Category: State of the States

State Efforts to Protect Consumers from Balance Billing

While the U.S. Congress is considering multiple proposals to combat the problem of unexpected balance billing for health care services, several states have moved ahead. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Jack Hoadley, Kevin Lucia, and Maanasa Kona share findings from a 50-state review of balance billing protections.

In the Wake of New Association Health Plan Standards, States are Exercising Authority to Protect Consumers, Providers, and Markets

States have begun to respond to the Trump administration’s new rules for association health plans with a wide range of regulatory strategies. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR researchers analyzed how states are using their authority to set association health plan standards and protect consumers, providers, and their markets.

States Lean In as the Federal Government Cuts Back: Navigator and Advertising Funding for the ACA’s Sixth Open Enrollment

With open enrollment into the Affordable Care Act marketplaces beginning November 1st, there will be considerable divergence among states in the amount of information and personalized assistance consumers receive about coverage options. While the federally run marketplace has dramatically cut back its investments in both advertising and the Navigator program, the state-based marketplaces are making big investments in those activities. In their latest To The Point blog for the Commonwealth Fund, CHIR’s Sabrina Corlette and Rachel Schwab discuss the findings from a new survey of state-based marketplaces.

Direct Primary Care Arrangements Raise Questions for State Insurance Regulators

Over the past year, new health coverage products that are not subject to the consumer protections of the Affordable Care Act have hit the individual market. One type of limited health-insurance-like offering that was already available but is now gaining attention is a direct primary care arrangement. For Commonwealth Fund’s To the Point blog, experts at CHIR took a closer look at state law to understand how states regulate these entities and highlight some of the concerns that state insurance regulators might want to consider going forward.

Lawsuit Threatens Affordable Care Act Preexisting Condition Protections But Impact Will Depend on Where You Live

On September 5, 2018, A federal district judge hears arguments in a lawsuit filed by 20 Republican governors and attorneys general to invalidate the Affordable Care Act, including its widely popular protections for people with pre-existing condition protections. Georgetown CHIR’s latest research for The Commonwealth Fund finds that a decision for the plaintiffs in this case could be be felt quite differently, depending on where you live.

Impact of Association Health Plans on Consumers and Markets Will Depend on State Approaches

In June, the U.S. Department of Labor issued a final regulation that implements President Trump’s executive order encouraging the expansion of association health plans for small businesses and self-employed individuals. Under these rules, professional or trade associations will be permitted to sell health plans that are exempt from many Affordable Care Act protections as early as September 1, 2018. To better understand how these new rules will affect states, CHIR experts interviewed six state regulators.

Health Care Sharing Ministries: What Are the Risks to Consumers and Insurance Markets?

Health Care Sharing Ministries (HCSMs) are a form of health coverage in which members – who typically share a religious belief – make monthly payments to cover expenses of other members. HCSMs do not have to comply with the consumer protections of the ACA and may provide value for some individuals, but pose risks for others. We interviewed officials in 13 states and analyzed state laws in all states to better understand state regulators’ perspectives on regulation of HCSMs.

Understanding the Market for Short-Term Health Plans: States Prepare to Identify, Oversee Sellers and Products

Last week, the Trump administration issued a final rule reversing federal limits on short-term health coverage, allowing such plans to become a long-term alternative to individual market coverage. On the eve of this policy shift, we surveyed Departments of Insurance in the seventeen state-based marketplace states to better understand their short-term markets. We found that most states do not have a complete picture of which insurers are marketing short-term policies in their state.

The Road Not Traveled: How Policy, Business Decisions in Iowa Led to Higher Premiums

Iowa’s legislature recently made the extraordinary decision to abdicate that state’s authority over health insurance products. And in doing so they’ve made a bad insurance market worse. In their latest piece for the Commonwealth Fund’s To the Point blog, CHIR’s Sabrina Corlette and Kevin Lucia team up with actuaries at Wakely Consulting Group to assess what premiums and marketplace enrollment in Iowa would look like if the state had taken a slightly different path.

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.