Author Archive: CHIR Faculty

New Special Enrollment Roadblocks for Consumers: Hindering, not Helping Consumers Get Coverage

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While Congressional leaders debate how to repeal and replace the Affordable Care Act, the Trump administration recently implemented new requirements for consumers seeking a special enrollment period for marketplace coverage. Designed to prevent people from waiting until they are sick before signing up for coverage, some of these new requirements could make it more difficult to enroll; others could reduce consumers’ plan choices. Sandy Ahn summarizes the new policy changes that went into effect last month.

Have Employer Coverage? GOP Proposals Will Affect You Too (Part 2)

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Much of the focus of the debate over repealing and replacing the ACA has been on the individual insurance market. But over 150 million people get coverage through their employer, and bills pending in the House and Senate will affect them, too. In a post originally published on the Health Affairs’ Blog, CHIR’s JoAnn Volk and Sabrina Corlette explain what’s preserved, and what’s at risk, for people in job-based plans.

What Makes Covering Maternity Care Different?

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The United States has a higher maternal mortality rate than any other developed country, but federal policy makers are considering reducing access to insurance coverage for pregnancy care. In a post for the Health Affairs blog, CHIR experts Dania Palanker and Kevin Lucia and Harkness Fellow Dimitra Panteli assess the latest policy proposal to allow states to waive out of the requirement that insurance plans in the individual market cover maternity and newborn care.

Amid Market Uncertainty, Trump Administration Retreats from Health Plan Oversight

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In mid-April, the Trump administration announced it would stop monitoring marketplace plans for compliance with several important federal protections and instead defer to states. In their latest blog post for The Commonwealth Fund, Justin Giovannelli and Kevin Lucia explain the new changes to insurance oversight, and assess the potential impact of this federal deregulation for states and consumers.

Signs of Marketplace Stability May Be Undercut by Federal Policy Uncertainty

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Recently, analysts have found evidence of marketplace stability after a number of insurers scaled back participation and increased premiums for 2017. Despite this progress, federal efforts to repeal and replace the ACA have sparked growing concerns about the marketplace’s sustainability. To understand how insurers are faring in the marketplaces amidst federal reform activity, CHIR experts reviewed the first quarter financial earnings of seven of the largest, publicly traded insurers.

Lots of Changes for 2018 Marketplace Enrollment Mean Confusion for Consumers

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Open enrollment will be here sooner than we know it. But this year’s open enrollment, will be quite different from previous years due to numerous policy changes and proposed budget cuts to marketplace consumer outreach, assistance, and enrollment system under the Trump administration. These changes will make it much more confusing for consumers and place much more of a burden on the assisters that help them. CHIR’s Sandy Ahn summarizes some of the change in store for 2018 open enrollment.

New Georgetown Issue Brief: 50-state Survey of State Action to Protect Consumers from Surprise Medical Bills

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Balance billing occurs when a consumer who is treated by an out-of-network provider is subsequently billed by that provider for the difference between what their health plan paid and what the provider charges. In their latest issue brief published by the Commonwealth Fund, Kevin Lucia, Jack Hoadley, and Ashley Williams analyzed laws in all fifty states and the District of Columbia to understand the current scope of state laws that protect consumers from balance billing.

State Efforts to Lower Cost-Sharing Barriers to Health Care for the Privately Insured

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Current federal proposals to replace the Affordable Care Act are likely to result in higher out-of-pocket costs for consumers. Six states and D.C., however, have policies to lower cost-sharing barriers to important health care services and drugs for the privately insured. In a new research brief, CHIR researchers take a closer look at some of these states’ experiences developing and implementing these policies.

The Ins and Outs of the New Approach to Special Enrollment Periods: Pre-enrollment Verification (SEPV)

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Starting June 23, 2017, healthcare.gov will be rolling out a special enrollment period pre-enrollment verification (SEPV) process, which will require new consumers applying for marketplace coverage because of loss of minimum essential coverage (MEC) or permanently moving to prove their eligibility for a special enrollment period. How will this process work and what do consumer assisters need to know? CHIR’s Sandy Ahn provides a summary.

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.