Category: CHIR

How Oregon’s Merger Review Law Combats Consolidation and What Other States Can Learn From It

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Since the early 1990s, health care provider consolidation in states like Oregon has led to higher prices, reduced access, and worsened health inequities. In response, Oregon established the Health Care Market Oversight Program in 2022 to review major health care transactions, aiming to ensure they reduce costs and improve care access, especially for underserved populations. While the program has approved most transactions so far, concerns about transparency, resource adequacy, and high profit thresholds for review persist. CHIR’s Nadia Stovicek discusses the need for ongoing evaluation and improvement, and how other states can learn from Oregon.

August Research Roundup: What We’re Reading

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More hot days mean more hot research! This month we read about the growing divergence between Medicare Advantage bids and payments, the impact of enhanced premium tax credits by race and ethnicity, and about how narrow or broad ACA marketplace physician networks really are.

Taking a Look at California’s Program to Assist People Losing Medi-Cal Enroll in Marketplace Coverage

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A recently enacted law creates a streamlined pathway to health insurance for individuals who are found ineligible for Medi-Cal but are likely eligible for Marketplace subsidies. In a recent report, CHIR experts assess the critical policy and operational decisions to implement the program and how these choices have affected consumers’ coverage transitions.

Unpacking the Unwinding: Medicaid to Marketplace Coverage Transitions

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As Medicaid unwinding draws to a close, millions of people have had to find new health coverage options, many of them through the Affordable Care Act (ACA) Marketplaces. Emma Walsh-Alker discusses what we know about how they have fared, and whether state efforts to smooth coverage transitions have been successful.

Biden Administration Proposes Rule To Ban Medical Debt From Credit Reporting

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In response to widespread concerns about the impact of medical debt, the Consumer Financial Protection Bureau (CFPB) proposed a rule in June 2024 aimed at limiting the influence of medical debt on credit reports and preventing certain debt collection practices. Despite recent changes by credit agencies to exclude small medical debts from reports, many Americans still face significant medical debt, particularly affecting vulnerable populations. In a recent piece for Health Affairs Forefront, Georgetown experts examine this proposed rule and the effect it could have on consumers.

Enforcing Mental Health Parity: State Options to Improve Access to Care

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The 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) is the primary federal law protecting access to behavioral health care for privately insured Americans. In a new issue brief for the Commonwealth Fund, CHIR experts interviewed insurance regulators in ten states to identify the tools state regulators are using for MHPAEA oversight and enforcement, as well as the barriers they are facing.

July Research Roundup: What We’re Reading

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Last month CHIR stayed cool indoors to catch up on the latest in health policy research. In July, we read studies that assessed policies to increase insurance coverage rates and forecasted insurance coverage and health expenditures for the next decade.

New Georgetown CHIR Report Examines State Reforms of Prior Authorization

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Health insurers use of prior authorization appears to be on the rise. A recent report by CHIR researchers examines four states’ prior authorization policies for the commercial market to identify potential reform strategies to ease provider burden and improve patient access without also increasing insurers’ costs.

State And Federal Efforts To Improve Ownership Transparency

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While there is some movement toward improved health care provider ownership transparency at the federal level and in some states, more attention is warranted given increasingly complex and obscured provider ownership structures and the impact they can have on health care prices, access, and quality. In a recent piece for Health Affairs Forefront, CHIR experts Stacey Pogue and Nadia Stovicek analyze efforts to improve ownership transparency at the state and federal levels.

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.