Virginia’s Enrollment Season Perfect Storm

Across the country, states are yet again dealing with policy changes just before the fall open enrollment season. Virginia, however, is a special case. The state is dealing with simultaneous implementation of Medicaid expansion, expanded short-term limited duration insurance and association health plans, and changes to the definition of sole proprietors for small employers, all with less funding for the navigator program. CHIR’s Olivia Hoppe breaks down how each change affects Virginians. Continue reading

The Trump Administration’s Association Health Plans Emerge: What Early Announcements Tell Us About this New Market

This past summer, the Department of Labor (DOL) finalized a regulation calling for the expansion of association health plans (AHPs) for small businesses and self-employed individuals. There continue to be significant questions about the impact of the rule, including how many associations will form, the role major medical insurers will play in AHP administration and marketing, and the extent to which AHPs can offer cheaper premiums than plans that must meet federal and state consumer protection standards. Now, with the rule for fully insured AHPs effective on September 1, we are starting to see AHPs emerge as groups take advantage of the relaxed requirements. Continue reading

House Farm Bill Supports AHPs with Federal Grants—Following in the Footsteps of the ACA’s CO-OP Program

The Farm Bill currently being debated in a House-Senate conference committee enables the Secretary of Agriculture to create a loan and grant program to assist in the establishment of agricultural association health plans (AHPs). The bill’s injection of federal funding for the purpose of creating new health insurance options is strikingly reminiscent of the ACA’s CO-OP Program. As Congress considers directing federal dollars into AHPs, we look back at the experience of the CO-OP program, which demonstrates just how difficult it is to build a new insurance company. 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

Stakeholders Respond to the Proposed Short-Term, Limited-Duration Insurance Rule. Part II: Major Medical Insurers

The Departments of Labor, Health and Human Services, and Treasury received over 9,000 comments on their proposed rule, which aims to expand the availability of short-term, limited duration insurance. CHIR reviewed comments submitted by health care stakeholders to better understand industry reactions to the proposal. In part two of this four-part series, CHIR’s Emily Curran analyzes comments from nine major medical insurers and associations. Continue reading

The Future of the Affordable Care Act under President Trump: Stakeholders Respond to the Proposed Association Health Plan Rule. Part V: Departments of Insurance

In this final blog in our series reviewing stakeholder comments on the Department of Labor’s proposed rule to expand Association Health Plans, CHIR’s Emily Curran summarizes responses from the National Association of Insurance Commissioners and nine state departments of insurance (DOI). While the DOIs expressed some areas of support for the proposed rule, their comments were largely negative, with most expressing deep concerns about the rule’s ambiguity. Continue reading

ACA “Bare Counties”: Policy Options to Ensure Access Must Address Longer-Term Stability and Competition

September 27th marks the day most insurers have to formally decide whether they’ll stay in the Affordable Care Act marketplaces in 2018. While the danger of bare counties seems to have subsided, many more counties appear likely to have just one insurer offering marketplace coverage. In their latest blog post for the Commonwealth Fund, CHIR experts look at the policy options for ensuring access and competition. Continue reading