Category: Implementing the Affordable Care Act

Early Signals from Executive Orders and Congressional Budget Proposals Bode Ill for Marketplace Enrollees

The Trump Administration is considering a change that would cut financial assistance for health insurance by removing protections for people whose income increases during the year, potentially resulting in many individuals having to repay the subsidy they received. CHIR’s Karen Davenport discusses what this would mean, specifically for people with incomes below 400% of the poverty level.

December Research Roundup: What We’re Reading

A snowy first week of January gave us plenty of time to read some of the last research from 2024. This month we read about prescription drug pricing and the impacts of rebates on consumers, as well as market shares of Medicare Advantage carriers.

Georgetown CHIR & Association of Health Care Journalists Release Update to Health Insurance Tool

The Association of Health Care Journalists has released an updated, interactive 50-state Media Guide to help journalists navigate the complexities of the U.S. health care system, offering detailed data on health insurance coverage, state policies, and regulatory agencies. Developed in partnership with Georgetown University’s Center on Health Insurance Reforms, the guide includes a national overview, state-level resources, and essential tools for reporting on health coverage and consumer experiences.

HHS’s Competition Officer Offers Healthcare Cost Containment Opportunities for the Trump Administration

The Biden administration has advanced several pro-competition reforms aimed at lowering health care costs and increasing consumer choice, an area of potential alignment with the incoming Trump administration. CHIR’s Kennah Watts discusses competition as a bipartisan policy and what the incoming Trump administration can do to support competitive markets and improve health care affordability.

Biden Administration Proposal to Improve Access to Free Preventive Services Faces Uncertain Future

The Biden Administration has proposed a rule to expand coverage of preventive services, including over-the-counter (OTC) contraceptives, without cost sharing. However, the proposal’s future is uncertain due to potential legal challenges and the political factors surrounding reproductive health. CHIR faculty Leila Sullivan and Amy Killelea discuss the proposal.

Making Financial Assistance Programs Equitable and Accessible

In a recently published JAMA article, CHIR’s Maanasa Kona discusses the steps states can take to improve the financial assistance programs offered by hospitals, as well as the need for better state oversight of hospitals’ eligibility criteria and decision-making.

States Have New Flexibility to Add Adult Dental Care to Essential Health Benefits

The Centers for Medicare & Medicaid Services (CMS) has introduced a new option for states to update their essential health benefits (EHB) benchmark plan to include routine adult dental coverage, aiming to address disparities in oral health outcomes, particularly for low-income and minority adults. In their latest Expert Perspective for the State Health & Value Strategies program, CHIR’s JoAnn Volk and Manatt’s Tara Straw discuss considerations for states weighing this addition.

Advancing Health Care Transparency: A Menu of Options for State Policymakers

Many Americans struggle with high healthcare costs, leading state policymakers to explore transparency measures to lower prices. While transparency alone has limited impact on cost reduction, states are innovating by increasing transparency in areas like provider ownership, billing practices, and price data, which can inform broader policy solutions and have bipartisan support, paving the way for more effective cost-containment strategies. In their latest article for CHIRblog, CHIR experts Stacey Pogue and Nadia Stovicek explore transparency options for state policymakers.

Revisiting Federal Price Transparency Proposals as the End of Congress’ Session Nears

In recent years, federal price transparency rules have required hospitals and health plans to publicly post their prices. However, challenges persist with data access and use, limiting the data’s effectiveness for consumers and policymakers. Two bipartisan bills in Congress seek to strengthen these rules. CHIR experts Stacey Pogue and Nadia Stovicek discuss the federal price transparency landscape in their latest article for CHIRblog.

The Incursion Of Profit-Enhancing Middlemen In US Health Care

The U.S. health care system’s lack of regulation over provider pricing and insurer claims has led to a rise in profit-driven middlemen, such as revenue cycle management firms. While these intermediaries aim to maximize reimbursements for providers, they often increase costs for consumers and complicate access to care. This complex environment underscores the urgent need for regulatory oversight to address the inefficiencies and rising expenses in the system. In their latest piece for Health Affairs Forefront, Linda J. Blumberg and Kennah Watts break down the effect of middlemen on US health care.

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.