A provider association has recently heard from member physician offices about patients enrolled in “church plans” in which preventive services, such as child well visits and immunizations, aren’t covered. What are these church plans and why don’t they have to comply with the Affordable Care Act insurance reforms? CHIR’s Sabrina Corlette has some answers.
In the wake of formal complaints that insurers are marketing health plans with discriminatory benefit designs, state insurance regulators are under increasing pressure to subject these plans to greater scrutiny. But with limited resources and manpower, states are feeling squeezed. As part of a Robert Wood Johnson Foundation project to support states with Affordable Care Act implementation, CHIR researchers Kayla Connor and Sally McCarty created a directory of consumer organizations willing to partner with states to conduct plan analyses.
Hard to believe, but open enrollment for 2016 coverage is just four months away. As we get closer to the start of OE 2016 – November 1, 2015 to January 31, 2016 – CHIR’s Sandy Ahn highlights some of the FFM’s approach to redeterminations and re-enrollments.
On July 7 the Senate Health Education Labor and Pensions Committee held a roundtable discussion about challenges and opportunities facing the small business health insurance market. CHIR Senior Research Fellow Sabrina Corlette was invited to join the conversation about the SHOP marketplaces, self-funded plans, the change in the definition of the small group market, and more.
In the wake of the Supreme Court’s decision in King v. Burwell, our colleague at Georgetown University Law Center’s O’Neill Institute, Tim Westmoreland, considers the case. He finds that, for all the accompanying politics and drama, it never passed the laugh test.
The Affordable Care Act’s Summary of Benefits and Coverage – standardized, easy-to-use summaries of health plan benefits got an update last week with new regulations out from the Obama Administration. CHIR’s JoAnn Volk provides an overview – as well as a preview of some likely additional upgrades.
A new report from Georgetown University researchers examines the phenomenon of surprise bills for out-of-network medical services, often called “balance billing.” These unexpected charges can often be significant and cause great stress for patients. Several states have implemented consumer protections, but they take different approaches with varying effectiveness. Jack Hoadley provides the highlights.
There’s been some renewed attention to the status and future of the small business health insurance market, particularly as an Affordable Care Act reform scheduled to go into effect in 2016 could cause some disruption. Last week CHIR researchers contributed to three great new resources to help policymakers and others understand changes in the market and some of the challenges ahead.
The Centers for Medicare and Medicaid Services (CMS) recently released draft regulations governing Medicaid managed care plans. In setting standards for network adequacy, the agency looked to both the Medicare Advantage program and the health insurance marketplaces created under the Affordable Care Act. Sabrina Corlette examines approaches to ensuring adequate plan networks across the three programs.
The Affordable Care Act requires most health plans to cover preventive services without cost sharing and enables consumers to access evidence-based medical care such as cancer screenings and immunizations for children. Implementation of this requirement, however, has raised questions and caused confusion among insurers, providers and consumers. Sandy Ahn reviews the Administration’s most recent guidance on this critical ACA provision, designed to clarify for insurers what they must do to comply and ensure that consumers receive the benefits they are promised under the law.
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.
