The leaves are falling but the latest health policy research is evergreen! Last month we read about health system competition in metropolitan areas, health care affordability prior to the American Rescue Plan (ARPA,) how high deductible health insurance can exacerbate racial and ethnic wealth disparities, and about unmet dental vision and hearing needs among low-income Medicare Advantage beneficiaries.
Many Americans struggle with high healthcare costs, leading state policymakers to explore transparency measures to lower prices. While transparency alone has limited impact on cost reduction, states are innovating by increasing transparency in areas like provider ownership, billing practices, and price data, which can inform broader policy solutions and have bipartisan support, paving the way for more effective cost-containment strategies. In their latest article for CHIRblog, CHIR experts Stacey Pogue and Nadia Stovicek explore transparency options for state policymakers.
In recent years, federal price transparency rules have required hospitals and health plans to publicly post their prices. However, challenges persist with data access and use, limiting the data’s effectiveness for consumers and policymakers. Two bipartisan bills in Congress seek to strengthen these rules. CHIR experts Stacey Pogue and Nadia Stovicek discuss the federal price transparency landscape in their latest article for CHIRblog.
The 2024 election results will require concerted and aggressive efforts to preserve gains in insurance coverage, improvements in health equity, and greater health care affordability. CHIR’s faculty share thoughts on the work ahead.
The U.S. health care system’s lack of regulation over provider pricing and insurer claims has led to a rise in profit-driven middlemen, such as revenue cycle management firms. While these intermediaries aim to maximize reimbursements for providers, they often increase costs for consumers and complicate access to care. This complex environment underscores the urgent need for regulatory oversight to address the inefficiencies and rising expenses in the system. In their latest piece for Health Affairs Forefront, Linda J. Blumberg and Kennah Watts break down the effect of middlemen on US health care.
CMS recently released their draft Notice of Benefit & Payment Parameters (NBPP) for plan year 2026. In their latest piece for Health Affairs Forefront, Sabrina Corlette and Jason Levitis discuss what this means for Marketplaces, insurance reforms and Advance Premium Tax Credits (APTCs.)
The 2021 expansion of federal premium tax credits (PTCs) drove uninsured rates to a record low in 2023, but this critical financial assistance will expire after 2025 unless Congress acts. CHIR faculty Rachel Swindle and Justin Giovannelli talk more about this in their latest issue brief for the Commonwealth Fund.
The Affordable Care Act (ACA) marketplaces have become vital lifelines for millions, especially for communities of color, significantly reducing the uninsured rate and expanding access to affordable coverage. However, the future of these marketplaces hangs in the balance, with political priorities influencing their stability and funding, particularly regarding federal subsidies. As the 2024 election cycle approaches, the choices voters make could reinforce the progress achieved or risk undoing critical health care coverage advancements.
While the weather may be cooling down, the research is not! This month we read about Medicare Advantage quality bonus payments, out-of-pocket drug costs for consumers, effects of enhanced premium tax credits on older adults, and strategies to increase eligibility verification and receipt of Marketplace subsidies.
CHIR expert Christine Monahan recently testified before the Texas House Insurance Committee regarding outpatient facility fee billing. Her research highlights how facility fees contribute to significantly higher healthcare costs. In her testimony, she discussed measures to curtail hospital billing tactics that inflate costs and ways to mitigate financial burdens on patients.
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.
