Category: Implementing the Affordable Care Act
Do Nothing to Renew or Get an Updated Eligibility Determination? CMS Puts out Final Marketplace Renewal Rules

Last week the federal Centers for Medicare and Medicaid Services (CMS) published final rules for the health insurance marketplaces and participating insurers to renew consumers into coverage for 2015. Our colleague from Georgetown’s Center for Children and Families, Tricia Brooks, discusses what the rule means for consumers and their families.
Reforming State Regulation of Provider Networks: Efforts at the NAIC to Re-draft a Model State Law

Almost two decades ago, the National Association of Insurance Commissioners (NAIC) adopted a model state law to regulate the adequacy of health plan provider networks. In the wake of consumer and provider concerns about narrow networks, the NAIC is revising the model law. Sabrina Corlette shares an update on their process and timing.
Consumer Assistance: Getting the Most Out of Limited Resources

While open enrollment is less than three months away, consumer assisters will have to do more with less. Resources will be limited, even though the Congressional Budget Office projects more than 5 million more people will enroll through a marketplace. CHIR’s Sandy Ahn examines support from the state and federal marketplaces for consumer assistance funding.
New Issue Brief Examines Specialty Drugs in Tiered Pharmacy Benefit Structures

Health plans have been increasingly using tiered pharmacy benefit designs. These new designs raise challenges for consumers and the state insurance regulators responsible for reviewing and approving plans for sale. CHIR faculty members Sally McCarty and David Cusano explore these issues in a new brief for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network.
CHIR Launches First in Video Series: Coffee Conversations on Timely Health Insurance Topics

We at the Center on Health Insurance Reforms are excited to share the first of an upcoming video series on timely health insurance topics. In our debut video, CHIR experts Sabrina Corlette, JoAnn Volk, and Dave Cusano provide a preview of upcoming action at the National Association of Insurance Commissioners’ (NAIC) national meeting to address concerns about network adequacy of health plans offered through the new health insurance Marketplaces.
After Halbig: Considerations for States Revisiting the Option to Establish a State-Based Marketplace

A federal appeals court’s ruling that premium subsidies aren’t available for consumers who purchase health coverage through one of the ACA’s federally run insurance marketplaces could have drastic consequences. But policymakers in the 34 states with a federal marketplace have options for protecting their residents. In one of CHIR’s blogs for the Commonwealth Fund, Kevin Lucia and Justin Giovannelli discuss those options here.
Summing Up Questions from Navigators: A Grab Bag of Consumer Queries

Though open enrollment into the new health insurance marketplaces is a distant memory and folks are gearing up for round 2 later this year, consumers continue to turn to Navigators and other assisters with questions. JoAnn Volk shares – and provides answers to – a selection of questions we’ve been getting from the field.
Decoding 2015 Health Insurance Rate Increase Requests

“The rates are coming, the rates are coming.” The release of 2015 health insurance premium rates provides new fodder for the latest pronouncements on the success or failure of the Affordable Care Act. In a blog post originally published by the Health Affairs blog, Christopher Koller and Sabrina Corlette decode what’s happening with insurers’ 2015 rate requests and why.
All Enrollees Should Contact the Marketplace at Renewal

We’re about 110 days away from open enrollment into coverage for 2015. In recent guidance, CMS has revealed its plans for plan renewals and eligibility re-determinations for people enrolled in plans through the marketplaces. Our Georgetown colleague Tricia Brooks takes a look at the envisioned process and some of the benefits – and pitfalls – for consumers.