, Retail Partnerships, and More

Last month, health insurers reported on their third-quarter (Q3) financial earnings, offering insights on their yearly performance to date and commenting on the market and regulatory challenges they see ahead. CHIR reviewed the quarterly filings and earnings call transcripts for seven publicly traded health insurers, and found that many continue to experience financial stability in the individual market and are closely monitoring major policy changes that could have an impact on their businesses moving forward. Continue reading

This Thanksgiving, We’re Thankful for the Affordable Care Act’s Protections

It’s that time of year again. Our team at CHIR is heading far and wide for Thanksgiving, and as we gather around different tables, we’ll be sure to give thanks. One thing on our minds this season is our gratitude for the ongoing insurance protections provided by the Affordable Care Act. CHIR’s Rachel Schwab highlights some of the reforms we’re grateful for. Continue reading

Navigator Guide FAQ of the Week: Can I Get Help Paying for Coverage and Care?

Open Enrollment is in full swing in all 50 states and Washington, DC. As consumers consider their coverage options, many will qualify for subsidies to help pay for premiums and out-of-pocket expenses if they enroll in a plan through the marketplace. Throughout the enrollment period, CHIR is highlighting frequently asked questions from our recently updated Navigator Resource Guide. In this installation, we answer questions about financial assistance available to individuals and families. Continue reading

Will Sutter Health Settlement Dampen Provider Systems’ Anti-Competitive Tactics or Prompt More States to Take Action on Costs?

On October 16, Sutter Health announced that it had reached a tentative agreement to settle the class-action lawsuit against it, which alleged that the system has used its market dominance to drive up the cost of care. Though Sutter Health denied all allegations, the plaintiffs argued that the system relies on three core tactics to maintain a competitive edge, including: all-or-nothing contracting, anti-incentive contract terms, and price secrecy contract terms. CHIR’s Emily Curran and Sabrina Corlette explain these tactics and recent findings on the impacts of provider consolidation. Continue reading

What’s New for 2020 Marketplace Enrollment?

On November 1, the seventh open enrollment period begins for marketplace coverage under the Affordable Care Act. We at CHIR are tracking several policy changes that could affect marketplace enrollment and plan affordability in 2020, including: changes to health reimbursement arrangements, new direct enrollment pathways, and recent court rulings on association health plans and the public charge rule. To learn what’s new for 2020, read our CHIRBlog summarizing the major policy changes consumers might encounter this year. Continue reading

CHIR Launches New Resource Center for Policymakers on Surprise Medical Bills

CHIR experts have launched a new project to provide policymakers with a dedicated, independent resource for unbiased and comprehensive information on the issue of surprise medical bills. Leveraging our experience advising state insurance regulators and monitoring surprise medical bill legislation in all 50 states and before Congress, our goal is to help policymakers protect consumers, promote affordability, and adopt comprehensive surprise medical bill protections. Continue reading

States Leaning In: Colorado

This year several states have taken an increasingly active role in expanding health insurance coverage, overseeing their insurance markets, and protecting consumers. Perhaps no state did more in 2019 than Colorado, which enacted a dizzying array of health insurance bills. CHIR’s Rachel Schwab takes a look in this installment of States Leaning In. Continue reading

Aliera Healthcare Prompts Increased State Activity on Health Care Sharing Ministries

Over the last few months, state officials have increasingly acted to warn consumers about the potential risks of enrolling in health care sharing ministries (HCSMs). These efforts have ranged from educating consumers on HCSMs to initiating legal action against fraudulent practices. While some consumers may find value in HCSMs, recent actions by Aliera Healthcare provide one example of how entities may use HCSMs’ unregulated status to skirt oversight and take advantage of consumers. Continue reading