…set to go into effect in 2014, could extend through 2015. States and insurance companies are primarily responsible for executing the policy fix, which comes at a time when stakeholders have undertaken significant efforts to prepare for new changes beginning in 2014. In this blog update for The Commonwealth Fund blog, Kevin Lucia, Katie Keith, and Sabrina Corlette provide the…
Today, the Kaiser Family Foundation—in collaboration with Kevin Lucia and Katie Keith of CHIR—released a new report exploring factors leading to medical debt among people with insurance. The report identifies common causes and consequences of medical debt, and discusses the triggers of medical debt that will and won’t be affected by the Affordable Care Act. It finds that health plan…
…market conduct checklists reflect the changes made by the ACA, and incorporate a broader set of data sources into exams, such as accreditation data, HEDIS and CAHPS. Make market conduct reports publicly available. Establish multi-agency teams to meet on a regular basis to compare notes about marketplace activity and trends among insurers. Regularly update the coding system for tracking consumer…
…condition. Yet shopping for a health plan can be a confusing process, requiring consumers to weigh multiple factors such as premiums, cost-sharing, and the financial risk of unforeseen health needs. The Affordable Care Acts introduces significant reforms to the health insurance market to make decision-making easier, including setting common benchmarks for cost-sharing and benefits for plans sold through health insurance…
…on benefits, don’t have to limit out-of-pocket costs, can limit benefits based on pre-existing conditions, and don’t have to comply with the minimum benefits standard required by the Affordable Care Act – all of which can mean individuals with significant health needs may be getting less from their coverage than they would under a plan that must comply with the…
…call centers for inquiries by pharmacists. But in January 2006 pharmacists calling the lines faced long waits. CMS took steps to resolve technical issues, increased the number of representatives at the call centers from 150 to 4,500, and expanded operations to 24 hours per day. CMS also instructed plans to expand their call centers for pharmacists. CMS had created in…
…their eagerness to encourage insurers to participate in the new marketplaces, many states did little to review plans’ networks or hold them to strict standards. One exception is Washington Insurance Commissioner Mike Kreidler. He rejected one company seeking to offer on his state’s insurance marketplace because its provider network did not include a pediatric hospital or a Level 1 burn…
By Tricia Brooks, Georgetown University’s Center for Children and Families In my former life as a CHIP director, I came to appreciate how tough it is for low-income families to make ends meet. In the hierarchy of needs, I think we all agree that paying the rent and utilities, putting food on the table, and making sure you can show…
…choice of in-network providers. These questions – and a couple hundred more – are addressed in our Navigator Resource Guide. In future blogs we’ll continue to answer commonly asked questions about private health insurance and marketplace topics. *Editor’s Note: The CHIR Navigator Resource Guide was developed in collaboration with the Kaiser Family Foundation and the Center on Budget and Policy…
…state. Include a meaningful opportunity for public input as states design and significantly change their Basic Health Program. The proposed rule requires a state to provide an opportunity for public comment on its BHP blueprint before submitting it to HHS, but offers no specific time period or process for accepting such input. Our comments suggest that the BHP blueprint follow…
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.
