How Did State-Run Health Insurance Marketplaces Fare in 2017?

In a new Commonwealth Fund issue brief, CHIR’s Justin Giovannelli and Emily Curran interviewed leadership staff of 15 of the 17 state-run marketplaces to understand how states on the forefront of health reform perceived and responded to federal policy changes and political uncertainty in 2017. Their research finds that federal administrative actions and repeal efforts created confusion and uncertainty in 2017 that negatively affected state-run markets. Continue reading

Proposed Federal Changes to Short-Term Health Coverage Leave Regulation to States

The Trump administration issued proposed rules on February 20, 2018 that rescind Obama-era restrictions on short-term, limited duration insurance products. This action, if finalized, would leave regulation of short-term health plans almost entirely to states. In their latest post for The Commonwealth Fund’s To the Point blog, CHIR experts Dania Palanker, Kevin Lucia, Sabrina Corlette and Maanasa Kona review current short-term plan standards in a sampling of 10 diverse states. Continue reading

Association Health Plans: Maintaining State Authority is Critical to Avoid Fraud, Insolvency, and Market Instability

Earlier this month, the Trump Administration issued a proposed regulation that would allow individuals and small employers to more easily purchase health insurance across state lines through professional or trade associations. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Kevin Lucia and Sabrina Corlette examine the proposal’s impact on consumers and insurance markets, and discuss implications for state regulatory autonomy. Continue reading

Insurer Participation in ACA Marketplaces: Federal Uncertainty Triggers Diverging Business Strategies

A reliable indicator of health insurance markets’ stability is insurer participation, including the number of insurers that elect to sell individual plans and whether they participate over subsequent years. In a recent analysis for the Commonwealth Fund, CHIR experts looked at insurer participation in the state-based Affordable Care Act (ACA) marketplaces from 2014 to 2018, which sheds light on how state marketplaces have maintained competition despite uncertainty about the law’s future. Continue reading

Insurers, State Regulators Avoid Bare Counties in 2018, but Seek Long-Term Solutions

As we near the end of the second week of a so-far successful Open Enrollment, uncertainty over the future of the Affordable Care Act remains a challenge. As insurers and state regulators prepared for the 2018 plan year, they addressed questions of whether Congress or the Trump Administration would make major changes to the law. This led to a situation in several states where some or all counties seemed likely to have no insurance plan available for residents seeking marketplace coverage. In a new issue brief for the Robert Wood Johnson Foundation, CHIR experts examine the actions of six states that faced the prospect of bare counties for 2018. Continue reading

State-Based Marketplaces Push Ahead, Despite Federal Resistance

Open enrollment for 2018 started last week on the Affordable Care Act’s health insurance marketplaces. Along with its executive actions designed to weaken marketplaces operations, the Trump administration has taken a number of steps over the past year to curb marketplace enrollment. While the administration has scaled back efforts to provide health coverage, state-based marketplaces have taken a different approach. In their latest post for The Commonwealth Fund’s To The Point blog, CHIR’s Emily Curran and Justin Giovannelli share their findings from interviews with executives at 15 of the 17 states that operate their own marketplaces. Continue reading

States Step Up to Protect Consumers in Wake of Cuts to ACA Cost-Sharing Reduction Payments

In the wake of President Trump’s decision to cut off payments for a key ACA subsidy for low-income enrollees, the impact felt by consumers and insurers will vary from state to state, depending on the actions of insurance regulators and insurance companies. In their latest post for The Commonwealth Fund’s To The Point blog, CHIR’s Sabrina Corlette, Kevin Lucia, and Maanasa Kona share findings from their 50-state review of insurers’ responses to the loss of cost-sharing reduction payments for 2018. Continue reading

Trump’s Executive Order: Can Association Health Plans Accomplish What Congress Could Not?

In the wake of failed Congressional efforts to repeal and replace the Affordable Care Act, President Trump has threatened to issue an executive order that could effectively roll back key protections for people with pre-existing conditions. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Kevin Lucia and Sabrina Corlette assess the proposed regulatory changes and their impact on consumers and insurance markets. Continue reading

ACA “Bare Counties”: Policy Options to Ensure Access Must Address Longer-Term Stability and Competition

September 27th marks the day most insurers have to formally decide whether they’ll stay in the Affordable Care Act marketplaces in 2018. While the danger of bare counties seems to have subsided, many more counties appear likely to have just one insurer offering marketplace coverage. In their latest blog post for the Commonwealth Fund, CHIR experts look at the policy options for ensuring access and competition. Continue reading