The Trump Administration’s Association Health Plans Emerge: What Early Announcements Tell Us About this New Market

This past summer, the Department of Labor (DOL) finalized a regulation calling for the expansion of association health plans (AHPs) for small businesses and self-employed individuals. There continue to be significant questions about the impact of the rule, including how many associations will form, the role major medical insurers will play in AHP administration and marketing, and the extent to which AHPs can offer cheaper premiums than plans that must meet federal and state consumer protection standards. Now, with the rule for fully insured AHPs effective on September 1, we are starting to see AHPs emerge as groups take advantage of the relaxed requirements. Continue reading

New Report Shows Role of Medicaid Expansion in Rural Area, Small Town Health Coverage

Under the Affordable Care Act, 33 states and the District of Columbia expanded Medicaid, greatly increasing coverage under the public program. In a new report, our sister center,
the Center for Children and Families, examines the impact of Medicaid expansion on health coverage in rural areas and small towns, communities that for many years have faced high premiums and limited choices on the private insurance market. Continue reading

House Farm Bill Supports AHPs with Federal Grants—Following in the Footsteps of the ACA’s CO-OP Program

The Farm Bill currently being debated in a House-Senate conference committee enables the Secretary of Agriculture to create a loan and grant program to assist in the establishment of agricultural association health plans (AHPs). The bill’s injection of federal funding for the purpose of creating new health insurance options is strikingly reminiscent of the ACA’s CO-OP Program. As Congress considers directing federal dollars into AHPs, we look back at the experience of the CO-OP program, which demonstrates just how difficult it is to build a new insurance company. Continue reading

Federal Flexibility Grants Highlight State Priorities for Market Stability

Last month, the Department of Health & Human Services awarded $8.6 million in grants to 30 states and the District of Columbia to provide additional support to implement certain ACA market reforms, including guaranteed issue, guaranteed renewal, and the Essential Health Benefits. CHIR’s Rachel Schwab took a look at how states plan to use the federal funding, and what tops the list of state market stabilization and consumer protection priorities. Continue reading

Cities File Suit Against the Administration for Deliberately Failing to Enforce the ACA

On August 2, a coalition of cities filed a federal lawsuit against President Trump and the Department of Health and Human Services, alleging that the administration has “intentionally and unconstitutionally” sabotaged the Affordable Care Act. The complaint alleges that the President has increased the cost of health coverage by discouraging enrollment, stoking uncertainty in the insurance markets, and reducing consumer choice. CHIR’s Emily Curran breaks down their complaint and evidence of alleged harm. Continue reading

Health Care Sharing Ministries: What Are the Risks to Consumers and Insurance Markets?

Health Care Sharing Ministries (HCSMs) are a form of health coverage in which members – who typically share a religious belief – make monthly payments to cover expenses of other members. HCSMs do not have to comply with the consumer protections of the ACA and may provide value for some individuals, but pose risks for others. We interviewed officials in 13 states and analyzed state laws in all states to better understand state regulators’ perspectives on regulation of HCSMs. Continue reading

The District of Columbia’s Coverage Requirement Is Caught in Congressional Crosshairs, and Consumers Could Pay the Price

When Congress repealed the individual mandate’s financial penalty, some states acted quickly to protect their markets from deterioration. A handful of state legislatures and the Council of the District of Columbia considered or enacted legislation creating a state-based coverage requirement. While many states faced political hurdles and unforgiving timelines in enacting their own mandates, D.C. now has an additional obstacle: the U.S. Congress. Continue reading

Coverage That (Doesn’t) Count: How the Short-Term, Limited Duration Rule Could Lead to Underinsurance

Any day now, the Trump administration is expected to publish new rules that will expand access to short-term, limited duration insurance (STLDI). These plans are allowed to discriminate against sick people, exclude coverage of essential health services, and impose lifetime and annual benefit limits. The Congressional Budget Office (CBO) says that the majority of plans expanded under this rule will be considered health insurance. CHIR’s Rachel Schwab takes a closer look at how CBO defines health insurance, and explains how the expansion of STLDI could lead to widespread underinsurance. Continue reading

To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States

Through both inaction and design, federal policymakers have put the onus on states to ensure access to affordable, adequate health insurance. In a new work for The Commonwealth Fund, CHIR researchers are launching an interactive map that will track and describe state actions likely to affect residents’ access to individual market coverage. Continue reading

Stakeholder Views on the Proposed Short-Term Plan Insurance Rule: Key Takeaways from Our Review of Comment Letters

In February, the Trump administration published a proposed rule to expand the availability of short-term, limited duration insurance by relaxing federal restrictions put in place by the Obama administration. Federal agencies received over 9,000 comments in response. In a four-part blog series, CHIR dug into comments to evaluate the proposed rule’s potential impact on consumers, major medical insurers, states, and sellers of short-term plans. Here’s what we found. Continue reading