Author Archive: CHIR Faculty
What’s Going on in Tennessee? One Possible Reason for Its Affordable Care Act Challenges

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

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

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

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.
House Proposal to Promote Association Health Plans Poses Risks for Insurance Markets, Consumers

The U.S. House of Representatives passed a bill to promote federally certified association health plans (AHPs) on March 22, 2017. Widely seen as a “second phase” of Affordable Care Act repeal, the AHP proposal poses significant risks for small employers and would hinder states’ ability to protect their consumers. In their latest post for The Commonwealth Fund, Kevin Lucia and Sabrina Corlette take a look at the bill and what it would mean for the small business health insurance market.
Eliminating Essential Health Benefits Will Shift Financial Risk Back to Consumers

In a new article published on The Commonwealth Fund’s To The Point site, CHIR experts Dania Palanker, JoAnn Volk, and Justin Giovannelli look at the individual health insurance market before the Essential Health Benefits and the financial risk consumers will bear if we return to a market without benefit protections.
With all Eyes on AHCA, House Advances 3 Bills that Could Reduce Benefits, Raise Costs for People in Employer-Based Coverage
What’s the Difference Between Reinsurance and a High-Risk Pool? Two approaches to insuring those with pre-existing conditions

Congressional leaders and the President have said any plan to replace the Affordable Care Act (ACA) will ensure access for people with pre-existing conditions. However, how they are covered matters a great deal, in part because of the effects on the stability of the risk pool in the individual market.
Maryland CO-OP Health Plan Becomes a For-Profit Company

Just hours before President Trump took the oath of office, the Maryland health insurance CO-OP Evergreen Health officially closed a deal with the Centers on Medicare and Medicaid Service (CMS) to sever its ties with the Affordable Care Act’s (ACA) CO-OP program. The company will now transition from a nonprofit to a for-profit company, allowing it to gain an infusion of financing from outside investors. Executives credited the deal with enabling Evergreen to survive and stay competitive. However, it also provides insight into the immense challenges involved in starting up a new insurance company in the current market, even with federal financing.