SHOP marketplaces promise small employers features they say they want but typically have not been able to obtain, such as the ability to give their employees a greater choice of plans and make a predictable contribution towards coverage. In a new issue brief for The Commonwealth Fund, CHIR faculty examine the design decisions states have made to add value for small employers in their SHOP marketplaces.
CHIR faculty Sally McCarty, David Cusano, and Max Farris serve as technical assistance professionals (TAPS) in the Robert Wood Johnson Foundation State Health Reform Assistance Network. In that capacity, they have developed the Consumer Services Toolkit to help assure that consumer service representatives in state insurance departments have critical information about the Affordable Care Act at their fingertips. Sally McCarty introduces the toolkit and its components.
One challenging question for families as they enroll in health insurance coverage on the new Marketplaces is what to do about kids’ dental coverage. Our colleague at Georgetown’s Center for Children and Families, Joe Touschner, has the skinny and links to some helpful resources to better understand this complex policy area – and how things might change for 2015.
While we’re struggling with Affordable Care Act (ACA) issues, there’s value in taking the time to look back and appreciate the impact of the ACA and other healthcare reforms implemented over the past few decades. To that end, former insurance commissioner and health insurance company executive Sally McCarty begins a series of blogs that compare the healthcare coverage landscape before and after reform. The series is called “Back in the Day – Lessons from Pre-reform Days,” and begins with a look at narrow networks.
Blue Cross Blue Shield of Mississippi has included a new provision in its plan description that could mean huge costs for plan participants. The new policy does not cover prescription drugs prescribed by out-of-network providers. How does this policy square with the ACA? And what does it mean for consumers? Elissa Dines discusses.
There are reports that at least some formerly reluctant states are thinking of moving from a federally facilitated to a state-based health insurance marketplace. Our colleague at Georgetown’s Center for Children and Families, Sonya Schwartz, walks us through what states need to do to make the transition.
In January, a federal court in Missouri became the first to rule on whether states have the legal authority to restrict the work of the Affordable Care Act’s consumer assistance “navigators.” In a new post for The Commonwealth Fund, Justin Giovannelli, Kevin Lucia, and Sabrina Corlette discuss the decision and explore its significance for Missouri and the other states that have adopted restrictions on navigators and consumer assisters.
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.
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.
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.
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.
