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

Understanding the Market for Short-Term Health Plans: States Prepare to Identify, Oversee Sellers and Products

Last week, the Trump administration issued a final rule reversing federal limits on short-term health coverage, allowing such plans to become a long-term alternative to individual market coverage. On the eve of this policy shift, we surveyed Departments of Insurance in the seventeen state-based marketplace states to better understand their short-term markets. We found that most states do not have a complete picture of which insurers are marketing short-term policies in their state. 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

The Road Not Traveled: How Policy, Business Decisions in Iowa Led to Higher Premiums

Iowa’s legislature recently made the extraordinary decision to abdicate that state’s authority over health insurance products. And in doing so they’ve made a bad insurance market worse. In their latest piece for the Commonwealth Fund’s To the Point blog, CHIR’s Sabrina Corlette and Kevin Lucia team up with actuaries at Wakely Consulting Group to assess what premiums and marketplace enrollment in Iowa would look like if the state had taken a slightly different path. Continue reading

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