Author Archive: CHIR Faculty

Wondering What Marketplace Rate Increases Mean for Consumers?

The third open enrollment season for the Affordable Care Act’s health insurance marketplaces begins on Sunday, November 1. The administration has released new data showing average health plan rate changes, with an average increase nationwide of 7.5 percent compared to 2015. Our colleague Tricia Brooks breaks down what these rate changes mean for consumers.

Accessing Provider Directories and Formularies: CHIR Goes Sleuthing

We’re counting down again to Open Enrollment 3 and this year, all health plans must make accessing provider directories and formularies, or the list of covered prescription drugs, easy for consumers. This means consumers should be able to find this information on insurer website sites without creating an account or entering a policy number. CHIR’s Sandy Ahn flexes her investigative skills and looks to see how accessible this information really is.

The Next Big Thing in Network Adequacy: The NAIC Model Act

In November, the National Association of Insurance Commissioners (NAIC) will finalize the Network Adequacy Model Act – a draft bill designed to be used by states to enact provider access standards for private health insurance plans. Consumer representative Claire McAndrew explores what the act includes as well as areas for improvement.

Half of the Uninsured are Eligible for ACA Coverage

A recent Kaiser Family Foundation reports finds that 49 percent of the remaining uninsured in our country are eligible for either Medicaid or marketplace coverage under the Affordable Care Act. Graduate researcher Jordan Messner unpacks the data.

New Resource on Enrollment Now Available

As we draw nearer to the start of Open Enrollment 3, a new resource is available from the Centers for Medicare and Medicaid Services (CMS), the FFM and FF-SHOP Enrollment Manual. A complete guide of policy and operational information, the new Manual covers all topics related to eligibility and enrollment in the FFM and FF-SHOP. CHIR’s Sandy Ahn provides a quick summary of the new CMS resource.

Balance Billing for Air Ambulance Remains a Problem in Maryland

Although Maryland is among the handful of states that regulate balance billing for out-of-network situations, as we discuss in a previous report, the state’s law does not address air ambulance charges. Balance billing for air ambulances remain a problem in Maryland and its insurance department held a public meeting last Friday to discuss the issue. CHIR’s Sandy Ahn provides highlights of the meeting and other state efforts to address this consumer problem.

Why ACA Marketplaces Should Report Comprehensive Enrollment Data

The Affordable Care Act’s new health insurance marketplaces could be critical sources of data about how people access and use coverage. Yet, to date, the marketplaces have released varying degrees of information, with little uniformity or consensus over what data should be collected and how. In our latest post for The Commonwealth Fund, CHIR researchers Sean Miskell, Justin Giovannelli and Kevin Lucia examine data collection and reporting by the health insurance marketplaces.

The ACA Triggers Largest Decline in Uninsured since 1987: Now What?

U.S. Census data out last week shows that in 2014, the number of uninsured Americans declined by 8.8 million. As debates about the legitimacy and impact of the ACA fade in the rearview mirror, many policy experts are now shifting their attention to ways to improve the ACA for consumers. CHIR’s Hannah Ellison shares some ideas from a recent Urban Institute report.

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.