Category: CHIR

The No Surprises Act Interim Final Rule on Dispute Resolution, Uninsured Protections, and External Review: Implications for States

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Last month, the Biden administration published a third rule implementing the No Surprises Act, the comprehensive federal law banning balance bills in emergency and certain non-emergency settings beginning January 1, 2022. The interim final rule (IFR) provides details on the independent dispute resolution process, protections for uninsured patients, and more. In a new Expert Perspective for the Robert Wood Johnson Foundation’s State Health & Value Strategies program, CHIR experts provide a summary of the IFR, identifying implications and considerations for states.

The Pandemic Exacerbated Gaps in Mental Health Care Access, but State and Federal Enforcement of Parity Requirements Can Help Improve Coverage

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The COVID-19 pandemic has brought about a greater need for mental health and substance use disorder (MH/SUD) services, but many have difficulty obtaining timely, affordable care, including the insured. The Mental Health Parity and Addiction Equity Act (MHPAEA) requires plans and insurers that cover MH/SUD services to cover those services in parity with other medical benefits. CHIR’s JoAnn Volk looks at state and federal enforcement of mental health parity requirements, and what these efforts mean for consumers.

Navigator Guide FAQs of the Week: Who is Eligible for Marketplace Coverage?

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Open Enrollment is underway, and our newly updated Navigator Resource Guide can help Navigators and consumers throughout the entire enrollment process. During Open Enrollment, CHIR will highlight FAQs that are likely top of mind for consumers and those assisting them. This week, CHIR’s Emma Walsh-Alker focuses on who is eligible for marketplace coverage.

Three New State-Based Marketplaces are Up and Running

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We’re a week into Affordable Care Act marketplace open enrollment, and it looks like the three newest state-based marketplaces, Kentucky, Maine, and New Mexico, are off to a solid start. The transition away from the federal marketplace, HealthCare.gov, has taken time, effort, and an up-front investment in the new state-run platforms and other SBM infrastructure. CHIR’s Rachel Swindle takes a look at some of the challenges and opportunities for states running their own marketplaces.

October Research Roundup: What We’re Reading

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In our newest monthly roundup of health policy research, CHIR intern Madison Berry reviews studies evaluating the impact of extending the American Rescue Plan’s subsidy expansion, COVID-19’s effect on health spending, and the importance of continuous marketplace coverage for pregnant people.

Misleading Marketing of Non-ACA Health Plans Continued During COVID-19 Special Enrollment Period

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Millions of Americans are eligible for health insurance plans with low or no premiums and significantly reduced cost-sharing this coming open enrollment, but misleading marketing practices may direct some consumers to alternative plans that lack the Affordable Care Act’s protections. Researchers at CHIR recently replicated a previous secret shopper study to determine if consumers shopping for comprehensive coverage during the COVID-19 special enrollment period were still being directed to these alternative plans.

What’s New for 2022 Marketplace Enrollment?

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Open Enrollment is just around the corner. There are new policies for the marketplace in 2022, including an expansion of opportunities to sign up for health coverage during and outside the annual open enrollment period. As a preview to our updated Navigator Resource Guide, CHIR provides a summary of some changes that may affect people enrolling in marketplace plans.

COVID “Long Haulers” Can Carry Additional Burden of Getting Insurers to Cover Care

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COVID-19 survivors may experience new symptoms well after their initial infection. Health systems offer these patients help with managing their conditions, but COVID-19 is a novel disease, and research demonstrating effectiveness of treatments for many post-COVID conditions is sparse. Karen Davenport takes a look at some of insurance implications of the dearth of information on “long COVID.”

State-Based Marketplaces Eye Health Equity, Expanding Enrollment Under New Federal Grants

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Last month, the Centers for Medicare & Medicaid Services announced $20 million in grant funding for the 21 state-based marketplaces (SBM). The federal funding, allocated under the American Rescue Plan, will allow SBMs to modernize their technology platforms, outreach programs, and other systems and operations to ensure compliance with federal requirements, including the temporary expansion of marketplace subsidies. CHIR’s Rachel Schwab takes a look at some of the initiatives SBMs are planning with the new grant funding.

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.