Changing Provider Networks In Marketplace Health Plans: Balancing Affordability And Access To Quality Care

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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.

The Extended “Fix” for Canceled Health Insurance Policies: Latest State Action

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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.

New Healthcare.Gov Screener Tool Needs Fixes to Avoid Confusing Consumers

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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.

Florida Complaint Should be Welcomed by Regulators and Advocates

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A recent complaint filed with the U.S. Department of Health and Human Services’ Office of Civil Rights against four Florida insurers targets them for violating the Affordable Care Act’s prohibition against discrimination. CHIR expert Sally McCarty evaluates the complaint and its implications for consumers and state insurance regulators.

New Survey by Enroll America Provides Insights into ACA Implementation

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A new survey commissioned by Enroll America helps us understand why some of the uninsured enrolled in new coverage options under the Affordable Care Act, but others did not. And it includes recommendations to prepare for the next round of open enrollment. Our colleague at Georgetown University’s Center for Children and Families, Cathy Hope, provides this overview.

New Federal Guidance Helps Protect People from Discrimination in Benefit Design

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In response to actions by some health plans to impose benefit-specific waiting periods for coverage of serious health conditions, such as organ transplants, the Obama Administration recently issued guidance to prohibit the practice and protect consumers from discriminatory benefit design. Georgetown Law Center’s Sandy Ahn reviews the new guidance and the impact for consumers in this guest post.

New Rules Protect Navigators and Certified Application Counselors from Over-Reaching State Laws but Also Impose New Requirements

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The Obama Administration has released final rules curtailing state laws that overly restrict the ability of navigators and certified application counselors to effectively enroll people into new coverage options through the health insurance marketplaces. Our Georgetown University Center for Children and Families colleague, Tricia Brooks, provides the overview of the rule and what it means for consumer assisters.

The Expatriate Health Coverage Act: Like “Using a Bat to Swat a Fly?”

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Recent legislation passed by the U.S. House of Representatives attempts to fix a problem in the Affordable Care Act for a relatively small group of people with health coverage who live overseas. But in the process it creates loopholes that could undermine consumer protections for a much larger group of people. Our colleague at Georgetown University’s Center for Children and Families, Sonya Schwartz, provides this assessment.

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.