A case before the Supreme Court and a new Secretary of the U.S. Department of Health & Human Services could substantially weaken the ACA’s guarantee of no-cost preventive services in private insurance. Experts Sabrina Corlette and Tara Straw provide a roadmap for state policymakers to protect their residents, in a recent article for State Health and Value Strategies.
The Notice of Benefit & Payment Parameters prescribes standards and rules that govern insurers and Marketplaces under the ACA. This annual regulation, that went into effect January 15, represents a final set of health insurance policies from the Biden administration focusing on quality and affordability. In their latest piece for Health Affairs Forefront, Sabrina Corlette and Jason Levitis discuss this final rule and what it means.
Like other employer health plans across the commercial insurance market, state employee health plans (SEHPs) regularly face significant increases in health care costs. A new piece by CHIR faculty for Health Affairs explores how SEHPs’ use of provider-based reference pricing to constrain cost growth has been gaining traction.
The No Surprises Act (NSA) has largely succeeded in protecting consumers from surprise medical bills by reducing out-of-network billing and establishing a dispute resolution process. However, while compliance has improved, challenges with the IDR process, legal actions, and incomplete data hinder a full assessment of its cost containment goals and effectiveness. CHIR experts Nadia Stovicek and Jack Hoadley discuss recent complaint data in their newest piece for CHIRblog.
The Association of Health Care Journalists has released an updated, interactive 50-state Media Guide to help journalists navigate the complexities of the U.S. health care system, offering detailed data on health insurance coverage, state policies, and regulatory agencies. Developed in partnership with Georgetown University’s Center on Health Insurance Reforms, the guide includes a national overview, state-level resources, and essential tools for reporting on health coverage and consumer experiences.
In November, CHIR was thankful for the latest health policy research. We read about charity care provided by non-profit hospitals, Marketplace coverage for small business and self-employed workers, and out-of-pocket costs of traditional fee-for-service Medicare versus Medicare Advantage.
The Biden Administration has proposed a rule to expand coverage of preventive services, including over-the-counter (OTC) contraceptives, without cost sharing. However, the proposal’s future is uncertain due to potential legal challenges and the political factors surrounding reproductive health. CHIR faculty Leila Sullivan and Amy Killelea discuss the proposal.
The Affordable Care Act mandates that health plans in the individual and small-group markets cover essential health benefits (EHB), with states setting the scope through a benchmark plan. A new brief for the Commonwealth Fund by CHIR faculty explores how states have used recent flexibility to expand EHB, address consumer needs, and advance health policy, while highlighting ongoing challenges
In 2023, for the first time, more than half of Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans, which offer private insurance alternatives to traditional Medicare, with 34 million enrollees in MA and 23 million in standalone Part D drug plans. A compendium of 70 policy proposals, created by Georgetown’s Center on Health Insurance Reforms, Medicare Policy Initiative offers a comprehensive resource for improving these programs, addressing issues like cost efficiency, provider networks, and many more.
The Centers for Medicare & Medicaid Services (CMS) has introduced a new option for states to update their essential health benefits (EHB) benchmark plan to include routine adult dental coverage, aiming to address disparities in oral health outcomes, particularly for low-income and minority adults. In their latest Expert Perspective for the State Health & Value Strategies program, CHIR’s JoAnn Volk and Manatt’s Tara Straw discuss considerations for states weighing this addition.
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.
