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

Navigator Guide FAQ of the Week: Eligibility for Premium Tax Credits

The midterm elections are over, but open enrollment for the Affordable Care Act marketplaces is in full swing. Georgetown CHIR has created a Navigator Resource Guide with 300+ answers to frequently asked questions (FAQ) about marketplace eligibility, enrollment, and coverage. For our FAQ of the Week we’re focusing on: Who is eligible for financial help with premiums? Continue reading

States Lean In as the Federal Government Cuts Back: Navigator and Advertising Funding for the ACA’s Sixth Open Enrollment

With open enrollment into the Affordable Care Act marketplaces beginning November 1st, there will be considerable divergence among states in the amount of information and personalized assistance consumers receive about coverage options. While the federally run marketplace has dramatically cut back its investments in both advertising and the Navigator program, the state-based marketplaces are making big investments in those activities. In their latest To The Point blog for the Commonwealth Fund, CHIR’s Sabrina Corlette and Rachel Schwab discuss the findings from a new survey of state-based marketplaces. Continue reading

States Opt to Run their Own Exchanges to Save Money, Reclaim Autonomy

Last month, the Board of New Mexico’s health insurance exchange voted to transition from HealthCare.gov to a state-based exchange. The state will undertake the task of building its own eligibility and enrollment platform with the hopes of launching a website in time for the 2021 plan year. This is the same exchange that, in 2015, called the federal platform HealthCare.gov the “safest, most risk-free way to proceed.” So, what changed? CHIR’s Rachel Schwab looks at the reasons behind the growing call to leave HealthCare.gov. Continue reading

The 2019 Affordable Care Act Payment Rule: Summary & Implications for States

The Trump administration has released a new final rule to govern the Affordable Care Act’s individual and small-group markets, known as the 2019 Notice of Benefit and Payment Parameters. The rule includes an expansion of states’ role over the ACA’s health plan benefit and affordability provisions. In her latest Expert Perspective for the Robert Wood Johnson Foundation’s State Health and Value Strategies Program, Sabrina Corlette untangles the rule and its implications for state decision-makers. 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