Implementing the Affordable Care Act

Consumer Services ACA Toolkit

Posted March 21, 2014 by CHIR Faculty

CHIR faculty Sally McCarty, David Cusano, and Max Farris serve as technical assistance professionals (TAPS) in the Robert Wood Johnson Foundation State Health Reform Assistance Network. In that capacity, they have developed the Consumer Services Toolkit to help assure that consumer service representatives in state insurance departments have critical information about the Affordable Care Act at their fingertips. Sally McCarty introduces the toolkit and its components.

Update on Fixed Indemnity Insurance: No Longer an ACA Loophole?

Posted March 19, 2014 by

In recent rulemaking, the Obama administration attempts to close a potential loophole in the Affordable Care Act – the sale of fixed indemnity insurance policies marketed to look like health insurance but leaving consumers without the same protections. Sabrina Corlette takes a look at the proposal and what it might mean for consumers.

HHS Proposes to Preempt Some State Navigator Laws; Lays Out Federal Enforcement Framework

Posted March 17, 2014 by

In a proposed regulation released Friday, March 14, the U.S. Department of Health and Human Services drew a line in the sand for states with laws restricting the ability of Navigators and consumer assisters to perform the jobs required of them under the ACA. Sabrina Corlette has an overview of the proposed rules and what they mean for Navigators and for states.

Shifting into Post-Enrollment Issues: Fielding New Questions from Consumers

Posted March 17, 2014 by JoAnn Volk

As we approach the end of open enrollment into new coverage options under the Affordable Care Act, many consumers have questions about their new health plans – what benefits are covered, what doctors are included in their networks, and what to do if there’s a problem. JoAnn Volk has them covered, with a series of frequently asked questions about post-enrollment issues, excerpted from our Navigator Resource Guide.

Time for a Dental Check Up

Posted March 14, 2014 by CHIR Faculty

One challenging question for families as they enroll in health insurance coverage on the new Marketplaces is what to do about kids’ dental coverage. Our colleague at Georgetown’s Center for Children and Families, Joe Touschner, has the skinny and links to some helpful resources to better understand this complex policy area – and how things might change for 2015.

New Medical Loss Ratio Policy Means Consumers Will Receive Less in Rebates – But That’s OK

Posted March 12, 2014 by

The Obama administration is proposing to provide insurers with temporary relief from an Affordable Care Act requirement that they maintain a minimum medical loss ratio (MLR). This could mean that consumers will receive lower rebates than they otherwise would. Sabrina Corlette examines the thinking behind the decision.

Back in the Day — Lessons Learned from Pre-reform Days: Going “Old School” with Narrow Networks

Posted March 10, 2014 by CHIR Faculty

While we’re struggling with Affordable Care Act (ACA) issues, there’s value in taking the time to look back and appreciate the impact of the ACA and other healthcare reforms implemented over the past few decades. To that end, former insurance commissioner and health insurance company executive Sally McCarty begins a series of blogs that compare the healthcare coverage landscape before and after reform. The series is called “Back in the Day – Lessons from Pre-reform Days,” and begins with a look at narrow networks.

READ THE FINE PRINT: A New Provision in BCBS of Mississippi Plan Could Mean Huge Unexpected Costs for Plan Enrollees

Posted March 7, 2014 by CHIR Faculty

Blue Cross Blue Shield of Mississippi has included a new provision in its plan description that could mean huge costs for plan participants. The new policy does not cover prescription drugs prescribed by out-of-network providers. How does this policy square with the ACA? And what does it mean for consumers? Elissa Dines discusses.

Help for Consumers Who Faced Marketplace Glitches

Posted March 3, 2014 by

The Obama administration recently announced that the health insurance Marketplaces can offer consumers retroactive coverage and financial assistance, if technical problems prevented them from enrolling. But the administration’s guidance also leaves some unanswered questions. Sabrina Corlette takes a look and helps us understand what the new policy actually means for consumers.

Getting the most from your benefits: the ACA gives consumers new right to appeal a health plan denial

Posted February 28, 2014 by JoAnn Volk

The ACA established new appeal rights for consumers facing a denial of a benefit or service from their health plan. As consumers start to use their new Marketplace coverage, JoAnn Volk takes a look at the health plan appeals process required of all new plans, and what these new rights mean for patients.