Stakeholders Respond to the Proposed Health Reimbursement Arrangement Rule. Part I: State Insurance Departments and Marketplaces

In October 2018, the Trump administration proposed rules to expand the use of health reimbursement arrangements (HRAs) by loosening current federal limitations. The administration’s proposal would allow employers to offer employees the tax-advantaged accounts to assist with health care expenses, including premiums, in lieu of employer-sponsored coverage. To understand the potential impact of the proposals, CHIR reviewed comments from various stakeholder groups. For the first blog in our series, Rachel Schwab summarizes comments from state marketplaces and state insurance departments. Continue reading

What About “Don’t Discriminate Against Sick People” Do You Not Understand?

Although it’s a complicated law, there’s one thing about the ACA that’s not at all complicated: the requirement that insurers stop discriminating against sick people. Yet some insurance companies still appear confused by this rule. Sabrina Corlette looks at recent insurer attempts to discourage sicker, older people from enrolling in their plans – and the efforts of at least one state to combat them. Continue reading

New Report Evaluates States’ Strategies to Stabilize Health Insurance Premiums and Build Sustainable Exchanges

The Affordable Care Act includes a range of health insurance reforms that will lead to health care costs being shared more evenly between the healthy and the sick. Some experts have pointed to concerns that in the short term, there will be premium “rate shock” for some individuals, while in the long term, exchanges will be vulnerable to adverse selection if they attract a disproportionate number of older, sicker enrollees. Under the ACA, states have considerable flexibility to implement additional strategies to manage their markets and protect consumers. In collaboration with researchers at the Urban Institute, CHIR faculty members Sabrina Corlette and Sarah Dash examine states’ strategies to make premiums more affordable and protect the exchanges from potential adverse selection. Continue reading