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

Payer-Provider Contract Disputes Dominate Headlines in 2019, With No Signs of Slowing Down

For several years, we at CHIR have tracked health insurance industry trends by monitoring trade and mass media, Wall Street analyses, earnings, and other reports. In 2019, we observed an increase in reporting on contract disputes between health insurers and providers. These discussions are becoming more contentious as insurers face mounting pressure to rein in health care costs while ensuring consumers’ access to providers. CHIR’s Emily Curran digs into what’s behind the trend and what it means for patients. Continue reading

The Texas Two-Step: Implementation of State Balance Billing Law Reveals Gaps in Consumer Protections

In Congress and state legislatures across the country, policymakers are debating fixes to surprise medical bills. The federal government has yet to enact comprehensive reforms, but a number of states have taken steps to protect consumers. One such state is Texas, which last year enacted a new law holding consumers harmless in situations that commonly lead to surprise medical bills. However, the state’s new protections were almost gutted due to an implementation loophole, a cautionary tale for federal and state policymakers. CHIR’s Rachel Schwab takes a look at what happened in Texas. Continue reading

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