Author Archive: CHIR Faculty

Consumer Assistance: Getting the Most Out of Limited Resources

While open enrollment is less than three months away, consumer assisters will have to do more with less. Resources will be limited, even though the Congressional Budget Office projects more than 5 million more people will enroll through a marketplace. CHIR’s Sandy Ahn examines support from the state and federal marketplaces for consumer assistance funding.

The Next Frontier: Insurance Marketplaces That Promote Quality Improvement

While most state-based marketplaces in 2014 are rightly focused on the operational challenges of connecting people with coverage, over time technical improvements will allow them to prioritize providing better quality, more cost-effective care to enrollees. CHIR experts Sabrina Corlette and Sarah Dash, in their latest blog post for the Commonwealth Fund, discuss the opportunities and challenges for states working to implement the ACA’s quality improvement initiatives.

New Issue Brief Examines Specialty Drugs in Tiered Pharmacy Benefit Structures

Health plans have been increasingly using tiered pharmacy benefit designs. These new designs raise challenges for consumers and the state insurance regulators responsible for reviewing and approving plans for sale. CHIR faculty members Sally McCarty and David Cusano explore these issues in a new brief for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network.

After Halbig: Considerations for States Revisiting the Option to Establish a State-Based Marketplace

A federal appeals court’s ruling that premium subsidies aren’t available for consumers who purchase health coverage through one of the ACA’s federally run insurance marketplaces could have drastic consequences. But policymakers in the 34 states with a federal marketplace have options for protecting their residents. In one of CHIR’s blogs for the Commonwealth Fund, Kevin Lucia and Justin Giovannelli discuss those options here.

Decoding 2015 Health Insurance Rate Increase Requests

“The rates are coming, the rates are coming.” The release of 2015 health insurance premium rates provides new fodder for the latest pronouncements on the success or failure of the Affordable Care Act. In a blog post originally published by the Health Affairs blog, Christopher Koller and Sabrina Corlette decode what’s happening with insurers’ 2015 rate requests and why.

New Report Reviews State Action on Quality Improvement in State-Based Marketplaces

The Affordable Care Act envisions that the new health insurance marketplaces will encourage plans to provide better quality, more cost-effective care. But achieving that is easier said than done. A recent report by CHIR faculty Sarah Dash and Sabrina Corlette charts action by the state-based marketplaces to achieve quality improvements and assesses future prospects. Ashley Williams provides an overview.

All Enrollees Should Contact the Marketplace at Renewal

We’re about 110 days away from open enrollment into coverage for 2015. In recent guidance, CMS has revealed its plans for plan renewals and eligibility re-determinations for people enrolled in plans through the marketplaces. Our Georgetown colleague Tricia Brooks takes a look at the envisioned process and some of the benefits – and pitfalls – for consumers.

ACA Days of Summer

It’s getting to be a summer tradition: a new set of court decisions on the Affordable Care Act. This past week two courts reached opposite conclusions on whether the IRS can issue subsidies through the federally facilitated marketplaces, affecting potentially 7.3 million people. Research Fellow Sandy Ahn talks about these decisions and their impact on the ACA’s ability to address the “three As” of health coverage: access, affordability, and adequacy.

New Report Finds that, Under the ACA, Consumers Nationwide Are Experiencing Improved Protections in the Individual Insurance Market

The ACA includes numerous consumer protections designed to remedy shortcomings in the availability, affordability, adequacy, and transparency of individual market insurance. However, because states continue to be the primary regulators of health insurance and implementers of these requirements, consumers are likely to experience some of these new protections differently, depending on where they live. CHIR’s latest issue brief finds that consumers nationwide will enjoy improved protections in each area targeted by the reforms.

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.