…process focused on identifying problems as they happen, fixing problems for the individuals involved, but also looking for patterns that suggest systematic issues and jumping on those. Almost as important, the community needs to hear about the fixes to specific problems, as those resolutions are being pursued and completed. That is critical to maintaining community support.” The brief contains other…
…to a pre-existing condition to gain access to affordable, comprehensive insurance. A number of committee members used the hearing as an opportunity to draw attention to policy “cancellation notices” that their constituents have received from their insurance carriers in recent weeks. Tavenner acknowledged that insurance companies are transitioning people to new policies, but reminded the Committee that plan modification is…
…most states insurers are allowed to increase premiums, increase cost-sharing, and/or reduce the scope of benefits covered. And, more often than not, insurance companies have done one or all of these things to policyholders. It is part of the reason individual health insurance is often called “swiss cheese” coverage compared to employer-based plans – because it’s full of holes. Under…
The House Committee on Energy and Commerce held an oversight hearing on Thursday, October 24, during which they took the testimony of three private contractors responsible for building the new federal health insurance site Healthcare.gov, along with the contractor handling the paper applications. The Committee called on the contractors – CGI Federal, Optum/QSSI, Equifax Workforce Solutions, and Serco – to…
The Centers for Medicare and Medicaid Services (CMS) released this week a “Request for Comment,” asking organizations that believe they meet the standards for being a “health care sharing ministry” (HCSM) to step forward. Under the Affordable Care Act, members of HCSMs are exempted from the individual responsibility requirement to maintain health insurance coverage. But before individuals can qualify for…
By Cathy Hope, Georgetown University Center for Children and Families There’s been a lot of attention to the technical issues that have plagued healthcare.gov and other health insurance marketplace websites. Those issues are serious, but they should be resolved shortly. In contrast, a new report out from the Kaiser Family Foundation demonstrates a far larger, and more long-term problem for…
…respect to younger, healthier individuals–indicate for the prospect of creating robust competitive health insurance Marketplaces with balanced risk pools. While it may be too soon to offer a prognosis on the ultimate success of the law, the guests pointed out some of the critical indicators to watch over the coming weeks and months. You can find their discussion here. …
First, Affordable Care Act (ACA) opponents charged that premiums for the new marketplace health plans would be too high, and consumers would face “rate shock.” But then states and federally facilitated marketplaces (FFMs) started to publish premium rates and they were actually lower than projected. So critics pivoted to a new argument, conceding that marketplace coverage might, indeed come with…
…in the answers coming from call center representatives once consumers got through to a person. But what about enrollment? Similar to the schedule the White House recently announced, the Bush Administration waited to release the first enrollment numbers until a month after open enrollment started. The first release from the Department of Health and Human Services (December 13, 2005) reported…
…no lifetime or annual dollar limits. Essential health benefits include coverage for a wide range of medical services necessary to assure quality, comprehensive acute, chronic and preventive care. As a former Indiana insurance regulator and longtime consumer advocate, I am most buoyed by what the Marketplace will offer people stuck in what are commonly known as “death spiral” policies. These…
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