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.
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.
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.
The individual health insurance markets of most states are stable but face ongoing challenges. In a new work for The Commonwealth Fund, Justin Giovannelli, JoAnn Volk, and Kevin Lucia examine state efforts to address the affordability of comprehensive individual market coverage.
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.
Last month, health insurers reported on their third-quarter (Q3) financial earnings, offering insights on their yearly performance to date and commenting on the market and regulatory challenges they see ahead. CHIR reviewed the quarterly filings and earnings call transcripts for seven publicly traded health insurers, and found that many continue to experience financial stability in the individual market and are closely monitoring major policy changes that could have an impact on their businesses moving forward.
It’s that time of year again. Our team at CHIR is heading far and wide for Thanksgiving, and as we gather around different tables, we’ll be sure to give thanks. One thing on our minds this season is our gratitude for the ongoing insurance protections provided by the Affordable Care Act. CHIR’s Rachel Schwab highlights some of the reforms we’re grateful for.
With Open Enrollment now underway, consumers are weighing their options for 2020 and trying to find the right plan that meets their health needs. As consumers make their decision, it is important for them to understand what they are buying and what coverage their plan provides. This week we answer four questions about marketplace plans’ coverage standards.
Open Enrollment is in full swing in all 50 states and Washington, DC. As consumers consider their coverage options, many will qualify for subsidies to help pay for premiums and out-of-pocket expenses if they enroll in a plan through the marketplace. Throughout the enrollment period, CHIR is highlighting frequently asked questions from our recently updated Navigator Resource Guide. In this installation, we answer questions about financial assistance available to individuals and families.
On October 16, Sutter Health announced that it had reached a tentative agreement to settle the class-action lawsuit against it, which alleged that the system has used its market dominance to drive up the cost of care. Though Sutter Health denied all allegations, the plaintiffs argued that the system relies on three core tactics to maintain a competitive edge, including: all-or-nothing contracting, anti-incentive contract terms, and price secrecy contract terms. CHIR’s Emily Curran and Sabrina Corlette explain these tactics and recent findings on the impacts of provider consolidation.
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.
