Category: Health reform

Federal Court Decision Threatens the ACA’s Preventive Services Benefit: State Options to Mitigate Harm to Consumers

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A federal judge in Texas has ruled that Affordable Care Act requirements that insurers cover and waive cost-sharing for preventive services is unconstitutional. While the case is likely to be appealed, states can act now to preserve residents’ access to affordable and often life-saving preventive care. In a new Expert Perspective for the State Health & Value Strategies project, Sabrina Corlette and Justin Giovannelli outline how.

The No Surprises Act Final Rule: Implications for State Regulators

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The Biden administration has published its final rules governing the independent dispute resolution process outlined in the No Surprises Act. In a new Expert Perspective for the State Health & Value Strategies project, CHIR’s Jack Hoadley, Kevin Lucia, and JoAnn Volk review the rule and its implications for state regulators.

Amidst Rising Overdose Deaths, Policymakers Look for Ways to Expand Access to Proven Opioid Use Disorder Treatment

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As the number of opioid-related overdose fatalities remains alarmingly high, access to medication-assisted treatment (MAT) is inconsistent. Private insurance does not always cover the full range of MAT options, and when it does provide coverage cost sharing can be prohibitive. CHIR’s Rachel Swindle takes a look at state and federal reforms that can help lessen private insurance related barriers to treatment.

Healthcare Provisions in the Inflation Reduction Act: Implications for States

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Congress is poised to enact the Inflation Reduction Act, a $740 billion reconciliation package that includes sweeping climate change, deficit reduction, and health policy provisions. In her latest Expert Perspective for the State Health & Value Strategies project, Sabrina Corlette reviews the health care changes and their implications for states.

Ensuring Continuity of Care for Individuals Transitioning from Medicaid to Marketplace: Post-PHE Considerations for States

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Many of those losing their Medicaid eligibility after the COVID-19 public health emergency will have illnesses or conditions requiring uninterrupted access to health care services. In their latest Expert Perspective for the State Health & Value Strategies project, Sabrina Corlette and Jason Levitis outline several policy and operational changes states can make to ensure that people transitioning from Medicaid to the Marketplace can maintain continuity of care.

Delays Extending The American Rescue Plan’s Health Insurance Subsidies Will Raise Premiums And Reduce Coverage

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Congress has spent months debating an extension of enhanced premium tax credits enacted under the American Rescue Plan Act of 2021. However, as CHIR’s Sabrina Corlette and the Urban Institute’s Jason Levitis discuss in this recent Health Affairs Forefront article, the clock is ticking. Continued delays would likely cause coverage losses and additional costs that wouldn’t be restored even if a subsidy extension is later enacted.

The End of the Public Health Emergency Will Prompt Massive Transitions in Health Insurance Coverage: How State Insurance Regulators Can Prepare

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It will be “all hands on deck” for state officials once the public health emergency ends and up to 16 million people face the loss of their Medicaid coverage. As many of these individuals will be eligible for commercial health insurance (and up to one-third will be eligible for Marketplace subsidies), state insurance regulators will play an important role. In a new issue brief for State Health & Value Strategies, Sabrina Corlette provides a checklist to help departments of insurance navigate the impending massive shift in coverage.

New Georgetown Report on Medicaid and Marketplace Network Adequacy

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A recently published report from Georgetown’s Center on Health Insurance Reforms and Center for Children & Families finds significant differences in standards for network adequacy between Medicaid and Marketplace plans, as well as gaps in oversight. The authors share several recommendations for protecting enrollees’ timely access to health services.

Preparing for the Biggest Coverage Event Since the ACA: The Role of States as Medicaid Continuous Coverage Comes to an End

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CHIR and our colleagues at the Center for Children and Families (CCF) have published two new resources examining state-level preparations for the end of the COVID-19 public health emergency and the redetermination of the Medicaid eligibility of close to 85 million people. CHIR and the Urban Institute published a review of how state-based Marketplaces and Medicaid agencies are working together to ease coverage transitions, and CCF and KFF released their 20th 50-state survey of Medicaid agencies, with a particular focus on their post-PHE planning efforts.

Adoption of Value-Based, Alternative Payment Models: Where Are We Today and Where Do We Go from Here?

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Employer-sponsored health insurance costs had their highest annual increase since 2010 last year, and some experts are projecting additional health spending increases in 2022. Research has found that provider prices are the leading cause of high and rising health care spending in the US, and many policy experts have advocated for moving towards value-based, alternative payment models (APMs). CHIR’s Maanasa Kona takes a look how APMs have performed thus far and what the future may hold.

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.