Category: Implementing the Affordable Care Act

May Research Roundup: What We’re Reading

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This month, the CHIR team celebrated the end of the school year with new health policy research. For the latest installment of our monthly research roundup, we reviewed studies on access to providers in Medicaid managed care networks, how the Employee Retirement Income Security Act (ERISA) affects state cost containment reforms, and the health coverage implications of the Biden administration’s recent changes to the public charge rule for immigrant communities.

Standards for Provider Network Adequacy in Medicaid and the Marketplaces

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Beginning in 2023, CMS will require QHP provider networks for plans sold on the federal marketplace to meet minimum time-and-distance standards and, beginning in 2024, minimum standards for appointment wait times. CHIR joined with colleagues at the Georgetown Center for Children and Families to examine the new marketplace network adequacy standards and how they compare to Medicaid’s standards.

The Final 2023 Notice of Benefit & Payment Parameters: Implications for States

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The Biden administration is advancing new standards and policies for the Affordable Care Act health insurance marketplaces, including tougher network adequacy oversight, standardized benefit designs, and new requirements for insurance brokers. In her latest Expert Perspective for the State Health & Value Strategies project, CHIR’s Sabrina Corlette reviews provisions that have particular import for state marketplaces and insurance regulators.

State and Federal Policies to Increase Access to Medication Abortion

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A leaked draft of an impending Supreme Court decision has previewed the potential for states to prohibit and even criminalize abortion. Access to abortion has long been a story of the haves and have-nots. Medication abortion can improve access to this basic health care service, but the delivery and coverage of medication abortion are subject to numerous restrictions and requirements, creating multi-faceted obstacles for patients seeking care. CHIR’s Rachel Schwab looks at several policy actions that can reduce barriers to medication abortion.

What Four States Are Doing to Advance Health Equity in Marketplace Insurance Plans

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The implementation of the Affordable Care Act (ACA) led to historic reductions in racial and ethnic disparities related to health insurance coverage. However, equal access to health coverage is not enough to ensure health equity. In their latest issue brief for the Commonwealth Fund, Dania Palanker and Nia Denise Gooding examine how four state-based health insurance marketplaces have acted to reduce health inequity, and outline considerations for other state-based marketplaces developing a health equity strategy.

Congress, Administration Work to Meet Growing Need for Behavioral Health Care

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The need for mental health and substance use disorder services is substantial and growing. One in five adults in the United States, or 53 million people, had a mental illness in 2020, including 14 million adults who had serious mental illness; forty million adults had a substance use disorder. In response to these troubling trends, policymakers are seeking multi-pronged approaches to provide greater access to services that treat and manage mental health and substance use disorders. CHIR’s JoAnn Volk outlines how both Congress and the Biden administration plan to improve access to behavioral health care.

April Research Roundup: What We’re Reading

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April brought us a shower of health policy research, including studies on the implications of the American Rescue Plan Act’s (ARP) enhanced premium tax credits (PTCs) expiring for marketplace beneficiaries, how value-based payment models have fared in the commercial health insurance market, and trends in prices that private health plans pay for hospital care across the United States. We took some time away from checking out the cherry blossoms to dig in.

Fixing the Family Glitch: Federal Rules Aim to Improve Coverage Affordability for Working Families

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Roughly 5 million people are currently unable to access marketplace subsidies due to a flawed interpretation of the Affordable Care Act dubbed the “family glitch.” Last month, the Biden administration proposed new rules, grounded in a revised interpretation of the law, which would increase access to affordable coverage for families of low and moderate-income workers. Karen Davenport looks at the proposed regulatory fix and how it will impact consumers and other health insurance stakeholders.

New Georgetown Report on Medicaid and Marketplace Network Adequacy

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A recently published report from Georgetown’s Center on Health Insurance Reforms and Center for Children & Families finds significant differences in standards for network adequacy between Medicaid and Marketplace plans, as well as gaps in oversight. The authors share several recommendations for protecting enrollees’ timely access to health services.

California’s Marketplace Tries New Tactics to Reduce the Number of Uninsured and Underinsured

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Despite a significant reduction in the uninsured rate over the last decade, millions of people still lack coverage, and many people who have insurance are unable to access care because of high cost sharing. In a new post for the Commonwealth Fund’s To the Point blog, CHIR’s Rachel Schwab, Justin Giovannelli, and Kevin Lucia look at California’s recently adopted strategies to reduce and prevent uninsurance and lower cost barriers to care for marketplace enrollees.

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.