Narrow Networks Under the ACA: Financial Drivers and Implementation Strategies

Posted by

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.

“For the first time in forever” women are now on more equal footing when it comes to health insurance

Posted by

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.

Halbig v. Sebelius and State Motivations to Opt for Federally Run Exchanges

Posted by

A number of states recently filed amicus briefs in a court battle over whether federally facilitated exchanges can provide premium tax credits to low- and middle-income consumers. Because the Affordable Care Act’s employer mandate penalties are contingent on employees accessing subsidized coverage through an exchange, the states are asserting that they purposefully opted for federally run exchanges so employers would not face this burden. In a guest post, former CHIR researcher Christine Monahan assesses the veracity of this claim.

How Do Updated 2014 Federal Poverty Level Thresholds Impact Medicaid, CHIP & Premium Tax Credit Eligibility?

Posted by

The Administration recently released updated federal poverty level thresholds for 2014. With eligibility for Medicaid, CHIP and premium tax credits under the Affordable Care Act at stake, consumers and those assisting them need to understand what these new thresholds mean. Here to explain is our colleague at Georgetown University’s Center for Children and Families, Martha Heberlein.

New CBO Numbers: Cause for Controversy or Celebration?

Posted by

The Congressional Budget Office’s release of new numbers on the ACA’s impact on employment sparked attack and counter attack among opponents and supporters of the law. But CHIR blogger Sabrina Corlette noticed that the CBO’s projections suggest something we at CHIR have suspected and written about for a while: the beginning of the end of job lock.

Here’s the Latest on Mandate Exemptions

Posted by

Now that 2014 is here, the ACA’s individual mandate is in effect. In the last few months the Administration has issued some more guidance about how the mandate works, and our colleague Joe Touschner at Georgetown University’s Center for Children and Families provides this update.

New Report Finds that Most States Have Taken Some Action To Prepare For Major Components of the ACA

Posted by

States have taken substantially varying actions to implement and enforce the Affordable Care Act’s three major components designed to expand health insurance coverage and protect consumers—health insurance market reforms, health insurance marketplaces, and Medicaid expansion—according to a new report prepared for The Commonwealth Fund. Kevin Lucia summarizes the findings and what states’ varying approaches to implementation means for consumers.

Republican Health Proposal Likely Means Less Coverage, Higher Costs, Fewer Consumer Protections

Posted by

A trio of Republican Senators have introduced legislation repealing the Affordable Care Act and detailing alternative reforms to the health care system. However, as noted in this blog by Edwin Park of the Center on Budget and Policy Priorities, the bill rolls back important insurance reforms, makes coverage less affordable for low income people, and hobbles the Medicaid program.

How the “3 Rs” Contributed to the Success of Medicare Part D

Posted by

Opponents of the Affordable Care Act are latching onto the law’s “3Rs” (risk corridors, risk adjustment, and reinsurance) as a “bailout” for insurers. Yet one of the models for the 3Rs is the Medicare Part D drug benefit, where these programs have been working for years to help stabilize premiums. Georgetown University Health Policy Institute’s Jack Hoadley provides some context – and strong evidence that the 3Rs are in place to protect beneficiaries and taxpayers – not bail out health plans.

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.