Category: Health reform
Enhanced Premium Tax Credits Provide an Early Opportunity for Addressing Affordability Issues

Enhanced premium tax credits (PTCs) have significantly reduced health insurance premiums and expanded coverage for millions of Americans, particularly low- and middle-income individuals, but these subsidies are set to expire in 2025. If Congress doesn’t act to make them permanent, premiums will rise, leading to coverage losses and greater financial hardship for millions. CHIR’s Karen Davenport discusses what the incoming Congress can do to address healthcare affordability issues.
The Work Goes On: Preserving Equitable Access to Affordable, High Quality Health Insurance in Challenging Times
September Research Roundup: What We’re Reading

While the weather may be cooling down, the research is not! This month we read about Medicare Advantage quality bonus payments, out-of-pocket drug costs for consumers, effects of enhanced premium tax credits on older adults, and strategies to increase eligibility verification and receipt of Marketplace subsidies.
CHIR Expert Testifies About Facility Fees Before Texas House Insurance Committee

CHIR expert Christine Monahan recently testified before the Texas House Insurance Committee regarding outpatient facility fee billing. Her research highlights how facility fees contribute to significantly higher healthcare costs. In her testimony, she discussed measures to curtail hospital billing tactics that inflate costs and ways to mitigate financial burdens on patients.
Current Considerations for State Reinsurance Programs

Reinsurance has been a popular mechanism to stabilize insurance markets and reduce premiums. However, some argue that it could negatively affect affordability and enrollment for low-income individuals. In a new article for the State Health & Value Strategies program, Jason Levitis, Sabrina Corlette, and Claire O’Brien review the evidence and discuss considerations for state reinsurance programs.
High-Risk Pools: A High Risk Proposition for People with Pre-Existing Conditions
Delays In Extending Enhanced Marketplace Subsidies Would Raise Premiums And Reduce Coverage

A debate is looming for the U.S. Congress – whether or not to extend enhanced premium tax credits for Affordable Care Act insurance coverage. In their latest article for Health Affairs, Jason Levitis, Sabrina Corlette, and Claire O’Brien identify several reasons Congress needs to act as soon as possible to preserve coverage and prevent a spike in premiums.
Taking a Look at California’s Program to Assist People Losing Medi-Cal Enroll in Marketplace Coverage

A recently enacted law creates a streamlined pathway to health insurance for individuals who are found ineligible for Medi-Cal but are likely eligible for Marketplace subsidies. In a recent report, CHIR experts assess the critical policy and operational decisions to implement the program and how these choices have affected consumers’ coverage transitions.
2023 Data From The Independent Dispute Resolution Process: Select Providers Win Big

The No Surprises Act (NSA) protects consumers from unexpected medical bills, with disputes between payers and providers settled through independent dispute resolution (IDR). CHIR’s Jack Hoadley and Kennah Watts review the latest results from the IDR process and discuss the ongoing legal and regulatory challenges affecting the NSA.