August Research Round Up: What We’re Reading

Summer is over, but health policy researchers have hardly taken a vacation. In August’s research round up, CHIR’s Olivia Hoppe looks into studies examining specialty drug coverage across commercial plans, the effects of the Affordable Care Act on people of different income levels, individual market premium predictions, employer-sponsored high-deductible health plans, and surprise medical bills in employer-sponsored insurance. 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

Cities File Suit Against the Administration for Deliberately Failing to Enforce the ACA

On August 2, a coalition of cities filed a federal lawsuit against President Trump and the Department of Health and Human Services, alleging that the administration has “intentionally and unconstitutionally” sabotaged the Affordable Care Act. The complaint alleges that the President has increased the cost of health coverage by discouraging enrollment, stoking uncertainty in the insurance markets, and reducing consumer choice. CHIR’s Emily Curran breaks down their complaint and evidence of alleged harm. Continue reading

New Report Examines State Options for Oversight of Risk-Bearing Provider Organizations

Value-based payment models are promoted as a way to transform our health care system from one that rewards value rather than the volume of health care services delivered. These models require providers to accept the risk of financial losses should spending on patients in their care exceed targeted levels. A new brief from State Health and Value Strategies, authored by researchers at Bailit Health and CHIR, explores potential state approaches to oversight of provider organizations that accept financial risk. 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

The District of Columbia’s Coverage Requirement Is Caught in Congressional Crosshairs, and Consumers Could Pay the Price

When Congress repealed the individual mandate’s financial penalty, some states acted quickly to protect their markets from deterioration. A handful of state legislatures and the Council of the District of Columbia considered or enacted legislation creating a state-based coverage requirement. While many states faced political hurdles and unforgiving timelines in enacting their own mandates, D.C. now has an additional obstacle: the U.S. Congress. Continue reading

July Research Round Up: What We’re Reading

Health policy researchers are keeping busy, assessing the impact of recent and potential state and federal actions. CHIR’s Olivia Hoppe digs into new research on how interruptions in insurance coverage impact chronic disease management, the debate over the Affordable Care Act’s (ACA) employer mandate, the innovative ways that California is keeping its risk pool healthy, characteristics of the uninsured in the U.S., and the coverage and premium effects of state-based individual mandates. 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