State-Based Marketplaces Push Ahead, Despite Federal Resistance

Open enrollment for 2018 started last week on the Affordable Care Act’s health insurance marketplaces. Along with its executive actions designed to weaken marketplaces operations, the Trump administration has taken a number of steps over the past year to curb marketplace enrollment. While the administration has scaled back efforts to provide health coverage, state-based marketplaces have taken a different approach. In their latest post for The Commonwealth Fund’s To The Point blog, CHIR’s Emily Curran and Justin Giovannelli share their findings from interviews with executives at 15 of the 17 states that operate their own marketplaces. Continue reading

Proposed 2019 Affordable Care Act Payment Rule: A Big Role for States

The U.S. Department of Health & Human Services published an annual set of proposed rules for the Affordable Care Act marketplaces on October 27. Called the “Notice of Benefit and Payment Parameters,” the rules set out expectations for insurers and the states that regulate them. In her latest post for CHIR, Katie Keith highlights key areas in which this administration would give states new autonomy and authority. Continue reading

States Work to Preserve Affordable Care Act Progress amidst Federal Disorder

It’s been a bumpy year for state insurance and marketplace officials, thanks to considerable uncertainty over the future of the ACA. CHIR’s Emily Curran highlights recent action suggesting that some states may be poised to reassert their authority over their insurance markets, as they work to maintain the ACA’s coverage gains and keep their markets stable. Continue reading

2017 Federal and State Marketplace Trends Show Value of Outreach

The fourth open enrollment period ended in early 2017, with dwindling momentum behind enrollment efforts at the federal level following the presidential election. In a new publication for the Commonwealth Fund, Emily Curran, Sabrina Corlette, Kevin Lucia and Justin Giovannelli provide an overview of potential factors influencing enrollment changes in the state-based marketplaces, including increased efforts that may have had a positive effect on final selections. Continue reading

Proposed Trump Administration Rule Shortens Open Enrollment: Policy Goals, Potential Impact, and State Options

In February, the Trump administration proposed a number of rules that they hope will stabilize the individual market. One of these rules would cut this year’s open enrollment period from 90 days to 45 days. While HHS argues that the shorter timeframe could streamline the enrollment process and improve the risk pool, other health care stakeholders have expressed concern that a shortened OE might dampen enrollment and overwhelm state-based marketplaces. With the final rule expected any day, what are the possible impacts of shortening the annual enrollment period? CHIR’s Rachel Schwab takes a look. Continue reading

Proposed Pre-Verification Process for Special Enrollment Periods: Policy Goals, Potential Impact, and the need for State Flexibility

In the wake of failed congressional attempts to repeal and replace the Affordable Care Act, we turn back our focus on the administration and its approach to the marketplaces. The proposed market stabilization rule would require a pre-verification process for special enrollment periods for all marketplaces, including states operating their own. This move is largely in response to insurer concerns, indicating an interest in working with participating marketplace insurers. But how does this fare with states that have their own special enrollment processes? CHIR’s Sandy Ahn takes a look. Continue reading

Stakeholders React to HHS’ Proposed Market Stabilization Regulations: Part 1 – Insurers

In February, the Department of Health & Human Services released proposed rules affecting the ACA’s health insurance marketplaces. In response, they received close to 4,000 public comments. In the first of a series of three posts examining reactions among health care stakeholders, CHIR’s Emily Curran assesses the reaction of insurance companies. Continue reading

States That Leaned In on the Affordable Care Act Have Much to Lose

In the wake of the Affordable Care Act’s passage, 17 states embraced the chance to set up and manage their own marketplace and design an insurance market to meet local needs. In their latest article for the Commonwealth Fund, CHIR experts Sabrina Corlette, Emily Curran and Kevin Lucia review these states’ progress on expanding coverage and stabilizing their markets and find that they have much to lose if the law is repealed. Continue reading

Ch-ch-ch-ch-changes: Special Enrollment Periods Provide Essential Coverage During Common Life Transitions, but Many People Don’t Know They Exist

Change in life is unavoidable: people move, get married, change jobs and have babies. Special enrollment periods (SEPs) allow people experiencing such life changes to access marketplace coverage, often with financial assistance. Unfortunately the majority of people don’t know about them. CHIR’s Sandy Ahn takes a look at SEPs, including the administration’s current approach to SEPs and the missed opportunities to raise overall awareness of them, strengthen the risk pool, and reduce the number of uninsured. Continue reading