2019 Insurer Participation: A “Quieter” Year As Companies Maintain, Expand Their Presence

Since implementation of the Affordable Care Act, insurer participation in the ACA marketplaces has fluctuated. As states prepare to enter their annual rate review processes for 2020, CHIR’s Emily Curran and Justin Giovannelli interviewed officials in seven of the state-based marketplaces to understand their strategies for maintaining insurer participation in 2019 and ensuring marketplace competition in the future. Continue reading

States Step Up to Protect Insurance Markets and Consumers from Short-Term Health Plans

Short-term plans are now being sold to consumers as a replacement for Affordable Care Act (ACA) coverage. However, because these plans are exempt from many consumer protections and ACA rules, a number of states have stepped up to regulate the design and marketing of these plans. In their latest issue brief for The Commonwealth Fund, CHIR experts document recent state action to regulate short-term plans and protect their residents and markets. Continue reading

ACA Marketplace Open Enrollment Numbers Reveal the Impact of State-Level Policy and Operational Choices on Performance

During the last open enrollment period, the Affordable Care Act’s marketplaces faced a number of headwinds, including federal policy changes predicted to curb enrollment. Given myriad obstacles to enrollment efforts, it came as no surprise that overall marketplace plan selections dropped slightly this year. But a deeper dive into enrollment trends reveals that most state-based marketplaces outperformed the federally facilitated marketplace. In a new post for the Commonwealth Fund’s To the Point blog, CHIR’s Rachel Schwab and Sabrina Corlette unpack data from the recent open enrollment period to see how the marketplaces performed during a turbulent time, finding that certain policy and operational decisions were associated with better results. Continue reading

The Administration Tried to Make It Easier for States to Waive ACA Rules: Will Any Take the Plunge?

Recent federal guidance made significant changes to the ACA’s section 1332 waiver program in order to give states greater leeway to sidestep ACA rules. But the move has triggered questions about whether the waiver options the Trump administration is touting are practical for states, or even legal. In a new work for The Commonwealth Fund, Justin Giovannelli and JoAnn Volk examine how states are approaching ACA waivers in the wake of the federal policy change. Continue reading

Short-Term Health Plans Sold Through Out-of-State Associations Threaten Consumer Protections

The expansion of short-term policies has raised concerns that they may be deceptively marketed, with some sellers leading consumers to believe they are buying a comprehensive policy when they are not. While twenty-four states have sought to regulate short-term plans, their efforts may be undermined by a loophole that allows the policies to be sold through out-of-state associations – a practice we found to be quite common. Continue reading

In the Wake of New Association Health Plan Standards, States are Exercising Authority to Protect Consumers, Providers, and Markets

States have begun to respond to the Trump administration’s new rules for association health plans with a wide range of regulatory strategies. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR researchers analyzed how states are using their authority to set association health plan standards and protect consumers, providers, and their markets. Continue reading

States Lean In as the Federal Government Cuts Back: Navigator and Advertising Funding for the ACA’s Sixth Open Enrollment

With open enrollment into the Affordable Care Act marketplaces beginning November 1st, there will be considerable divergence among states in the amount of information and personalized assistance consumers receive about coverage options. While the federally run marketplace has dramatically cut back its investments in both advertising and the Navigator program, the state-based marketplaces are making big investments in those activities. In their latest To The Point blog for the Commonwealth Fund, CHIR’s Sabrina Corlette and Rachel Schwab discuss the findings from a new survey of state-based marketplaces. Continue reading

Direct Primary Care Arrangements Raise Questions for State Insurance Regulators

Over the past year, new health coverage products that are not subject to the consumer protections of the Affordable Care Act have hit the individual market. One type of limited health-insurance-like offering that was already available but is now gaining attention is a direct primary care arrangement. For Commonwealth Fund’s To the Point blog, experts at CHIR took a closer look at state law to understand how states regulate these entities and highlight some of the concerns that state insurance regulators might want to consider going forward. Continue reading

Lawsuit Threatens Affordable Care Act Preexisting Condition Protections But Impact Will Depend on Where You Live

On September 5, 2018, A federal district judge hears arguments in a lawsuit filed by 20 Republican governors and attorneys general to invalidate the Affordable Care Act, including its widely popular protections for people with pre-existing condition protections. Georgetown CHIR’s latest research for The Commonwealth Fund finds that a decision for the plaintiffs in this case could be be felt quite differently, depending on where you live. Continue reading