Category: CHIR

Idaho Misses Opportunities to Help Consumers Get Affordable, Comprehensive Health Coverage During COVID-19 Pandemic

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Since the COVID-19 pandemic began, states have taken charge of responding to the public health emergency. As a state that runs its own health insurance marketplace, Idaho has tools at its disposal to help consumers enroll in comprehensive coverage. But like the federal marketplace, Idaho decided not to wield all of them, leaving large marketplace enrollment barriers and instead promoting alternative and less comprehensive coverage.

In the Age of COVID-19, Short-Term Plans Fall Short for Consumers

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During February’s State of the Union address, President Trump touted his administration’s efforts to expand access to short-term health plans that do not comply with any of the ACA’s consumer protections. Short-term plans are often cheaper than ACA-compliant plans because they can deny coverage to people and exclude entire categories of services. In a recent post supported by The Commonwealth Fund, we reviewed 12 short-term plans to determine what coverage consumers would have if they needed treatment for COVID-19. We found that consumers in short-term plans are likely to have less financial protections than those enrolled in ACA plans.

COVID-19 Response: States That Run Their Own ACA Marketplace Are Better Positioned to Help Consumers Get Covered

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During the current public health and financial crises brought by the COVID-19 pandemic, the ACA’s health insurance marketplaces offer a crucial safety net. States that run their own marketplaces have a significant advantage in helping consumers obtain comprehensive, affordable health insurance. CHIR’s Rachel Schwab looks at some opportunities for state-based marketplaces that don’t exist for states relying on the federal marketplace.

State-Based Marketplaces Find Value, Potential Opportunity for Growth in Small-Business Offering

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Small businesses have historically struggled to provide coverage to their workers. The ACA sought to address these issues through the Small Business Health Options Program (SHOP), creating marketplaces for small employers to offer coverage to their employees. In a new post for the Commonwealth Fund’s To the Point blog, CHIR experts take a look at ways that state-based marketplaces are investing in their SHOPs, and how some are seeing enrollment growth and savings for small businesses.

Coronavirus Exposes Big Gaps in the U.S. System Of Coverage: What Can States Do to Help?

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The cost of medical care associated with the novel coronavirus can be a barrier for many people who should get tested, raising a public health risk. Given our patchwork quilt system of health insurance coverage and the lack of a timely and comprehensive federal response, CHIR’s Sabrina Corlette and Kevin Lucia consider actions states can take to encourage people to get the care they need.

A Placeholder Won’t Protect People with Pre-Existing Conditions

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President Donald Trump has voiced an “ironclad pledge” to protect patients with pre-existing conditions, but his 2021 budget proposal, which repeats this promise, is silent on how he would do that. At the same time, the Trump administration has taken numerous actions that undermine the Affordable Care Act, including its support of a lawsuit to overturn the ACA and its key protections for people with pre-existing conditions.

Payer-Provider Contract Disputes Dominate Headlines in 2019, With No Signs of Slowing Down

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For several years, we at CHIR have tracked health insurance industry trends by monitoring trade and mass media, Wall Street analyses, earnings, and other reports. In 2019, we observed an increase in reporting on contract disputes between health insurers and providers. These discussions are becoming more contentious as insurers face mounting pressure to rein in health care costs while ensuring consumers’ access to providers. CHIR’s Emily Curran digs into what’s behind the trend and what it means for patients.

The Texas Two-Step: Implementation of State Balance Billing Law Reveals Gaps in Consumer Protections

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In Congress and state legislatures across the country, policymakers are debating fixes to surprise medical bills. The federal government has yet to enact comprehensive reforms, but a number of states have taken steps to protect consumers. One such state is Texas, which last year enacted a new law holding consumers harmless in situations that commonly lead to surprise medical bills. However, the state’s new protections were almost gutted due to an implementation loophole, a cautionary tale for federal and state policymakers. CHIR’s Rachel Schwab takes a look at what happened in Texas.

New Resource for Consumer Advocates on Out-of-Network Payment Disputes in Balance Billing Legislation

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State lawmakers across the country are are gearing up for a new legislative session. Many will be considering state-level protections for consumers to prevent surprise out-of-network medical bills. Just as with the federal legislation, however, one of the key sticking points for state policymakers will be how to approach out-of-network provider reimbursement. To aid stakeholders in these efforts, Community Catalyst teamed up with CHIR experts to create a guide for its health insurance reform toolkit: The Advocate’s Guide to Addressing Out-Of-Network Payment in Surprise Balance Billing Legislation.

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.