Implementing the Affordable Care Act

Georgetown Experts Help States Weigh Solutions to Protect Consumers from Unexpected Medical Bills

Posted December 4, 2015 by CHIR Faculty

As reports of patient encounters with unexpected provider bills continue to make headlines, state and federal policymakers are working to find solutions to the problem of surprise out-of-network billing. A recent Georgetown report on the issue caught the eye of two states – Pennsylvania and Florida – that are attempting to set new standards to protect consumers from balance bills. CHIR’s Ashley Williams shares a summary of what these states heard from our report’s lead authors.

No QHPs Comparable to CHIP, Says (Delayed) HHS Certification

Posted December 2, 2015 by CHIR Faculty

The U.S. Department of Health and Human Services has finally released a long-awaited study comparing coverage in CHIP plans to qualified health plans offered through the Affordable Care Act marketplaces. Our colleague from Georgetown University’s Center for Children and Families, Elisabeth Wright Burak, takes a look and shares the (not altogether surprising) findings.

Filing Fee and External Appeals

Posted November 30, 2015 by CHIR Faculty

One of the most significant consumer protections in the Affordable Care Act (ACA) is the right to appeal a denied claim, including the right to take your appeal to an independent, third-party reviewer. Although the ACA guarantees this right, recent federal rules have codified barriers to the process that still exist in some states, such as filing fees. Sandy Ahn provides a short summary of this issue.

Feds Propose Changes – and an Expanded Role – for Marketplace Navigators

Posted November 23, 2015 by

A new proposed rule from the Obama Administration contains wide-ranging new requirements for insurance companies and marketplaces under the Affordable Care Act, including changes that expand the role of marketplace navigators. CHIR’s Sabrina Corlette shares some highlights.

Shop to Renew During Open Enrollment

Posted November 12, 2015 by CHIR Faculty

While many consumers with marketplace coverage will be eligible for automatic renewal, there are many reasons for all consumers to shop to renew this year. For example, price changes to health plans as well as changes to the health plans themselves will impact the amount of premium tax credits and coverage for many consumers. We go over the reasons why all consumers should shop to renew this open enrollment.

Open Enrollment Begins, Kinks in the Cost Calculator Tool on Healthcare.gov and Other OE News

Posted November 3, 2015 by CHIR Faculty

Open Enrollment 3 (OE3) is now underway and by all accounts, things are going smoothly. There are a few minor kinks with the out-of-pocket cost calculator, which officials have fixed or are working on fixing now. CHIR highlights two consumer facing tools that healthcare.gov is pilot testing and should be available to all users before the end of open enrollment.

Updated Navigator Resource Guide

Posted October 28, 2015 by CHIR Faculty

CHIR is pleased to release an updated online Navigator Guide on Private Health Insurance and Health Insurance Marketplaces with searchable frequently asked questions (FAQs) and easy-to-read background information on key health insurance and marketplace issues. With Open Enrollment just a few days away, get your Guide on!

Wondering What Marketplace Rate Increases Mean for Consumers?

Posted October 27, 2015 by CHIR Faculty

The third open enrollment season for the Affordable Care Act’s health insurance marketplaces begins on Sunday, November 1. The administration has released new data showing average health plan rate changes, with an average increase nationwide of 7.5 percent compared to 2015. Our colleague Tricia Brooks breaks down what these rate changes mean for consumers.

NAIC Wraps Up Recommended Changes to the Summary of Benefits and Coverage

Posted October 26, 2015 by JoAnn Volk

The National Association of Insurance Commissioners wrapped up work on recommended changes to the Summary of Benefits and Coverage. JoAnn Volk provides an update on what some of those changes are and how consumers may benefit.

Accessing Provider Directories and Formularies: CHIR Goes Sleuthing

Posted October 23, 2015 by CHIR Faculty

We’re counting down again to Open Enrollment 3 and this year, all health plans must make accessing provider directories and formularies, or the list of covered prescription drugs, easy for consumers. This means consumers should be able to find this information on insurer website sites without creating an account or entering a policy number. CHIR’s Sandy Ahn flexes her investigative skills and looks to see how accessible this information really is.