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

Stepping in When States Don’t Step Up: First “State-Based” Plans Filed in Idaho, Violating the Affordable Care Act

Last week Blue Cross of Idaho filed the first “state-based” health plans, products that don’t comply with the Affordable Care Act’s requirements for coverage offered on the individual market. When a state can’t or won’t enforce federal law, the Department of Health & Human Services (HHS) is supposed to step in. CHIR’s Rachel Schwab outlines HHS’ authority to protect the rule of law and ensure that Idaho consumers continue to receive the benefits they are promised under the ACA. Continue reading

States Face Key Decisions if Alexander-Murray Proposal Is Included in Year-End Budget Bill

The Alexander-Murray bill to fund the Affordable Care Act’s cost-sharing subsidies could be included in an end-of-year budget deal. It includes provisions requiring states to make some quick decisions on an issue that many may have thought was put to bed. CHIR’s Justin Giovannelli provides an overview of what states may need to do, and when, if Alexander-Murray passes. Continue reading

States Step Up to Protect Consumers in Wake of Cuts to ACA Cost-Sharing Reduction Payments

In the wake of President Trump’s decision to cut off payments for a key ACA subsidy for low-income enrollees, the impact felt by consumers and insurers will vary from state to state, depending on the actions of insurance regulators and insurance companies. In their latest post for The Commonwealth Fund’s To The Point blog, CHIR’s Sabrina Corlette, Kevin Lucia, and Maanasa Kona share findings from their 50-state review of insurers’ responses to the loss of cost-sharing reduction payments for 2018. Continue reading

Got Questions on Private Health Insurance? Get the New and Improved Navigator Resource Guide

Marketplace enrollment is upon us. November 1 marks the start to the fifth open enrollment season. To help marketplace Navigators and others assisting consumers with marketplace eligibility and enrollment, we at CHIR have updated and improved our Navigator Resource Guide. The Guide houses over 300 frequently asked questions (FAQs) and answers about all things marketplace coverage-related, as well as information about employer-sponsored coverage. CHIR’s Sandy Ahn highlights some of the changes. Continue reading