Category: Health reform

It’s All About the Rating: Touted “Benefits” of Association Health Plans Ignore Key Facts

A recent Washington Post article touted the emergence of association health plans under recent Trump administration rules, noting their lower cost and generous benefits. But the truth is more complicated, as CHIR experts Kevin Lucia and Sabrina Corlette point out, noting that AHPs often rely on medical underwriting and low “teaser” rates to lure new members. As a result, history is littered with insolvencies and even fraud connected to these arrangements.

Complacency Slows Aggressive Approaches to Health Care Cost Containment: A View from Three Markets

Consolidation among hospitals and physician practices is driving a steady rise in health care costs. Employers who purchase insurance and the payers that negotiate on their behalf have a limited set of tools available to counter providers’ demands, but they have also displayed a complacency that has allowed prices to rise with little resistance. In a post for the Health Affairs blog, Sabrina Corlette, Jack Hoadley, and Katie Keith share findings from a series of market-level case studies on responses to provider consolidation.

Texas Court Ruling Throws Future of ACA’s Pre-existing Condition Protections, Coverage Gains into Doubt

A district court judge in Texas has issued a ruling that could throw close to one-fifth of the U.S. economy into chaos and upend health care for millions. While the case over the future of the Affordable Care Act wends its way through the courts, CHIR takes a moment to think about what the decision could mean for the consumers and families for whom the law has been a literal lifeline.

Large Employer Strategies to Combat Increasing Healthcare Costs: Trends in Direct Contracting, On-Site Clinics and More

Employers currently insure 155 million people, but many are finding it increasingly challenging to maintain this benefit in the face of rising costs. One of the primary drivers of these costs is high provider prices. Some employers are taking matters into their own hands by disrupting traditional modes of care delivery. CHIR’s Emily Curran takes look at some of the tactics that have been gaining traction among employers.

Proposed Marketplace Program Integrity Rule: Summary and Implications for States

The U.S. Department of Health & Human Services has proposed new standards for Affordable Care Act marketplaces “program integrity.” CHIR expert Sabrina Corlette, in her latest piece for State Health & Value Strategies, summarizes the proposal and outlines implications for state marketplaces, insurance departments, and the consumers they serve.

Navigator Guide FAQ of the Week: Eligibility for Premium Tax Credits

The midterm elections are over, but open enrollment for the Affordable Care Act marketplaces is in full swing. Georgetown CHIR has created a Navigator Resource Guide with 300+ answers to frequently asked questions (FAQ) about marketplace eligibility, enrollment, and coverage. For our FAQ of the Week we’re focusing on: Who is eligible for financial help with premiums?

Trump Administration Hands States Another Tool for Dismantling Preexisting Condition Protections

Last week, the Trump administration issued long-anticipated guidance regarding the ACA’s Section 1332 “innovation waiver” program. The guidance breaks dramatically with past policy and, arguably, with the statute it purports to interpret, inviting states to undermine coverage for people with preexisting conditions. CHIR’s Justin Giovannelli analyzes the guidance and its implications.

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.