Author Archive: CHIR Faculty

Independent Dispute Resolution Process 2024 Data: High Volume, More Provider Wins

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While the independent dispute resolution (IDR) process is intended to lead to fair outcomes for out-of-network payment, new analysis demonstrates unexpectedly high use of the IDR process, mostly by private-equity-backed providers that win often and win large. In their latest piece for Health Affairs Forefront, Jack Hoadley, Kennah Watts, and Zachary Baron illustrate trends in the IDR process and explore implications for costs.

Early 2026 Rate Filings Show Marketplace Policy Changes Contribute to Eye-Popping Rate Increases

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This year, insurers are setting their rates for 2026 while Congress and the administration weigh several policies that are projected to cause premiums to spike and the number of people with Marketplace coverage to plummet. In a new blog, CHIR experts investigate early 2026 rate filings and related analysis to explore how insurers are responding to an array of anticipated federal ACA policy changes and uncertainty around them.

Second Verse, Same as the First: Senate Reconciliation Language Failes to Fix Paperwork Burdens, Other Barriers to Marketplace Coverage

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With the passage of H.R.1, the House of Representatives’ version of the budget reconciliation bill that will advance President Trump’s domestic policy agenda, all eyes are turned towards the Senate. In a new CHIRblog, ACA experts Karen Davenport, Stacey Pogue, and Sabrina Corlette discuss how draft legislation emerging from the Senate would create enrollment barriers to Marketplace coverage that largely mirror the House’s reconciliation bill.

The Reconciliation Bill Eliminates Long-Standing State Flexibility to Operate Marketplaces and Regulate Private Health Insurance

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The budget reconciliation bill passed by the U.S. House of Representatives would eliminate much of the flexibility granted to states over the operations of State-Based Marketplaces (SBMs), impose burdensome new requirements, and reduce their revenue base. In a new CHIRblog post, ACA experts Jason Levitis, Christen Linke-Young, Sabrina Corlette, Ellen Montz, and Claire O’Brien dive into the bill’s costly new mandates for states.

New Administration Plans to Reinstate Cuts to Funding for ACA Outreach and Enrollment Assistance

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One of the first actions by the Centers for Medicare and Medicaid Services under the Trump administration was to make extreme cuts in funding for Navigators. In a blog post for the Commonwealth Fund, CHIR’s Rachel Swindle, Jalisa Clark, and Justin Giovannelli dispute the rationale behind the funding cuts presented by the Trump administration and highlight the gravity of reducing the Navigator program and outreach and enrollment assistance.

Can States Harness Market Power to Rein In Health Care Costs?

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As U.S. health care spending continues to spiral higher, states are using a variety of tools to push back. In a new book of essays, CHIR experts examine the impacts and limitations of three mechanisms through which states are leveraging their role as a contractor to lower health care prices in the private health insurance market and to advance broader policy goals.

A New Rule to Limit ACA Enrollment Periods May Deter Sign-Ups and Worsen Risk Pools

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Recent proposals from the Trump administration and Congress would shorten or eliminate the windows of opportunity for people to enroll in the Affordable Care Act Marketplaces. In a recent article for the Commonwealth Fund, CHIR’s Sabrina Corlette and Rachel Swindle discuss how such policies would result in reduced access to coverage and higher costs for Marketplace enrollees.

Third-Party Administrators – The Middlemen Of Self-Funded Health Insurance

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Pharmacy benefit managers have received significant public attention for their exploitative, cost increasing practices, but similar practices of third-party administrators (TPAs) have received relatively little public attention. In their latest piece for Health Affairs Forefront, Karen Handorf, Christine Monahan, and Kennah Watts argue that understanding TPA business models and how they generate profits requires looking under the hood at their agreements with health care providers and other third-party intermediaries.

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.