Category: CHIR

Stakeholder Perspectives on CMS’s 2025 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces

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In November, the Biden administration released the proposed Notice of Benefits and Payment Parameters for plan year 2025, an annual rule setting standards for the Affordable Care Act (ACA) Marketplaces and health insurers. For CHIR’s third and final blog summarizing stakeholder comments on the proposed rule, Maanasa Kona and Rachel Schwab reviewed letters submitted by state insurance departments and state-based Marketplaces.

Stakeholder Perspectives on CMS’s 2025 Notice of Benefits and Payment Parameters: Consumer Advocates

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The Biden administration will soon finalize its annual rulemaking for the Affordable Care Act Marketplaces. To better understand the impact of the proposed changes, CHIR reviewed the public comments submitted by key stakeholder groups. In the second post in a 3-part blog series, CHIR’s Karen Davenport and Emma Walsh-Alker review the feedback provided by consumer advocates.

December–January Research Roundup: What We’re Reading

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This winter, CHIR curled up with some good reads: the latest in health policy research. In December and January, we read studies on trends in employer-sponsored insurance, expanding insurance options for non-citizens, and state efforts to improve provider directory accuracy.

Dental Coverage under the ACA: Marketplace Rule Would Give States the Opportunity to Expand Coverage

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Dental care is an important element of comprehensive health care. The Affordable Care Act (ACA) requires coverage of pediatric dental services in many commercial plans, but the law has had less of an impact on adult dental coverage. This first blog in a new series on dental coverage in the ACA Marketplaces summarizes the legal framework of dental coverage and potentially forthcoming changes under the proposed Notice of Benefit and Payment Parameters for 2025.

State Public Option Plans Are Making Progress on Reducing Consumer Costs

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States remain motivated to adopt reforms that improve affordability and expand access to coverage for populations that still lack access to care. State public option–style plans are a key candidate for consideration. In a post for the Commonwealth Fund, CHIR experts provide an update on states that have established or are laying groundwork for public option–style plans.

Proposed Rule Would Roll Back Expansion Of Association Health Plans

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Last month, the U.S. Department of Labor proposed a rule rescinding a Trump-era regulation that expanded the use of Association Health Plans (AHPs). In a post for Health Affairs Forefront, CHIR’s Sabrina Corlette takes a look at the history of AHPs and what’s at stake in the Biden administration’s proposal to roll back the 2018 rule.

Step-by-Step: Congressional Proposals Could Help Unlock Information Key to Curbing U.S. Health Care Spending

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In recent years, outpatient care has contributed considerably to growth in U.S. health care spending. Efforts to curb outpatient spending have been stymied by fundamental problems connecting data on sites of care, providers, and specific charges, but a bill that recently passed the U.S. House of Representatives could provide new information necessary to craft reforms and slow spending growth.

Navigator Guide FAQs of the Week: Wrapping Up Open Enrollment

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Open enrollment for the Affordable Care Act’s Marketplaces is coming to a close. In most states, January 16 is the last day to sign up for a 2024 plan. This week, we’re highlighting frequently asked questions from CHIR’s Navigator Resource Guide concerning the end of open enrollment.

Implementing the No Surprises Act: What We Know from Early Complaint Data

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The No Surprises Act (NSA) provides comprehensive protections from many of the most prevalent forms of surprise medical billing, and a new process for determining out-of-network provider reimbursement aims to control health care costs by limiting insurer payments for surprise bills. It remains to be seen if the new federal law—implemented only last year—will achieve these goals. Two recently released reports provide some of the first indicators of the NSA’s impact.

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.