Hybrid Approach to Resolving Payment Disputes Breaks Legislative Stalemates Over Balance Billing, How Will the No Surprises Act Affect These New State Laws?

Seven states in 2020 were able to break a longstanding stalemate and enact protections against surprise out-of-network billing. CHIR’s Jack Hoadley and Kevin Lucia delve into the factors that got these states across the finish line and how the federal No Surprises Act will impact these states’ new laws. Continue reading

Federal Policy Priorities for Preserving and Improving Access to Coverage: Perspectives from State-Based Marketplaces

The Affordable Care Act’s health insurance marketplaces provide a critical source of coverage and financial assistance. Federal actions under the Trump administration undermined the marketplaces, but the new administration and Congress have opportunities to implement and advocate for policies that strengthen state-based marketplaces (SBMs). In a new issue brief for the Commonwealth Fund, CHIR experts assessed how federal policy decisions have impacted SBMs and the consumers they serve by interviewing directors and officials from 17 marketplaces. Continue reading

Georgia’s ACA Waiver Flouts Federal Law, Drawing a Legal Challenge

With the approval of the Trump administration, the state of Georgia is poised to upend the Affordable Care Act, abandon HealthCare.gov, and place the coverage of hundreds of thousands of Georgians at risk. In their latest post for the Commonwealth Fund, CHIR’s Justin Giovannelli, JoAnn Volk, and Kevin Lucia evaluate the potential impact of Georgia’s proposed reforms, should they be implemented. Continue reading

Many States with COVID-19 Special Enrollment Periods See Increase in Younger Enrollees

President Joe Biden directed his administration to reopen the federal health insurance marketplace, an action the Trump administration refused to take last year after the COVID-19 pandemic struck due to adverse selection concerns. In a new post for the Commonwealth Fund, CHIR experts discuss how states that created a broad special enrollment period (SEP) for the uninsured in response to the pandemic – and broadcast the opportunity through outreach efforts – saw an increase in younger enrollees, seemingly contradicting claims that reducing SEP barriers inevitably leads to adverse selection. Continue reading

Surprise Billing Protections: Help Finally Arrives for Millions of Americans

Congress enacted the “No Surprises Act” as part of the $900 billion COVID-19 relief and government spending bill. The Act will protect millions of patients from surprise out-of-network medical bills. In their latest To the Point post for the Commonwealth Fund, CHIR experts Jack Hoadley, Kevin Lucia, and Beth Fuchs unpack the legislation and what it means for patients. Continue reading

The Benefits and Limitations of State-Run Individual Market Reinsurance

The Affordable Care Act brought about historic coverage gains, providing millions of Americans with vital access to comprehensive health insurance. But for many, high premiums continue to present a major barrier to coverage. States have adopted various policies to make health plans on the individual market more affordable, pursuing one approach more than others: reinsurance. In a new issue brief for the Commonwealth Fund, CHIR experts explore the benefits and limitations of state-run individual market reinsurance programs. Continue reading

The COVID-19 Vaccine is Coming, but Will it Be Paid For? Federal and State Policies to Fill Gaps in Insurance Coverage

Vaccinations against COVID-19 are on their way. For consumers in Affordable Care Act plans, immunization should have it fully covered by their insurance. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Sabrina Corlette and Madeline O’Brien review federal and state mandates to cover the COVID-19 vaccine, as well as potential gaps consumers could still fall into. Continue reading

State Efforts to Protect Preexisting Conditions Unsustainable Without the ACA

On November 10, the Supreme Court will hear oral arguments in a case that could result in the Affordable Care Act being declared unconstitutional. While there is no clear federal plan to protect people with preexisting conditions if this happens, some states have tried to enact their own laws. In their latest analysis for the Commonwealth Fund’s To the Point blog, CHIR’s Maanasa Kona and Sabrina Corlette assess whether these state-level efforts can fully protect people with preexisting conditions. Continue reading

Trump Administration Promotes Coverage That Fails to Adequately Cover Women’s Key Health Care Needs

The ACA expanded women’s access to comprehensive coverage. The Trump administration is seeking to overturn the law while promoting coverage options that are exempt from the ACA’s consumer protections, including short-term plans and health care sharing ministries. In a new post for The Commonwealth Fund, CHIR experts examine the differences between ACA plans and the alternatives promoted by the Trump administration, finding that these products frequently exclude or severely limit coverage of services that are critical to women’s health. Continue reading

Asymptomatic COVID-19 Testing for Essential Workers: Considerations and Challenges for State Policymakers

States are being forced to decide how to target, administer, and finance asymptomatic COVID-19 testing for essential workers in the midst of a global pandemic and their own budget crises. In a new post for the Commonwealth Fund’s To the Point blog, Kevin Lucia, Sara Rosenbaum, Sabrina Corlette and Madeline O’Brien identify challenges and considerations for state policymakers. Continue reading