The U.S. House of Representatives Education and Workforce Health Subcommittee held a hearing on health care costs, competition, and transparency. CHIR’s Christine Monahan testified before the committee regarding consolidation in health care markets.
April showers bring May flowers, and May was abloom with health policy research. Last month, we read about the impact of ending pandemic-related coverage policies, consumer awareness of the resumption of Medicaid renewals, and approaches to tackling rising health care costs in commercial health insurance markets.
The Affordable Care Act established health insurance Marketplaces to facilitate enrollment in comprehensive and affordable health insurance. Most states rely on the federal government to run their Marketplace, but recently, several states have expressed interest in taking over Marketplace operations. With Marketplace enrollment at an all-time high, and millions more people poised to transition from Medicaid to commercial insurance, the role of the Marketplaces as a coverage safety net has never been more pivotal. But federal rules impose few standards for states launching and maintaining a Marketplace. It may be time for the federal government to establish a stronger federal floor.
For our monthly research roundup, we reviewed studies on a public option proposal for California, how personalized outreach can increase enrollment in affordable Marketplace plans, and recent trends in Marketplace premiums and insurer participation.
Washington, Colorado, and Nevada are partnering with private health insurance carriers to offer new “public option” plans. In a post for the Commonwealth Fund’s To the Point blog, CHIR’s Christine Monahan and Madeline O’Brien compare state approaches to selecting insurance carriers to offer the new state plans.
Winter is finally over, and health policy research is in full bloom. In March, we read about disparities in health insurance coverage for people of color, medical debt, and preventive service usage among private health plan enrollees.
Under the No Surprises Act, consumers are held harmless beyond in-network cost sharing when they receive certain kinds of out-of-network care. In these scenarios, to determine the provider’s payment, payers and providers may enter independent dispute resolution (IDR). Recently, federal agencies released an initial report on the No Surprises Act’s IDR process. In a post for Health Affairs Forefront, CHIR experts Jack Hoadley and Kevin Lucia analyze the new report and discuss what it suggests about the No Surprises Act.
At the end of March, a federal judge in Texas partially invalidated one of the ACA’s most popular provisions—the requirement to cover a set of preventive services without cost sharing. In a recent post for the Commonwealth Fund’s To the Point blog, CHIR experts break down the recent decision and how it will impact access to care.
President Biden released his Fiscal Year 2024 budget earlier this month, outlining the administration’s spending and policy priorities for a number of key programs, including the Affordable Care Act (ACA) Marketplaces. However, with a sharply divided Congress, consumers who rely on Medicaid and the ACA’s Marketplaces are likely in the crosshairs of an upcoming spending showdown. CHIR’s Emma Walsh-Alker examines the potential impact of cutbacks to the ACA’s Marketplace subsidies on low- and moderate-income families.
Nearly half of U.S. residents are enrolled in employer-sponsored health insurance. Many of these plans use third-party administrators (TPAs), intermediaries—frequently insurance companies themselves—that help build provider networks, design benefit packages, and adjudicate claims, among other responsibilities. But a TPA’s interests may not align with those of their employer clients. CHIR’s Christine Monahan highlights several examples of questionable insurer-TPA practices uncovered in recent years.
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.
