One challenging question for families as they enroll in health insurance coverage on the new Marketplaces is what to do about kids’ dental coverage. Our colleague at Georgetown’s Center for Children and Families, Joe Touschner, has the skinny and links to some helpful resources to better understand this complex policy area – and how things might change for 2015.
The Obama administration is proposing to provide insurers with temporary relief from an Affordable Care Act requirement that they maintain a minimum medical loss ratio (MLR). This could mean that consumers will receive lower rebates than they otherwise would. Sabrina Corlette examines the thinking behind the decision.
While we’re struggling with Affordable Care Act (ACA) issues, there’s value in taking the time to look back and appreciate the impact of the ACA and other healthcare reforms implemented over the past few decades. To that end, former insurance commissioner and health insurance company executive Sally McCarty begins a series of blogs that compare the healthcare coverage landscape before and after reform. The series is called “Back in the Day – Lessons from Pre-reform Days,” and begins with a look at narrow networks.
Blue Cross Blue Shield of Mississippi has included a new provision in its plan description that could mean huge costs for plan participants. The new policy does not cover prescription drugs prescribed by out-of-network providers. How does this policy square with the ACA? And what does it mean for consumers? Elissa Dines discusses.
The Obama administration recently announced that the health insurance Marketplaces can offer consumers retroactive coverage and financial assistance, if technical problems prevented them from enrolling. But the administration’s guidance also leaves some unanswered questions. Sabrina Corlette takes a look and helps us understand what the new policy actually means for consumers.
The ACA established new appeal rights for consumers facing a denial of a benefit or service from their health plan. As consumers start to use their new Marketplace coverage, JoAnn Volk takes a look at the health plan appeals process required of all new plans, and what these new rights mean for patients.
There are reports that at least some formerly reluctant states are thinking of moving from a federally facilitated to a state-based health insurance marketplace. Our colleague at Georgetown’s Center for Children and Families, Sonya Schwartz, walks us through what states need to do to make the transition.
In January, a federal court in Missouri became the first to rule on whether states have the legal authority to restrict the work of the Affordable Care Act’s consumer assistance “navigators.” In a new post for The Commonwealth Fund, Justin Giovannelli, Kevin Lucia, and Sabrina Corlette discuss the decision and explore its significance for Missouri and the other states that have adopted restrictions on navigators and consumer assisters.
The ACA’s essential health benefits and metal tier coverage standards, guaranteed issue, and community rating requirements help level the playing field among insurers. To compete on price, many are turning to limited network products. CHIR experts David Cusano and Amy Thomas discuss insurers’ approaches to the development of plan networks in the post-ACA era in a new blog post originally published by Health Affairs.
A recent news article chronicled worries that the disproportionate number of women signing up for the new health insurance marketplaces will lead to an unbalanced risk pool and increases in premiums. But as Sarah Dash documents in her latest blog post, the ACA is requiring insurers to shift from denying care to women to providing them with better, more comprehensive coverage. And with insurers now required to offer coverage to everybody, it may be time to harness new, consumer-friendly ways to keep health care costs in check.
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.
