CHIRblog

New Issue Brief Reviews Employee Choice in Small Business Health Options Program (SHOP) Marketplaces

Posted September 22, 2014 by CHIR Faculty

The Affordable Care Act (ACA) aims to improve access to health insurance coverage for small-business employees by creating a Small Business Health Options Program (SHOP) Marketplace in every state. One key feature of SHOP Marketplaces is employee choice whereby employees can select among multiple insurers and plans for health insurance coverage that best suits their needs. CHIR’s Sarah Dash and Kevin Lucia review how SHOPs are implementing employee choice in a new Health Policy Brief published by Health Affairs.

Major Minnesota Insurer Withdraws from State Marketplace: What Does it Mean for Consumers?

Posted September 17, 2014 by

A major insurance company in Minnesota recently announced it would withdraw from the state’s health insurance marketplace. What does this decision mean for the marketplace and the consumers it serves? Sabrina Corlette offers up her take.

Question on Stand-alone Dental Plans and Upcoming Open Enrollment

Posted September 15, 2014 by CHIR Faculty

With the change in weather, we’re beginning to field questions related to the upcoming 2015 Open Enrollment period as part of our technical assistance work funded by the Robert Wood Johnson Foundation. We recently received a question about the consequences of not paying premiums for stand-alone dental plans (SADP) in federally based Marketplaces. Sandy Ahn provides a summary on this issue.

We Can Fix This, People! More than Half of Uninsured Parents Are Hispanic

Posted September 12, 2014 by CHIR Faculty

A recent Urban Institute study found that over half (57 percent) of uninsured parents are Hispanic. Our colleague from Georgetown University’s Center for Children and Families, Sonya Schwartz, discusses some of the factors that limit the accessibility of coverage for Hispanic and Spanish-speaking individuals, and offers strategies to fix the problems.

Damaging House Bill Would Undo Health Reform Protections and Raise Small Business Premiums

Posted September 9, 2014 by CHIR Faculty

The U.S. House of Representatives is debating legislation this week that would undermine consumer protections for small employers and cause premiums to increase for many. Edwin Park of the Center on Budget and Policy Priorities shares a new analysis of the bill and its impact on small businesses.

Do Nothing to Renew or Get an Updated Eligibility Determination? CMS Puts out Final Marketplace Renewal Rules

Posted September 7, 2014 by CHIR Faculty

Last week the federal Centers for Medicare and Medicaid Services (CMS) published final rules for the health insurance marketplaces and participating insurers to renew consumers into coverage for 2015. Our colleague from Georgetown’s Center for Children and Families, Tricia Brooks, discusses what the rule means for consumers and their families.

Reforming State Regulation of Provider Networks: Efforts at the NAIC to Re-draft a Model State Law

Posted September 2, 2014 by

Almost two decades ago, the National Association of Insurance Commissioners (NAIC) adopted a model state law to regulate the adequacy of health plan provider networks. In the wake of consumer and provider concerns about narrow networks, the NAIC is revising the model law. Sabrina Corlette shares an update on their process and timing.

Consumer Assistance: Getting the Most Out of Limited Resources

Posted August 25, 2014 by CHIR Faculty

While open enrollment is less than three months away, consumer assisters will have to do more with less. Resources will be limited, even though the Congressional Budget Office projects more than 5 million more people will enroll through a marketplace. CHIR’s Sandy Ahn examines support from the state and federal marketplaces for consumer assistance funding.

The Next Frontier: Insurance Marketplaces That Promote Quality Improvement

Posted August 21, 2014 by CHIR Faculty

While most state-based marketplaces in 2014 are rightly focused on the operational challenges of connecting people with coverage, over time technical improvements will allow them to prioritize providing better quality, more cost-effective care to enrollees. CHIR experts Sabrina Corlette and Sarah Dash, in their latest blog post for the Commonwealth Fund, discuss the opportunities and challenges for states working to implement the ACA’s quality improvement initiatives.

New Issue Brief Examines Specialty Drugs in Tiered Pharmacy Benefit Structures

Posted August 17, 2014 by CHIR Faculty

Health plans have been increasingly using tiered pharmacy benefit designs. These new designs raise challenges for consumers and the state insurance regulators responsible for reviewing and approving plans for sale. CHIR faculty members Sally McCarty and David Cusano explore these issues in a new brief for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network.