New Report Provides State Policy Recommendations on How to Protect Consumers, Reduce Disparities During the COVID-19 Pandemic

The COVID-19 pandemic presents unprecedented threats to health and safety, and exacerbates existing inequities that continue to jeopardize the wellbeing of millions of Americans. To help state policymakers during a time of great upheaval and uncertainty, the National Association of Insurance Commissioners’ Consumer Representatives put together recommendations on access to coverage and care, health equity and racial justice, and other state policy issues. Continue reading

Shopping for a Short-Term Plan? The Information You Get about it Will Depend on Your State

Stakeholders have expressed mixed views on the value of short-term limited duration insurance. However, most seem to agree that, at a minimum, consumers should know what they are purchasing. States have the authority to require insurers to provide disclosures in addition to the federal minimum standard. We looked at short-term disclosures in four states – Nebraska, North Dakota, Ohio, and Washington – and found that a wide spectrum exists regarding the amount of detail states require their insurers to disclose. Continue reading

If It Talks Like Insurance and Walks Like Insurance: The Curious Case of Direct Primary Care Arrangements

For decades, elite “concierge” practices have been providing easy access to primary care in return for several thousand dollars in retainer fees. Recently we’ve seen the emergence of more affordable versions of this arrangement, with monthly fees that cost far less than the average ACA marketplace plan premium. At first blush, these arrangements, frequently called “direct primary care arrangements” (DPCAs), might seem like a way to ensure access to health care services in the face of rising health insurance premiums. CHIR’s Maanasa Kona explains why this is not always the case. Continue reading

Filing Fee and External Appeals

One of the most significant consumer protections in the Affordable Care Act (ACA) is the right to appeal a denied claim, including the right to take your appeal to an independent, third-party reviewer. Although the ACA guarantees this right, recent federal rules have codified barriers to the process that still exist in some states, such as filing fees. Sandy Ahn provides a short summary of this issue. Continue reading