Category: CHIR
Massachusetts Data on Health Care Sharing Ministries Reveal Finances That Put Consumers at Risk
Health Care Sharing Ministries (HCSM) continue to be marketed widely, often as an alternative to the Affordable Care Act’s marketplace plans, even though HCSMs don’t follow the same rules and typically don’t provide the same protections. There is a dearth of data on HCSM operations and finances, but a Massachusetts rule has offered a glimpse behind the curtain. In a new post for the Commonwealth Fund, JoAnn Volk, Justin Giovannelli, and Christina Goe dig into new data on HCSMs.
Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces
After the Biden administration issued the proposed 2023 “Notice of Benefit and Payment Parameters,” several hundred stakeholders provided feedback on the new set of rules governing the ACA’s marketplaces and health insurance standards. To better understand the impact of the proposed rules, CHIR reviewed a sample of stakeholder comments. For the third blog in our series, Rachel Schwab summarizes comments submitted by state departments of insurance and state-based marketplaces.
Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: Consumer Advocates
In the recently released 2023 “Notice of Benefit & Payment Parameters,” the Biden administration is proposing significant changes to the Affordable Care Act marketplaces. In the first of a three-part series, CHIR’s Emma Walsh-Alker and JoAnn Volk reviewed public comments from multiple consumer advocacy organizations about the impact of the new policies on marketplace beneficiaries. Reviews of comments from insurers and state marketplaces and insurance departments will follow.
New Data Show Medical Debt Disproportionately Affects the Most Vulnerable Populations
Unpaid medical bills are among the largest contributors to personal debt in the United States. Evidence indicates that medical debt disproportionately affects people of color and individuals with lower incomes. CHIR’s Maanasa Kona reviews new data from the Census Bureau and state court records that demonstrate the disparate impact of medical debt on vulnerable populations, and explores what policymakers can do to protect consumers from aggressive debt collection.
Questionable Quality Improvement Expenses Drive Proposed Changes to Medical Loss Ratio Reporting
Under the Affordable Care Act, insurers must provide rebates to enrollees when their spending on clinical services and quality improvement, as a proportion of premium dollars, falls below a minimum threshold. Federal regulators have discovered some insurers are gaming the system by misallocating expenses or inflating their spending on providers. Karen Davenport takes a look at how this practice impacts consumers, and explains a new federal proposal to crack down on it.
New CHIR Report Assesses the Effectiveness of Policies in Improving Access to Primary Care for Underserved Populations
It is hard to overstate the importance of primary care in ensuring robust health outcomes at the population level. In a new report supported by the National Institute for Health Care Reform, CHIR experts reviewed research to assess whether policy initiatives targeting primary care access have been effective in reducing health care disparities.
January Research Roundup: What We’re Reading
In our newest monthly roundup of health policy research, CHIR’s Emma Walsh-Alker reviews studies on the potential of personalized phone outreach to boost marketplace enrollment, trends in the small-group health insurance market, and the Congressional Budget Office’s latest report comparing how much commercial insurers and Medicare pay for health services.
Oregon’s Public Option Implementation Report Emphasizes Cost Containment, Health Equity
The Oregon Health Authority recently released its Public Option Implementation Report, stemming from a legislative directive to develop a plan to make a public health insurance option available in the individual (and potentially small group) market. CHIR’s Christine Monahan takes a look at what’s in the new report and what’s next for the Oregon public option initiative.
Tackling “Analysis Paralysis”: New Federal Proposal Would Bring Standardized Benefit Design Back to the Federally Facilitated Marketplace
The Affordable Care Act’s health insurance marketplaces and consumer protections significantly improved the experience of purchasing individual health insurance, but consumers still face the difficult task of comparing a potentially overwhelming number of complicated benefit and network designs. A proposal in the Notice of Benefits and Payment Parameters for 2023 may improve this situation. Karen Davenport takes a look at the possible return of standardized plans to the federal marketplace, and what this change might mean for consumers.