Stakeholders Weigh in on the Risk Corridor Litigation: Are Public-Private Partnerships At Risk?

On December 10, the U.S. Supreme Court will hear oral arguments in Maine Community Health Options v. U.S., a case concerning the Affordable Care Act’s risk corridors program. This month, nine stakeholders filed amicus briefs in preparation of the arguments and we reviewed these briefs to identify common themes. One key theme emerged from the stakeholders reviewed: that the Court’s decision could negatively impact public-private partnerships. Continue reading

2019 Insurer Participation: A “Quieter” Year As Companies Maintain, Expand Their Presence

Since implementation of the Affordable Care Act, insurer participation in the ACA marketplaces has fluctuated. As states prepare to enter their annual rate review processes for 2020, CHIR’s Emily Curran and Justin Giovannelli interviewed officials in seven of the state-based marketplaces to understand their strategies for maintaining insurer participation in 2019 and ensuring marketplace competition in the future. Continue reading

Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 1: Insurers

On January 18, the Department of Health and Human Services issued its Notice of Benefit and Payment Parameters for 2020, which outlines the changes that it plans to apply to the Affordable Care Act marketplaces and insurance rules in the next plan year. The agency received over 26,100 comments on the proposal, including many from insurers, state-based marketplaces, departments of insurance, and consumer advocates. To better understand stakeholder reactions to the proposals, CHIR reviewed a sample of these comments, and, in Part I of this series, we summarize areas of support and concern from major medical insurers and associations. Continue reading

Stakeholders Respond to the Proposed Health Reimbursement Arrangement Rule. Part 2: Insurers

In October, the Departments of Treasury, Labor, and Health and Human Services issued a proposed rule that aims to expand the “flexibility and use” of health reimbursement arrangements. To understand reactions to the proposal, CHIR reviewed a sample of comments from state officials, insurers, consumer advocates, and employer, broker and benefit advisor groups. In Part 2 of this blog series, we highlight comments from ten major medical insurers and associations, who argued that stronger non-discrimination provisions are needed to prevent adverse selection and ensure stability in the individual market. Continue reading

The Trump Administration’s Association Health Plans Emerge: What Early Announcements Tell Us About this New Market

This past summer, the Department of Labor (DOL) finalized a regulation calling for the expansion of association health plans (AHPs) for small businesses and self-employed individuals. There continue to be significant questions about the impact of the rule, including how many associations will form, the role major medical insurers will play in AHP administration and marketing, and the extent to which AHPs can offer cheaper premiums than plans that must meet federal and state consumer protection standards. Now, with the rule for fully insured AHPs effective on September 1, we are starting to see AHPs emerge as groups take advantage of the relaxed requirements. Continue reading

Stakeholders Respond to the Proposed Short-Term, Limited-Duration Insurance Rule. Part II: Major Medical Insurers

The Departments of Labor, Health and Human Services, and Treasury received over 9,000 comments on their proposed rule, which aims to expand the availability of short-term, limited duration insurance. CHIR reviewed comments submitted by health care stakeholders to better understand industry reactions to the proposal. In part two of this four-part series, CHIR’s Emily Curran analyzes comments from nine major medical insurers and associations. Continue reading

Insurer Participation in ACA Marketplaces: Federal Uncertainty Triggers Diverging Business Strategies

A reliable indicator of health insurance markets’ stability is insurer participation, including the number of insurers that elect to sell individual plans and whether they participate over subsequent years. In a recent analysis for the Commonwealth Fund, CHIR experts looked at insurer participation in the state-based Affordable Care Act (ACA) marketplaces from 2014 to 2018, which sheds light on how state marketplaces have maintained competition despite uncertainty about the law’s future. Continue reading

Signs of Marketplace Stability May Be Undercut by Federal Policy Uncertainty

Recently, analysts have found evidence of marketplace stability after a number of insurers scaled back participation and increased premiums for 2017. Despite this progress, federal efforts to repeal and replace the ACA have sparked growing concerns about the marketplace’s sustainability. To understand how insurers are faring in the marketplaces amidst federal reform activity, CHIR experts reviewed the first quarter financial earnings of seven of the largest, publicly traded insurers. Continue reading

New Report Examines Early Indications of Insurer Participation and Competition in Health Insurance Exchanges

One of the key goals of the Affordable Care Act is to make health insurance coverage more affordable and consumer-friendly by managing competition among health insurers through the creation of health insurance exchanges. A new report from researchers at the Urban Institute and CHIR released by the Robert Wood Johnson Foundation explores state actions to encourage or require participation on exchanges, and early indications of the level of competition among health insurers. Kevin Lucia highlights some of the findings from the report. Continue reading