Author Archive: CHIR Faculty

First Compliance Review Focused on Policies and Procedures, but a Better Approach Exists to Assess Health Plan Compliance

The administration recently published the results of its compliance review of health plans participating in federally facilitated marketplaces. The review, however, focused more on process, such as whether plans have the appropriate policies and procedures in place. While this information is somewhat helpful, CHIR’s Sabrina Corlette and Sandy Ahn discuss why these types of compliance reviews fall short of helping regulators assess whether plans are meeting the ACA’s patient protection standards.

Little Known Provision Keeps Kids From Slipping Through Cracks Due to Differences in Eligibility Rules

For the most part, the ACA tries to align the ways that Medicaid and the health insurance marketplaces determine eligibility for their respective programs. But every once in a while, there’s a risk that someone might fall through the cracks. This initially appeared to be the case when our colleague Tricia Brooks was asked to help with a complex family situation in which a child seemed to be caught between the differences between each program’s rules, putting him at risk of being uninsured. Fortunately, Tricia was able to unearth a little known but important rule that helps kids get the coverage they’re entitled to.

A Look at Proposals for Improving Health Coverage Affordability

Welcome to 2016. With first votes being cast in the 2016 election cycle less than two weeks away and House Speaker Paul Ryan (R-WI) promising to unveil an ACA replacement plan to steer the 2016 party agenda, the policy debate on health reform is far from over. We here at CHIR are keeping an eye on reform proposals, and in this post, CHIR’s Hannah Ellison examines various proposals to improve affordability of coverage under the ACA.

Enroll Before Jan. 15 for Feb. 1 Coverage and Other Open Enrollment Reminders

With open enrollment set to close in two week, enroll now before or on January 15 to get coverage by February 1. As the clock ticks towards the end of January and the close of open enrollment, CHIR’s Sandy Ahn provides some reminders and references the Navigator Guide, your resource on eligibility, enrollment, and health insurance coverage.

Depressed Doctors and What Healthcare Payers and Providers Can Do

A recent study in the Journal of the American Medical Association found very high rates of depression among medical students. Georgetown medical student Josh Barrett takes a look at the implications for physician training and patient care, as well as the role of health insurers and health systems in supporting physicians’ mental health.

Proposed Mergers among Major Health Insurers: Context and Perspectives

Health plan consolidation has been in the news lately. The Department of Justice is reviewing proposed mergers between major insurers Aetna/Humana and Anthem/CIGNA, as are a number of state insurance regulators. CHIR’s Emily Curran attended a recent forum airing different perspectives on the mergers, and shares this overview.

Federal and State Policymakers Work to Ensure Continuity of Health Care for Consumers

Federal health insurance officials and the NAIC have recently put forward proposals to protect patients when a doctor or hospital leaves their health plan’s network. Both are grounded in longstanding state standards, although the scope and strength of these laws vary widely. In their latest post for the Commonwealth Fund, Sabrina Corlette, Ashley Williams and Kevin Lucia share findings from a 50-state survey of continuity of care laws and assess how they compare to the federal proposal.

Deadline for January 1, 2016 Coverage Approaching: What to Do

The deadline for having health insurance starting on January 1, 2016 is quickly approaching. Consumers who want marketplace coverage must enroll by December 15, 2015 for a January 1, 2016 effective date. CHIR summarizes what to do and highlights Frequently Asked Questions related to open enrollment.

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.