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

Impact of Association Health Plans on Consumers and Markets Will Depend on State Approaches

In June, the U.S. Department of Labor issued a final regulation that implements President Trump’s executive order encouraging the expansion of association health plans for small businesses and self-employed individuals. Under these rules, professional or trade associations will be permitted to sell health plans that are exempt from many Affordable Care Act protections as early as September 1, 2018. To better understand how these new rules will affect states, CHIR experts interviewed six state regulators. Continue reading

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