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.
On November 1, the seventh open enrollment period begins for marketplace coverage under the Affordable Care Act. We at CHIR are tracking several policy changes that could affect marketplace enrollment and plan affordability in 2020, including: changes to health reimbursement arrangements, new direct enrollment pathways, and recent court rulings on association health plans and the public charge rule. To learn what’s new for 2020, read our CHIRBlog summarizing the major policy changes consumers might encounter this year.
CHIR experts have launched a new project to provide policymakers with a dedicated, independent resource for unbiased and comprehensive information on the issue of surprise medical bills. Leveraging our experience advising state insurance regulators and monitoring surprise medical bill legislation in all 50 states and before Congress, our goal is to help policymakers protect consumers, promote affordability, and adopt comprehensive surprise medical bill protections.
This year several states have taken an increasingly active role in expanding health insurance coverage, overseeing their insurance markets, and protecting consumers. Perhaps no state did more in 2019 than Colorado, which enacted a dizzying array of health insurance bills. CHIR’s Rachel Schwab takes a look in this installment of States Leaning In.
Over the last few months, state officials have increasingly acted to warn consumers about the potential risks of enrolling in health care sharing ministries (HCSMs). These efforts have ranged from educating consumers on HCSMs to initiating legal action against fraudulent practices. While some consumers may find value in HCSMs, recent actions by Aliera Healthcare provide one example of how entities may use HCSMs’ unregulated status to skirt oversight and take advantage of consumers.
In supplemental briefings to the Fifth Circuit Court of Appeals, the Department of Justice recently proposed that the Affordable Care Act be struck down in the eighteen plaintiff states bringing suit in Texas v. United States, but upheld in all other states. CHIR’s Emily Curran, Dania Palanker, and Sabrina Corlette explain why this “solution” would upend our system of employer-based coverage and is illogical given the ACA’s national reforms.
In July, a federal district court judge upheld the Trump administration’s rule expanding availability of short-term, limited duration insurance, or short-term plans, which do not have to comply with the Affordable Care Act’s consumer protections. With the help of CHIR experts, Community Catalyst has published another resource for state advocates and policymakers, providing an overview of short-term plans, insight on unscrupulous sales practices that leave consumers at risk, and state regulatory options.
Next year, new Trump administration rules will allow employers to offer their employees an HRA to buy individual market coverage instead of a traditional group health plan. Because of an obscure provision of the tax code, many employees will be required to use the new accounts to shop for a plan outside of the ACA’s marketplaces, where they’ll face aggressive marketing of products that do not have to comply with the ACA’s consumer protections. Rachel Schwab looks at this perfect storm that puts workers at risk of ending up in the wrong plan.
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.
