CHIR Faculty

Lots of Changes for 2018 Marketplace Enrollment Mean Confusion for Consumers

Posted June 21, 2017 by CHIR Faculty

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

Posted June 20, 2017 by CHIR Faculty

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

Posted June 15, 2017 by CHIR Faculty

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)

Posted June 9, 2017 by CHIR Faculty

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.

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

Posted June 2, 2017 by CHIR Faculty

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.

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

Posted May 23, 2017 by CHIR Faculty

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

Posted May 5, 2017 by CHIR Faculty

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

Posted May 2, 2017 by CHIR Faculty

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.