State Efforts to Lower Cost-Sharing Barriers to Health Care for the Privately Insured

Current federal proposals to replace the Affordable Care Act are likely to result in higher out-of-pocket costs for consumers. Six states and D.C., however, have policies to lower cost-sharing barriers to important health care services and drugs for the privately insured. In a new research brief, CHIR researchers take a closer look at some of these states’ experiences developing and implementing these policies. Continue reading

Relaxing the Affordable Care Act’s Guaranteed Issue Protection: Issues for Consumers and State Options

As we’ve been blogging about, the Trump administration finalized a Market Stabilization rule that makes numerous changes in how marketplaces and insurers are operating. One of the biggest changes affecting consumers is the Trump administration’s new interpretation of guaranteed issue or availability; but states have a range of options regarding this policy under the rule. CHIR’s Sandy Ahn and JoAnn Volk break it down for us. Continue reading

What’s Going on in Tennessee? One Possible Reason for Its Affordable Care Act Challenges

Recently the Governor of Tennessee observed that his state was “ground zero” for insurers pulling out of the ACA marketplaces. In the wake of Humana’s decision to withdraw from the marketplaces for 2018, the residents of 16 counties in that state face the prospect of no insurance company at all from which to buy a subsidized health plan. Tennessee is not alone in having a fragile ACA marketplace, but its situation is particularly acute, especially if no other insurer can be persuaded to operate in those counties. Why is Tennessee’s market struggling, when other states with similar demographics, such as Arkansas, have more competition and market stability? Continue reading

In the Midst of Federal ACA Woes, States Play an Important Consumer Protection Role

In Washington, our health policy minds are on system overload. Since the election last week, the town is buzzing about the President-elect and new Congress’ promises to repeal the Affordable Care Act (ACA) as one of their first legislative actions. At the same time, they have also pledged allegiance to some of the law’s market reforms. Since most of those reforms are enforced at the state level, a continued state role will be critical to preserving these vital consumer protections. Continue reading

State-Run SHOPs: An Update Three Years Post ACA Implementation

Small-business owners face unique challenges covering their employees; to lower barriers and increase options, the Affordable Care Act (ACA) created the Small Business Health Options Program (SHOP). In a new blog published by The Commonwealth Fund, CHIR experts Emily Curran, Sabrina Corlette, and Kevin Lucia evaluate the current state of these marketplaces three years into implementation. Continue reading

Balance Billing for Air Ambulance Remains a Problem in Maryland

Although Maryland is among the handful of states that regulate balance billing for out-of-network situations, as we discuss in a previous report, the state’s law does not address air ambulance charges. Balance billing for air ambulances remain a problem in Maryland and its insurance department held a public meeting last Friday to discuss the issue. CHIR’s Sandy Ahn provides highlights of the meeting and other state efforts to address this consumer problem. Continue reading

New Report Finds that, Under the ACA, Consumers Nationwide Are Experiencing Improved Protections in the Individual Insurance Market

The ACA includes numerous consumer protections designed to remedy shortcomings in the availability, affordability, adequacy, and transparency of individual market insurance. However, because states continue to be the primary regulators of health insurance and implementers of these requirements, consumers are likely to experience some of these new protections differently, depending on where they live. CHIR’s latest issue brief finds that consumers nationwide will enjoy improved protections in each area targeted by the reforms. Continue reading

Arming Navigators for the Millions of Enrollees Headed Their Way

With the fast approach to open enrollment for the new health insurance marketplaces, there is growing interest in navigators and other assisters who will help people learn about their coverage options and get enrolled. JoAnn Volk explains how CHIR will be adding to the private insurance knowledge and support for navigators and assisters with a quick reference guide on private health insurance and the reforms of the ACA. Continue reading