Tag: transparency

Policy Experts Discuss Strategies to Keep Employer-Sponsored Health Insurance Afloat

On October 3, CHIR held the first in a series of in-person policy briefings on the future of employer-sponsored insurance (ESI), sponsored by Arnold Ventures and West Health. The event, featuring remarks from U.S. Senator Maggie Hassan and a panel discussion moderated by Sarah Kliff of The New York Times, spotlighted state cost containment policies and employer strategies to inform the federal policy process concerning ESI, which covers almost half of all Americans.

State Health Care Purchasers Can Push Hospitals To Comply With Federal Transparency Requirements

Federal law now requires hospitals to publish the prices they negotiate with private insurers, yet many of them are not complying. In this post for the Health Affairs Blog, CHIR’s Sabrina Corlette and Maanasa Kona and Marilyn Bartlett of the National Academy for State Health Policy discuss ways that state health benefit purchasers, such as state employee plans, can help increase hospital compliance.

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.

From Acne to EcZema: The Return of Medical Underwriting Puts Millions at Risk for Losing Coverage or Higher Premiums

Medical underwriting, outlawed by the Affordable Care Act (ACA), is a practice used by insurance companies to assess a consumer’s health status. In the event of an ACA repeal, millions of people could lose coverage, pay higher premiums, or receive inadequate benefits that exclude essential health services, all based on a pre-existing condition. While many of us don’t see ourselves as falling under that category, the list of health conditions that qualify you for the chopping block may surprise you.

First Compliance Review Focused on Policies and Procedures, but a Better Approach Exists to Assess Health Plan Compliance

The administration recently published the results of its compliance review of health plans participating in federally facilitated marketplaces. The review, however, focused more on process, such as whether plans have the appropriate policies and procedures in place. While this information is somewhat helpful, CHIR’s Sabrina Corlette and Sandy Ahn discuss why these types of compliance reviews fall short of helping regulators assess whether plans are meeting the ACA’s patient protection standards.

Accessing Provider Directories and Formularies: CHIR Goes Sleuthing

We’re counting down again to Open Enrollment 3 and this year, all health plans must make accessing provider directories and formularies, or the list of covered prescription drugs, easy for consumers. This means consumers should be able to find this information on insurer website sites without creating an account or entering a policy number. CHIR’s Sandy Ahn flexes her investigative skills and looks to see how accessible this information really is.

Big Data and Baby Steps: Two Very Different Approaches to Data Collection

Most Americans see the need for more data about health insurance and how it’s working for consumers, and the insurance industry itself seems to recognize the importance of collecting and analyzing data. But it’s not clear that our government regulators do. JoAnn Volk looks at the mismatch between what insurers are undertaking and what federal rules will require for data collection.

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.

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.