Author Archive: CHIR Faculty

Narrow Networks Under the ACA: Financial Drivers and Implementation Strategies

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The ACA’s essential health benefits and metal tier coverage standards, guaranteed issue, and community rating requirements help level the playing field among insurers. To compete on price, many are turning to limited network products. CHIR experts David Cusano and Amy Thomas discuss insurers’ approaches to the development of plan networks in the post-ACA era in a new blog post originally published by Health Affairs.

“For the first time in forever” women are now on more equal footing when it comes to health insurance

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A recent news article chronicled worries that the disproportionate number of women signing up for the new health insurance marketplaces will lead to an unbalanced risk pool and increases in premiums. But as Sarah Dash documents in her latest blog post, the ACA is requiring insurers to shift from denying care to women to providing them with better, more comprehensive coverage. And with insurers now required to offer coverage to everybody, it may be time to harness new, consumer-friendly ways to keep health care costs in check.

Halbig v. Sebelius and State Motivations to Opt for Federally Run Exchanges

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A number of states recently filed amicus briefs in a court battle over whether federally facilitated exchanges can provide premium tax credits to low- and middle-income consumers. Because the Affordable Care Act’s employer mandate penalties are contingent on employees accessing subsidized coverage through an exchange, the states are asserting that they purposefully opted for federally run exchanges so employers would not face this burden. In a guest post, former CHIR researcher Christine Monahan assesses the veracity of this claim.

How Do Updated 2014 Federal Poverty Level Thresholds Impact Medicaid, CHIP & Premium Tax Credit Eligibility?

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The Administration recently released updated federal poverty level thresholds for 2014. With eligibility for Medicaid, CHIP and premium tax credits under the Affordable Care Act at stake, consumers and those assisting them need to understand what these new thresholds mean. Here to explain is our colleague at Georgetown University’s Center for Children and Families, Martha Heberlein.

Here’s the Latest on Mandate Exemptions

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Now that 2014 is here, the ACA’s individual mandate is in effect. In the last few months the Administration has issued some more guidance about how the mandate works, and our colleague Joe Touschner at Georgetown University’s Center for Children and Families provides this update.

Republican Health Proposal Likely Means Less Coverage, Higher Costs, Fewer Consumer Protections

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A trio of Republican Senators have introduced legislation repealing the Affordable Care Act and detailing alternative reforms to the health care system. However, as noted in this blog by Edwin Park of the Center on Budget and Policy Priorities, the bill rolls back important insurance reforms, makes coverage less affordable for low income people, and hobbles the Medicaid program.

How the “3 Rs” Contributed to the Success of Medicare Part D

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Opponents of the Affordable Care Act are latching onto the law’s “3Rs” (risk corridors, risk adjustment, and reinsurance) as a “bailout” for insurers. Yet one of the models for the 3Rs is the Medicare Part D drug benefit, where these programs have been working for years to help stabilize premiums. Georgetown University Health Policy Institute’s Jack Hoadley provides some context – and strong evidence that the 3Rs are in place to protect beneficiaries and taxpayers – not bail out health plans.

Update: State Decisions on the Policy Cancellation Fix

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Implementation of the President’s proposed fix for health insurance policy cancellations rests with state officials and insurance companies. In this blog update for The Commonwealth Fund, Kevin Lucia, Katie Keith, and Sabrina Corlette provide the latest on states’ decisions, as well as an accompanying U.S. map.

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.