Category: CHIR

States Leaning In: Washington Doubles Down on Efforts to Shore up Market, Protect Consumers

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In the wake of federal actions to roll back the Affordable Care Act’s reforms, states have assumed an even greater role in protecting consumers and ensuring market stability. Washington State, a long-time leader in state health insurance reform, has taken up that mantle. Since our last post highlighting Washington’s policy playbook, the state has implemented several more policies to preserve their insurance market and bolster consumer protections. CHIR’s Rachel Schwab takes a look at some of the state’s new developments.

Coming up Short: The Problem with Counting Short-Term, Limited Duration Insurance as Coverage

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In April, the nonpartisan Congressional Budget Office (CBO) released an analysis of federal legislation to reverse the Trump administration’s rule expanding access to short-term, limited duration insurance policies, which do not have to comply with the Affordable Care Act’s consumer protections. CBO estimated that reversing the rule would result in 500,000 people going uninsured, predicated on the assumption that most short-term plans count as “insurance.” For people with preexisting conditions, nothing could be further from the truth.

New Reinsurance Toolkit for State Advocates

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Last month, North Dakota enacted legislation to establish a state reinsurance program, and a number states are considering similar bills. To help state consumer advocates engage with state officials on reinsurance and other health insurance reform issues, Community Catalyst, with support from CHIR experts, launched a new website that will house a health insurance reform toolkit for advocates. First up: The Advocate’s Guide to Reinsurance.

ACA Marketplace Open Enrollment Numbers Reveal the Impact of State-Level Policy and Operational Choices on Performance

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During the last open enrollment period, the Affordable Care Act’s marketplaces faced a number of headwinds, including federal policy changes predicted to curb enrollment. Given myriad obstacles to enrollment efforts, it came as no surprise that overall marketplace plan selections dropped slightly this year. But a deeper dive into enrollment trends reveals that most state-based marketplaces outperformed the federally facilitated marketplace. In a new post for the Commonwealth Fund’s To the Point blog, CHIR’s Rachel Schwab and Sabrina Corlette unpack data from the recent open enrollment period to see how the marketplaces performed during a turbulent time, finding that certain policy and operational decisions were associated with better results.

Proposed Rule on Basic Health Program Impedes States’ Progress

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Recently, CMS issued a proposed rule modifying the federal funding methodology for the Basic Health Program (BHP) for 2019 and 2020. Under the proposal, technical changes could cause participating states to lose $300 million in federal funding. While funding for the programs is being debated, we checked in on how Minnesota and New York’s BHPs are faring amidst federal uncertainty.

Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 2: State Insurance Departments and Marketplaces

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On April 18, 2019, the Department of Health and Human Services finalized changes to the Affordable Care Act marketplaces and insurance rules in the Notice of Benefit and Payment Parameters for the 2020 plan year. The agency received over 26,000 comments on the proposal. To gauge stakeholder reactions, CHIR reviewed a sample of these comments. In the second part of our blog series, Rachel Schwab summarizes responses from a selection of state insurance departments and state-based marketplaces.

Trump Administration Pushes for Sale of Insurance Across State Lines

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Recently, the Trump administration issued a request for information (RFI) seeking recommendations on ways to facilitate the sale of insurance across state lines, allowing insurers to bypass the insurance standards of states that have strong consumer protections and benefit requirements by headquartering in a state with few regulations in place. The policy is often touted as a way to reduce the cost of coverage and improve consumer choice, but states and insurers have been reluctant to embrace it. A CHIR study conducted after the ACA was signed into law sheds light on why.

Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 1: Insurers

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On January 18, the Department of Health and Human Services issued its Notice of Benefit and Payment Parameters for 2020, which outlines the changes that it plans to apply to the Affordable Care Act marketplaces and insurance rules in the next plan year. The agency received over 26,100 comments on the proposal, including many from insurers, state-based marketplaces, departments of insurance, and consumer advocates. To better understand stakeholder reactions to the proposals, CHIR reviewed a sample of these comments, and, in Part I of this series, we summarize areas of support and concern from major medical insurers and associations.

Shopping for a Short-Term Plan? The Information You Get about it Will Depend on Your State

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Stakeholders have expressed mixed views on the value of short-term limited duration insurance. However, most seem to agree that, at a minimum, consumers should know what they are purchasing. States have the authority to require insurers to provide disclosures in addition to the federal minimum standard. We looked at short-term disclosures in four states – Nebraska, North Dakota, Ohio, and Washington – and found that a wide spectrum exists regarding the amount of detail states require their insurers to disclose.

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.