Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 2: State Insurance Departments and Marketplaces

The final Notice of Benefit and Payment Parameters for 2020 is expected any day. In January, the Department of Health and Human Services proposed changes that it plans to apply to the Affordable Care Act marketplaces and insurance rules, and received over 26,000 comments on the proposal. To gauge stakeholder reactions, CHIR reviewed a sample of these comments. In the second part of our blog series, Rachel Schwab summarizes responses from a selection of state insurance departments and state-based marketplaces. Continue reading

Trump Administration Pushes for Sale of Insurance Across State Lines

Recently, the Trump administration issued a request for information (RFI) seeking recommendations on ways to facilitate the sale of insurance across state lines, allowing insurers to bypass the insurance standards of states that have strong consumer protections and benefit requirements by headquartering in a state with few regulations in place. The policy is often touted as a way to reduce the cost of coverage and improve consumer choice, but states and insurers have been reluctant to embrace it. A CHIR study conducted after the ACA was signed into law sheds light on why. Continue reading

Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 1: Insurers

On January 18, the Department of Health and Human Services issued its Notice of Benefit and Payment Parameters for 2020, which outlines the changes that it plans to apply to the Affordable Care Act marketplaces and insurance rules in the next plan year. The agency received over 26,100 comments on the proposal, including many from insurers, state-based marketplaces, departments of insurance, and consumer advocates. To better understand stakeholder reactions to the proposals, CHIR reviewed a sample of these comments, and, in Part I of this series, we summarize areas of support and concern from major medical insurers and associations. Continue reading

Shopping for a Short-Term Plan? The Information You Get about it Will Depend on Your State

Stakeholders have expressed mixed views on the value of short-term limited duration insurance. However, most seem to agree that, at a minimum, consumers should know what they are purchasing. States have the authority to require insurers to provide disclosures in addition to the federal minimum standard. We looked at short-term disclosures in four states – Nebraska, North Dakota, Ohio, and Washington – and found that a wide spectrum exists regarding the amount of detail states require their insurers to disclose. Continue reading

Saying Goodbye to a Hero

Over the weekend we said goodbye to a dear friend. Rob Restuccia lost his 6-month battle against pancreatic cancer, but he never gave up the fight for health equity and justice. We pay tribute to his leadership, commitment and legacy. His life and work inspire us all. Continue reading

The Administration Tried to Make It Easier for States to Waive ACA Rules: Will Any Take the Plunge?

Recent federal guidance made significant changes to the ACA’s section 1332 waiver program in order to give states greater leeway to sidestep ACA rules. But the move has triggered questions about whether the waiver options the Trump administration is touting are practical for states, or even legal. In a new work for The Commonwealth Fund, Justin Giovannelli and JoAnn Volk examine how states are approaching ACA waivers in the wake of the federal policy change. Continue reading

Stakeholders Respond to the Proposed Health Reimbursement Arrangement Rule. Part 2: Insurers

In October, the Departments of Treasury, Labor, and Health and Human Services issued a proposed rule that aims to expand the “flexibility and use” of health reimbursement arrangements. To understand reactions to the proposal, CHIR reviewed a sample of comments from state officials, insurers, consumer advocates, and employer, broker and benefit advisor groups. In Part 2 of this blog series, we highlight comments from ten major medical insurers and associations, who argued that stronger non-discrimination provisions are needed to prevent adverse selection and ensure stability in the individual market. Continue reading

House Hearings Shed Light on a Key Policy Priority: Protecting People with Pre-Existing Conditions

After becoming a rallying cry in the midterm elections, pre-existing condition protections have taken center stage on Capitol Hill: in January and February, the House of Representatives held three hearings about protecting people with pre-existing conditions, before the Ways & Means Committee, the Education & Labor Committee, and the Energy & Commerce Subcommittee. As the ACA faces legal challenges in federal court, these proceedings set the scene for how this policy debate will play out in Congress and offer insight into potential legislative action. Continue reading

Stakeholders Respond to the Proposed Health Reimbursement Arrangement Rule. Part I: State Insurance Departments and Marketplaces

In October 2018, the Trump administration proposed rules to expand the use of health reimbursement arrangements (HRAs) by loosening current federal limitations. The administration’s proposal would allow employers to offer employees the tax-advantaged accounts to assist with health care expenses, including premiums, in lieu of employer-sponsored coverage. To understand the potential impact of the proposals, CHIR reviewed comments from various stakeholder groups. For the first blog in our series, Rachel Schwab summarizes comments from state marketplaces and state insurance departments. Continue reading