Author Archive: CHIR Faculty

Relaxing the Affordable Care Act’s Guaranteed Issue Protection: Issues for Consumers and State Options

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As we’ve been blogging about, the Trump administration finalized a Market Stabilization rule that makes numerous changes in how marketplaces and insurers are operating. One of the biggest changes affecting consumers is the Trump administration’s new interpretation of guaranteed issue or availability; but states have a range of options regarding this policy under the rule. CHIR’s Sandy Ahn and JoAnn Volk break it down for us.

Running Down the Clock: Policy Uncertainty over Affordable Care Act Means Less Time for Oversight of Premium Hikes

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Insurers are required to submit their health plans and premium rates for regulatory review in the face of considerable uncertainty over the future of the Affordable Care Act’s marketplaces. In their latest post for The Commonwealth Fund, Sabrina Corlette and Kevin Lucia examine the sources of this uncertainty, how it affects insurers’ ability to plan for the coming year, and what it means for state and federal regulators who must assess the reasonableness of proposed premium hikes.

Responding to the Opioid Crisis: Insurers Balance Stepped up Monitoring, Restrictions with Need for Appropriate Pain Treatment

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The United States has an opioid epidemic, with an unprecedented number of opioid-related deaths in recent years. The rise in opioid addiction and overdose is further complicated by the need to effectively treat the approximately 100 million people living with chronic pain. In their latest issue brief for the Robert Wood Johnson Foundation, CHIR experts report on how insurers are responding to the opioid crisis while also meeting the needs of members living with chronic pain.

2017 Federal and State Marketplace Trends Show Value of Outreach

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The fourth open enrollment period ended in early 2017, with dwindling momentum behind enrollment efforts at the federal level following the presidential election. In a new publication for the Commonwealth Fund, Emily Curran, Sabrina Corlette, Kevin Lucia and Justin Giovannelli provide an overview of potential factors influencing enrollment changes in the state-based marketplaces, including increased efforts that may have had a positive effect on final selections.

Alexander-Corker Bill Would Likely Reduce, Not Expand, Consumers’ Health Insurance Options

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Humana’s decision to pull out of the individual market in 2018 has prompted more concern over areas facing a dearth of marketplace plans next year, or “bare” counties. Tennessee Senators Lamar Alexander and Bob Corker recently introduced a bill that would waive the individual mandate for residents of bare counties, and allow them to receive federal premium tax credits to purchase plans outside of the marketplace. Sarah Lueck of the Center on Budget and Policy Priorities shares a new analysis of the bill and its potential impact on insurers and consumers.

What’s Going on in Tennessee? One Possible Reason for Its Affordable Care Act Challenges

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Recently the Governor of Tennessee observed that his state was “ground zero” for insurers pulling out of the ACA marketplaces. In the wake of Humana’s decision to withdraw from the marketplaces for 2018, the residents of 16 counties in that state face the prospect of no insurance company at all from which to buy a subsidized health plan. Tennessee is not alone in having a fragile ACA marketplace, but its situation is particularly acute, especially if no other insurer can be persuaded to operate in those counties. Why is Tennessee’s market struggling, when other states with similar demographics, such as Arkansas, have more competition and market stability?

Selling Health Insurance Across State Lines Doesn’t Lower Costs for Consumers

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In the wake of the failure of the legislative effort to repeal and replace the Affordable Care Act, the fate of the President’s proposal to authorize the sale of insurance “across state lines” is unclear. In their latest article for the Commonwealth Fund’s To The Point blog, Sabrina Corlette and Kevin Lucia examine different potential approaches to promoting cross-state sale of insurance and what they mean for states and consumers.

Loss of Cost-Sharing Reductions in the ACA Marketplace: Impact on Consumers and Insurer Participation

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In an updated article published on The Commonwealth Fund’s To the Point site, CHIR experts JoAnn Volk, Dania Palanker, Justin Giovannelli and Kevin Lucia examine the possibility that the Trump administration will pull the plug on the Affordable Care Act’s cost-sharing reduction subsidies, and discuss the potential consequences for individual health insurance markets and the consumers who rely on it.

Proposed Pre-Verification Process for Special Enrollment Periods: Policy Goals, Potential Impact, and the need for State Flexibility

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In the wake of failed congressional attempts to repeal and replace the Affordable Care Act, we turn back our focus on the administration and its approach to the marketplaces. The proposed market stabilization rule would require a pre-verification process for special enrollment periods for all marketplaces, including states operating their own. This move is largely in response to insurer concerns, indicating an interest in working with participating marketplace insurers. But how does this fare with states that have their own special enrollment processes? CHIR’s Sandy Ahn takes a look.

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.