One of the key consumer protections in the Affordable Care Act is the requirement that plans must have a limit on out-of-pocket costs. However, there are limits on the limit, and the details matter. Consumers who need a non-formulary drug run smack into one of those limits, but they have options to get the drugs they need as a covered benefit. JoAnn Volk provides a run down.
The ACA includes numerous consumer protections designed to remedy shortcomings in the availability, affordability, adequacy, and transparency of individual market insurance. However, because states continue to be the primary regulators of health insurance and implementers of these requirements, consumers are likely to experience some of these new protections differently, depending on where they live. CHIR’s latest issue brief finds that consumers nationwide will enjoy improved protections in each area targeted by the reforms.
Washington DC’s NBC affiliate wanted a status report on the Affordable Care Act, 6 months after full implementation. They turned to one of CHIR’s ACA experts, Sabrina Corlette, for a look at the law’s successes to date, as well as challenges ahead.
Regulations issued last month by the Department of Health and Human Services show that laws in more than a dozen states may be invalid because they go too far in restricting the work of consumer assistance personnel certified under the Affordable Care Act. In a blog post published by The Commonwealth Fund, Justin Giovannelli, Kevin Lucia, and Sabrina Corlette discuss these new rules and how they affect state efforts to regulate consumer assisters.
This July the Georgetown University Law Center’s O’Neill Institute for National and Global Health Law is offering its first-ever summer program on the Affordable Care Act. The week long program promises a deep dive look at the legal and policy implications of the law and its implementation. Program co-director Sabrina Corlette shares a sneak peek at the faculty and agenda.
Now that open enrollment into the new health insurance marketplaces has ended, options for consumers seeking to change plans are more limited, even for those enrolled in plans that don’t cover essential health benefits, such as maternity services. Sabrina Corlette tackles one such situation in her latest blog post.
The Commonwealth Fund recently hosted a one-hour webinar on the small business health insurance marketplaces created under the Affordable Care Act. The webinar, led by CHIR’s Kevin Lucia and Sarah Dash and joined by state and federal officials, examined key state marketplace design decisions, small business perspectives, and the future of the program. Ashley Williams provides this overview.
While narrow provider networks are by no means new to health insurance, the practice has received renewed attention as plans participating in the marketplaces turn to network design to keep premium costs low. While consumers benefit from more affordable insurance, overly narrow networks can risk the quality of care consumers receive and increase their out-of-pocket costs. In this blog post originally published by Health Affairs, CHIR’s Sabrina Corlette and JoAnn Volk and the Urban Institute’s Robert Berenson and Judy Feder discuss the cost-access trade-offs for consumers and offer a few recommendations for policymakers.
In March, the Obama administration extended for two additional years a policy allowing states to permit insurers to renew health plans that are not compliant with the Affordable Care Act. In their latest blog post for the Commonwealth Fund, CHIR researchers Kevin Lucia, Sabrina Corlette, and Ashley Williams document states’ decisions on whether or not to allow the extension of non-compliant plans and the implications for 2015 premiums, SHOP enrollment, and consumer protection.
Now that open enrollment into the new health insurance marketplaces is over, the only way people can enroll in marketplace coverage is by qualifying for a special enrollment period because of a life change such as a birth, marriage, a move, or a divorce. Healthcare.gov recently made available a new “screener tool” to help consumers determine whether they qualify. CHIR’s Sabrina Corlette took the new tool for a test drive and has a few suggested improvements.
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.
