Author Archive: CHIR Faculty

New Georgetown Report on State Approaches to Protecting Consumers from the Unexpected Charges of Balance Billing

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A new report from Georgetown University researchers examines the phenomenon of surprise bills for out-of-network medical services, often called “balance billing.” These unexpected charges can often be significant and cause great stress for patients. Several states have implemented consumer protections, but they take different approaches with varying effectiveness. Jack Hoadley provides the highlights.

Not One, Not Two but Three New Resources from CHIR: Small Business Health Plans in a Post-ACA World

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There’s been some renewed attention to the status and future of the small business health insurance market, particularly as an Affordable Care Act reform scheduled to go into effect in 2016 could cause some disruption. Last week CHIR researchers contributed to three great new resources to help policymakers and others understand changes in the market and some of the challenges ahead.

State Decisions on Allowing Mid-Sized Employers to Delay a Move to the Small-Group Insurance Market

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Beginning in 2016, the Affordable Care Act requires states to change the definition of “small employer” from one with up to 50 employees to up to 100 employees. Such a change could affect health insurance coverage and prices for small businesses and their workers. However, many states are taking advantage of a transition period offered by the Obama Administration that would delay this change. Ashley Williams and Sabrina Corlette, in their latest blog post for the Commonwealth Fund, report on the results of a 50-state survey and the implications for the small group insurance market.

Telemedicine and its Effect on the Regulatory Landscape

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Some states are making policies related to the emergence of telemedicine or the delivery of health care services through telecommunication technology. While states are taking varying approaches, telemedicine can increase access to specialty services such as mental health services and help address network adequacy concerns. CHIR’s Sandy Ahn highlights some of the issues related to telemedicine.

New Guidance Clarifying Preventive Services under the Affordable Care Act

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The Affordable Care Act requires most health plans to cover preventive services without cost sharing and enables consumers to access evidence-based medical care such as cancer screenings and immunizations for children. Implementation of this requirement, however, has raised questions and caused confusion among insurers, providers and consumers. Sandy Ahn reviews the Administration’s most recent guidance on this critical ACA provision, designed to clarify for insurers what they must do to comply and ensure that consumers receive the benefits they are promised under the law.

The Affordable Care Act’s State Innovation Waivers: A Need for Transparency and a Role for Stakeholders

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Discussion of new “superwaiver” authority is a hot topic among many state and health policy circles. The Affordable Care Act allows states to modify key reforms beginning in 2017 through a so-called 1332 waiver application. States could also choose to coordinate this waiver with Medicaid and/or CHIP reforms through a 1115 waiver. CHIR’s Sabrina Corlette and Joan Alker of the Center for Children and Families assess the waiver process outlined to date and the need for transparency and stakeholder input on the critical policy decisions that will be required.

The Affordable Care Act: The Law Folks Love to Blame

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The Affordable Care Act (ACA) can take credit for a historic reduction in the number of people uninsured in this country, but it is also often blamed for a wide range of societal ills. Our colleague Sally McCarty notes one particularly egregious attempt to divert attention from bad policymaking by pinning blame on the ACA.

Healthcare.gov Fixes System Glitch in Counting Social Security Income for Certain Tax Dependents

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The Centers for Medicare and Medicaid Services (CMS) recently announced that they had fixed a technical glitch in healthcare.gov that may have cost people thousands of dollars in subsidies. Our colleague at Georgetown’s Center for Children and Families, Tricia Brooks, helped to identify the problem early on and offers this take on what CMS can do to help the people affected by the error.

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.