Author Archive: Rachel Schwab

A Fixer Upper: Washington State Enacts Legislation to Boost its Public Option

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Washington State enacted a first-of-its-kind public option, with the state-procured plans available beginning in 2020. But the inaugural year yielded underwhelming results, with fewer than 2,000 people enrolled in the plans and premiums that were on average higher than the prior year’s rates. After identifying several barriers to the program’s success, Washington enacted legislation this year to bolster the state’s public option.

Removing Roadblocks: Special Enrollment Period Data Show Increase in Marketplace Signups

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Last month, the Biden administration established a temporary special enrollment period (SEP) on the federal health insurance marketplace in response to the ongoing COVID-19 pandemic. In the first two weeks of the SEP, the federal marketplace saw a rise in enrollment activity, and the expansion of premium subsidies under the American Rescue Plan is expected to generate even greater enrollment increases. CHIR’s Rachel Schwab takes a look at how recent federal actions tap into the Affordable Care Act’s potential and expand its reach.

Stakeholder Perspectives on CMS’s 2022 Notice of Benefit and Payment Parameters. Part 2: State Insurance Departments and Marketplaces

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In one of the Trump administration’s last acts, the Centers for Medicare and Medicaid Services finalized some of the major provisions of the 2022 Notice of Benefit and Payment Parameters. In the second part of our blog series reviewing stakeholder comments, CHIR’s Rachel Schwab takes a look at how state insurance departments and state-based marketplaces responded to some of the recently finalized proposals.

The Congressional Budget Office Definition of “Health Insurance” Leaves Room for Wide Coverage Gaps, Discrimination

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The nonpartisan Congressional Budget Office (CBO) frequently estimates how policy proposals will affect rates of health insurance coverage. To make these assessments, the agency relies on a definition including coverage that can discriminate against people with pre-existing conditions and fail to cover key health services like prescription drugs, practices that are outlawed in the individual health insurance market under the ACA. CHIR’s Rachel Schwab takes a look at the CBO’s current definition of health insurance, and the impact it has on health insurance reform efforts.

Labor Day in a Pandemic: The Varnish of “Gold Standard” Employer Coverage is Wearing Thin

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CHIRblog took a break for Labor Day, but in light of the holiday, we continue to think about problems workers face getting access to affordable health insurance. Employer plans are often touted as the “gold standard” in health insurance. But millions of workers with job-based plans are underinsured, facing high cost sharing and premiums, and the COVID-19 pandemic is exacerbating problems with inadequate coverage as well as insurance access.

One Victim of the COVID-19 Pandemic? State Health Policy

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State legislative sessions are typically a flurry of health policy activity. In recent years, state lawmakers have taken action to stabilize their insurance markets and increase access to coverage. But like so many other constants we have come to rely on, state legislative sessions took a hit this year from the novel coronavirus pandemic, putting current and future state policy initiatives in jeopardy.

Idaho Misses Opportunities to Help Consumers Get Affordable, Comprehensive Health Coverage During COVID-19 Pandemic

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Since the COVID-19 pandemic began, states have taken charge of responding to the public health emergency. As a state that runs its own health insurance marketplace, Idaho has tools at its disposal to help consumers enroll in comprehensive coverage. But like the federal marketplace, Idaho decided not to wield all of them, leaving large marketplace enrollment barriers and instead promoting alternative and less comprehensive coverage.

COVID-19 Response: States That Run Their Own ACA Marketplace Are Better Positioned to Help Consumers Get Covered

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During the current public health and financial crises brought by the COVID-19 pandemic, the ACA’s health insurance marketplaces offer a crucial safety net. States that run their own marketplaces have a significant advantage in helping consumers obtain comprehensive, affordable health insurance. CHIR’s Rachel Schwab looks at some opportunities for state-based marketplaces that don’t exist for states relying on the federal marketplace.

A Placeholder Won’t Protect People with Pre-Existing Conditions

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President Donald Trump has voiced an “ironclad pledge” to protect patients with pre-existing conditions, but his 2021 budget proposal, which repeats this promise, is silent on how he would do that. At the same time, the Trump administration has taken numerous actions that undermine the Affordable Care Act, including its support of a lawsuit to overturn the ACA and its key protections for people with pre-existing conditions.

The Texas Two-Step: Implementation of State Balance Billing Law Reveals Gaps in Consumer Protections

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In Congress and state legislatures across the country, policymakers are debating fixes to surprise medical bills. The federal government has yet to enact comprehensive reforms, but a number of states have taken steps to protect consumers. One such state is Texas, which last year enacted a new law holding consumers harmless in situations that commonly lead to surprise medical bills. However, the state’s new protections were almost gutted due to an implementation loophole, a cautionary tale for federal and state policymakers. CHIR’s Rachel Schwab takes a look at what happened in Texas.

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.