Author Archive: CHIR Faculty
More Than a Website: Should the Federal Government Establish Additional Minimum Standards for the ACA’s Health Insurance Marketplaces?
The Affordable Care Act established health insurance Marketplaces to facilitate enrollment in comprehensive and affordable health insurance. Most states rely on the federal government to run their Marketplace, but recently, several states have expressed interest in taking over Marketplace operations. With Marketplace enrollment at an all-time high, and millions more people poised to transition from Medicaid to commercial insurance, the role of the Marketplaces as a coverage safety net has never been more pivotal. But federal rules impose few standards for states launching and maintaining a Marketplace. It may be time for the federal government to establish a stronger federal floor.
States Move Forward with Public Option Programs, but Differ in How They Select Insurance Carriers
Washington, Colorado, and Nevada are partnering with private health insurance carriers to offer new “public option” plans. In a post for the Commonwealth Fund’s To the Point blog, CHIR’s Christine Monahan and Madeline O’Brien compare state approaches to selecting insurance carriers to offer the new state plans.
Reducing Health Care Costs For Working Families
Providers Challenge Payments In ‘No Surprises’ Act Dispute Resolution Process
Under the No Surprises Act, consumers are held harmless beyond in-network cost sharing when they receive certain kinds of out-of-network care. In these scenarios, to determine the provider’s payment, payers and providers may enter independent dispute resolution (IDR). Recently, federal agencies released an initial report on the No Surprises Act’s IDR process. In a post for Health Affairs Forefront, CHIR experts Jack Hoadley and Kevin Lucia analyze the new report and discuss what it suggests about the No Surprises Act.
Coverage of Preventive Services Without Cost Sharing in Jeopardy as Texas Court Strikes Down ACA Protection
At the end of March, a federal judge in Texas partially invalidated one of the ACA’s most popular provisions—the requirement to cover a set of preventive services without cost sharing. In a recent post for the Commonwealth Fund’s To the Point blog, CHIR experts break down the recent decision and how it will impact access to care.
Stakeholder Perspectives on CMS’s 2024 Notice of Benefits and Payment Parameters: Consumer Advocates
The Biden administration is poised to finalize new rules governing the Affordable Care Act Marketplaces and insurance reforms for plan year 2024. In the second installment of our annual review of key stakeholder responses to the proposed policy changes, CHIR’s Kristen Ukeomah and Karen Davenport focus on consumer advocate comments on the proposed rule.
Happy 13th Birthday, ACA!
The State of State Protections: Maintaining Access to Services after Transitioning from Medicaid
As states resume conducting Medicaid and CHIP re-determinations of eligibility, the U.S. faces the most dramatic shift in coverage since implementation of the Affordable Care Act. As millions of people transition from Medicaid to private insurance coverage, they could experience disruptions in critical health care services. In their latest post for the Commonwealth Fund, Sabrina Corlette and Maanasa Kona review state-level continuity of care protections and actions states can take to preserve access to life-saving services for our most medically vulnerable.
Can Employer-Sponsored Insurance Be Saved? A Review of Policy Options: Limiting Provider Consolidation and Anti-Competitive Behavior
High and rising health care prices are a key driver of increased cost sharing in employer plans. A significant contributor to rising prices is the consolidation in health care provider markets. In the third post of a series on policy options to improve the affordability of employer-sponsored insurance, CHIR’s Maanasa Kona and Sabrina Corlette explore strategies to limit provider consolidation and anti-competitive behavior.