Successfully Splitting the Baby: Design Considerations for Federal Balance Billing Legislation

The U.S. Congress is advancing legislation to protect patients from surprise medical bills. Yet consensus on how to resolve payment disputes between providers and health plans has been difficult to reach. In their latest post for the Health Affairs Blog, Sabrina Corlette, Jack Hoadley, and Kevin Lucia break down different policy approaches, their pros and cons, and how recent state action could suggest a path forward. Continue reading

Can States Fill the Gap if the Courts Overturn Preexisting-Condition Protections?

The 5th Circuit Court of Appeals is expected to hear arguments in litigation over the future of the Affordable Care Act the week of July 8, 2019. If the plaintiffs prevail, millions could lose insurance coverage and millions more will lose preexisting condition protections. In their latest post for the Commonwealth Fund, CHIR’s Sabrina Corlette and Emily Curran document state-level efforts to preserve the ACA’s insurance market reforms. Continue reading

Protecting People with Preexisting Conditions Requires More Than a Piecemeal Approach: An Assessment of a Louisiana Bill to Codify Some, But Not All, ACA Protections

Several state legislatures are considering bills to re-instate the Affordable Care Act’s preexisting condition protections in the event a federal court invalidates the law in Texas v. Azar. While no state can fully protect consumers from the fallout of a bad court decision, attempts to “bake in” the preexisting protections shouldn’t leave large loopholes for insurance companies to exploit. CHIR experts examine a Louisiana bill that would codify some, but not all, of the ACA’s insurance reforms. Continue reading

New York’s Law to Protect People from Surprise Balance Bills is Working as Intended, but Gaps Remain

New York’s 2014 law to protect consumers from surprise out-of-network medical bills has been touted as a model for other states and even potential federal legislation. In their latest report for the Robert Wood Johnson Foundation, CHIR experts Sabrina Corlette and Olivia Hoppe share findings from a case study of how New York’s law has affected patients, providers, and insurers, 5 years post-enactment. Continue reading

New Study: Consumers Don’t Understand That Short-term Plans Lack Protections, Benefits

A study commissioned by consumer representatives to the National Association of Insurance Commissioners (NAIC) finds that consumers face significant challenges understanding the limitations of short-term health plans. These plans, championed by the Trump administration as a cheap alternative to ACA coverage, can leave consumers facing significant out-of-pocket costs if they have an unexpected medical event. Continue reading

What Does the Latest Federal Court Decision Mean for Association Health Plans – and the States that Regulate Them?

On March 28, 2019, a federal district court invalidated the Trump administration’s rule encouraging the formation of association health plans that would be exempt from many Affordable Care Act protections. In her latest “Expert Perspective” for the Robert Wood Johnson Foundation’s State Health & Value Strategies project, CHIR’s Sabrina Corlette provides an update on the court ruling and implications for state insurance departments. Continue reading