Category: State of the States

How Oregon’s Merger Review Law Combats Consolidation and What Other States Can Learn From It

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Since the early 1990s, health care provider consolidation in states like Oregon has led to higher prices, reduced access, and worsened health inequities. In response, Oregon established the Health Care Market Oversight Program in 2022 to review major health care transactions, aiming to ensure they reduce costs and improve care access, especially for underserved populations. While the program has approved most transactions so far, concerns about transparency, resource adequacy, and high profit thresholds for review persist. CHIR’s Nadia Stovicek discusses the need for ongoing evaluation and improvement, and how other states can learn from Oregon.

Taking a Look at California’s Program to Assist People Losing Medi-Cal Enroll in Marketplace Coverage

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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.

Enforcing Mental Health Parity: State Options to Improve Access to Care

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The 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) is the primary federal law protecting access to behavioral health care for privately insured Americans. In a new issue brief for the Commonwealth Fund, CHIR experts interviewed insurance regulators in ten states to identify the tools state regulators are using for MHPAEA oversight and enforcement, as well as the barriers they are facing.

State And Federal Efforts To Improve Ownership Transparency

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While there is some movement toward improved health care provider ownership transparency at the federal level and in some states, more attention is warranted given increasingly complex and obscured provider ownership structures and the impact they can have on health care prices, access, and quality. In a recent piece for Health Affairs Forefront, CHIR experts Stacey Pogue and Nadia Stovicek analyze efforts to improve ownership transparency at the state and federal levels.

New Nationwide Data on Outpatient Facility Fee Reforms

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As hospitals and health systems expand their ownership and control of ambulatory care practices, they are frequently charging new facility fees for routine medical services delivered in outpatient settings. These bills are driving up premiums and health expenditures for consumers, employers, and, ultimately, tax payers. With support from and working in partnership with West Health, CHIR experts are studying outpatient facility fee billing reforms and share their findings in a new online repository.

Facility Fee State Legislative Roundup: 2024 Session

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With more outpatient care being delivered in hospital outpatient departments (HOPDs) than in previous years, consumers increasingly face high hospital facility fee charges on top of their provider’s bill for routine medical care. CHIR’s Hanan Rakine discusses the 2024 legislative session and how different states have been successful in regulating outpatient facility fees.

States Expand Access to Affordable Private Coverage for Immigrant Populations

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In the United States, immigrants are disproportionately likely to be uninsured. This disparity stems from systemic inequalities such as legal barriers to affordable coverage for noncitizens—especially undocumented immigrants. While state efforts to provide Medicaid-equivalent benefits to some populations of undocumented residents have helped expand access to coverage, many low- and moderate-income undocumented residents remain without affordable health insurance options. In a recent post for the Commonwealth Fund’s To the Point blog, CHIR’s Justin Giovannelli and Rachel Schwab explore recent state actions to fill this gap.

State Options for Making Hospital Financial Assistance Programs More Accessible

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According to recent estimates, almost 100 million people have debt because of medical or dental bills. To mitigate this problem, nineteen states and the District of Columbia require hospitals to provide financial assistance to low-income populations, but the process of applying for financial assistance is often cumbersome and inaccessible. In a recent post for the Commonwealth Fund’s To the Point blog, CHIR’s Maanasa Kona discusses how some states have made the financial assistance application process easier for their residents.

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.