Author Archive: CHIR Faculty

Update on State Public Option-Style Laws: Getting to More Affordable Coverage

While federal health coverage reforms remain stalled in Congress, several states are pushing forward to establish modified versions of public health insurance options. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Christine Monahan, Justin Giovannelli, and Kevin Lucia provide an update on implementation of public option-style plans in Washington, Colorado, and Nevada.

Preparing for the Biggest Coverage Event Since the ACA: The Role of States as Medicaid Continuous Coverage Comes to an End

CHIR and our colleagues at the Center for Children and Families (CCF) have published two new resources examining state-level preparations for the end of the COVID-19 public health emergency and the redetermination of the Medicaid eligibility of close to 85 million people. CHIR and the Urban Institute published a review of how state-based Marketplaces and Medicaid agencies are working together to ease coverage transitions, and CCF and KFF released their 20th 50-state survey of Medicaid agencies, with a particular focus on their post-PHE planning efforts.

Massachusetts Data on Health Care Sharing Ministries Reveal Finances That Put Consumers at Risk

Health Care Sharing Ministries (HCSM) continue to be marketed widely, often as an alternative to the Affordable Care Act’s marketplace plans, even though HCSMs don’t follow the same rules and typically don’t provide the same protections. There is a dearth of data on HCSM operations and finances, but a Massachusetts rule has offered a glimpse behind the curtain. In a new post for the Commonwealth Fund, JoAnn Volk, Justin Giovannelli, and Christina Goe dig into new data on HCSMs.

Questionable Quality Improvement Expenses Drive Proposed Changes to Medical Loss Ratio Reporting

Under the Affordable Care Act, insurers must provide rebates to enrollees when their spending on clinical services and quality improvement, as a proportion of premium dollars, falls below a minimum threshold. Federal regulators have discovered some insurers are gaming the system by misallocating expenses or inflating their spending on providers. Karen Davenport takes a look at how this practice impacts consumers, and explains a new federal proposal to crack down on it.

New CHIR Report Assesses the Effectiveness of Policies in Improving Access to Primary Care for Underserved Populations

It is hard to overstate the importance of primary care in ensuring robust health outcomes at the population level. In a new report supported by the National Institute for Health Care Reform, CHIR experts reviewed research to assess whether policy initiatives targeting primary care access have been effective in reducing health care disparities.

Tackling “Analysis Paralysis”: New Federal Proposal Would Bring Standardized Benefit Design Back to the Federally Facilitated Marketplace

The Affordable Care Act’s health insurance marketplaces and consumer protections significantly improved the experience of purchasing individual health insurance, but consumers still face the difficult task of comparing a potentially overwhelming number of complicated benefit and network designs. A proposal in the Notice of Benefits and Payment Parameters for 2023 may improve this situation. Karen Davenport takes a look at the possible return of standardized plans to the federal marketplace, and what this change might mean for consumers.

Insurers are Now Covering At-Home COVID Tests but Implementation Varies

Private health plans are now required to cover at-home over-the-counter COVID-19 tests. CHIR’s Megan Houston and Rachel Swindle reviewed the coverage policies of 51 insurers to see how consumers can access this benefit. They found a number of plans with restrictions that go beyond what federal guidelines allow.

Changes to Wellness Programs Suggest Employers are Rethinking Health Promotion

January can feel like a time for new beginnings, and new year’s resolutions. In recent years, many employers have provided workplace wellness programs that may help employees stick with these resolutions, such as benefits, services, or financial incentives that encourage workers to improve their health. Recent data from KFF’s 2021 Employer Health Benefit Survey showing that employers are reconsidering key elements of their wellness initiatives prompted CHIR to take a look at some of the changes—and ongoing issues—with workplace wellness programs.

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.