The Texas Medical Association recently issued a warning to consumers about the risks of health care sharing ministries, noting an increase in calls about these coverage arrangements. Recent CHIR research documents the increased marketing of this coverage to insurance brokers and consumers, as well as the lack of state-level insurance oversight.
Value-based payment models are promoted as a way to transform our health care system from one that rewards value rather than the volume of health care services delivered. These models require providers to accept the risk of financial losses should spending on patients in their care exceed targeted levels. A new brief from State Health and Value Strategies, authored by researchers at Bailit Health and CHIR, explores potential state approaches to oversight of provider organizations that accept financial risk.
When Congress repealed the individual mandate’s financial penalty, some states acted quickly to protect their markets from deterioration. A handful of state legislatures and the Council of the District of Columbia considered or enacted legislation creating a state-based coverage requirement. While many states faced political hurdles and unforgiving timelines in enacting their own mandates, D.C. now has an additional obstacle: the U.S. Congress.
Health policy researchers are keeping busy, assessing the impact of recent and potential state and federal actions. CHIR’s Olivia Hoppe digs into new research on how interruptions in insurance coverage impact chronic disease management, the debate over the Affordable Care Act’s (ACA) employer mandate, the innovative ways that California is keeping its risk pool healthy, characteristics of the uninsured in the U.S., and the coverage and premium effects of state-based individual mandates.
Last week, the Trump administration issued a final rule reversing federal limits on short-term health coverage, allowing such plans to become a long-term alternative to individual market coverage. On the eve of this policy shift, we surveyed Departments of Insurance in the seventeen state-based marketplace states to better understand their short-term markets. We found that most states do not have a complete picture of which insurers are marketing short-term policies in their state.
The Trump administration has finalized a new federal definition of short-term, limited duration insurance. In a new post for the State Health & Value Strategies project, CHIR’s Sabrina Corlette summarizes the final rule and outlines the policy and regulatory options for states wishing to protect consumers and stabilize their insurance markets.
Any day now, the Trump administration is expected to publish new rules that will expand access to short-term, limited duration insurance (STLDI). These plans are allowed to discriminate against sick people, exclude coverage of essential health services, and impose lifetime and annual benefit limits. The Congressional Budget Office (CBO) says that the majority of plans expanded under this rule will be considered health insurance. CHIR’s Rachel Schwab takes a closer look at how CBO defines health insurance, and explains how the expansion of STLDI could lead to widespread underinsurance.
The Centers for Medicare and Medicaid Services announced on July 10, 2018 that they would fund up to $10 million for Navigator programs in the 34 federally facilitated marketplace states in 2018, an over 80 percent cut from the program’s original funding. CMS is also encouraging applicants to educate consumers about plans that don’t meet Affordable Care Act standards. CHIR’s Olivia Hoppe explains the effects these changes could have on consumers and the market.
On July 11, the full House Ways and Means Committee approved multiple health-related tax bills, many of which would expand tax breaks for Health Savings Accounts (HSAs). As Georgetown Center for Children and Families’ Edwin Park explains, these HSA bills would primarily benefit those with high incomes, rather than make health coverage more affordable for low- and moderate-income children and families.
The Trump administration recently decided to suspend payments under an obscure Affordable Care Act program called risk adjustment. The issue is technical and full of jargon, but at bottom it’s about undermining protections for people with pre-existing conditions. CHIR’s Sabrina Corlette explains why.
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.
