Effects of Medicaid Health Plan Dominance on the Health Insurance Marketplaces

Medicaid insurers dominate many of the Affordable Care Act health insurance marketplaces. Some health system stakeholders have raised concerns about the potential negative consequences of Medicaid insurer participation in the market, largely due to their limited networks. In a new report supported by the Robert Wood Johnson Foundation, CHIR and Urban Institute experts assess how Medicaid insurers function in the marketplace. Continue reading

On the Whole, Health Insurers Aren’t – Yet – Fearing COVID-19 Costs: A Review of 2021 Rate Filings

Several states ask for – and publicly post – health insurers’ proposed 2021 premium rates in May and June. These early rate filings can provide hints about how insurers are responding to market trends, policy changes, and emerging drivers of health care costs. CHIR’s Sabrina Corlette took a deep dive into insurers’ actuarial memos to find out how they’re thinking about COVID-19, repeal of the ACA’s individual mandate penalty, and more. Continue reading

Idaho Misses Opportunities to Help Consumers Get Affordable, Comprehensive Health Coverage During COVID-19 Pandemic

Since the COVID-19 pandemic began, states have taken charge of responding to the public health emergency. As a state that runs its own health insurance marketplace, Idaho has tools at its disposal to help consumers enroll in comprehensive coverage. But like the federal marketplace, Idaho decided not to wield all of them, leaving large marketplace enrollment barriers and instead promoting alternative and less comprehensive coverage. Continue reading

States Looking to Run Their Own Health Insurance Marketplace See Opportunity for Funding, Flexibility

Last week, Pennsylvania Governor Tom Wolf signed legislation to establish a state-based health insurance marketplace. Recently, along with Pennsylvania, several states have taken steps towards transitioning to their own marketplace and enrollment platform. In their newest post for the Commonwealth Fund’s To the Point blog, CHIR’s Rachel Schwab and JoAnn Volk review the latest state actions to transition to a state-run platform and break down some of the incentives for states to leave the federal marketplace. Continue reading

ACA Marketplace Open Enrollment Numbers Reveal the Impact of State-Level Policy and Operational Choices on Performance

During the last open enrollment period, the Affordable Care Act’s marketplaces faced a number of headwinds, including federal policy changes predicted to curb enrollment. Given myriad obstacles to enrollment efforts, it came as no surprise that overall marketplace plan selections dropped slightly this year. But a deeper dive into enrollment trends reveals that most state-based marketplaces outperformed the federally facilitated marketplace. In a new post for the Commonwealth Fund’s To the Point blog, CHIR’s Rachel Schwab and Sabrina Corlette unpack data from the recent open enrollment period to see how the marketplaces performed during a turbulent time, finding that certain policy and operational decisions were associated with better results. Continue reading

Affordable Care Act Back in the Spotlight: Build on its Progress or Scrap it Entirely?

It is hard to find a starker example of the different approaches our two political parties take to health care than the events of March 26, 2019. CHIR’s Sabrina Corlette breaks down the Trump administration’s push to have the Affordable Care Act declared unconstitutional and a comprehensive bill to expand coverage and improve affordability, introduced just hours later by leaders in the U.S. House of Representatives. Continue reading

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