CHIRblog

New Report on ACA Implications for State Network Adequacy Standards

Posted August 19, 2013 by CHIR Faculty

The Affordable Care Act promises consumers a more comprehensive set of health insurance benefits, but whether consumers are able to access those benefits depends in part on whether states adhere to or build upon the law’s network adequacy standards. CHIR researchers recently released a Robert Wood Johnson Foundation-funded report evaluating current federal and state efforts to regulate plan networks. Max Farris provides an overview.

It’s Not Too Late – Options for Employers and Insurers to Limit Out-of-Pocket Costs For Consumers Beginning in 2014

Posted August 16, 2013 by CHIR Faculty

A recent Administration decision allows employers and group health plans to delay an Affordable Care Act requirement capping enrollees out-of-pocket costs. In the second of two blogs examining the decision, David Cusano reviews the rationale for the delay and suggests ways insurers and employers can reduce harm to consumers.

Delay of Certain Cost Sharing Limitations under the Affordable Care Act: What does it Mean?

Posted August 15, 2013 by CHIR Faculty

This week the New York Times reported on an Administration decision to allow employers and group health plans to delay until 2015 an Affordable Care Act requirement to provide enrollees with a cap on their out-of-pocket costs. David Cusano takes a look at what the Administration’s decision says – and does not say – and what it means for group health plans.

New Report on State Implementation of Essential Health Benefit Standard

Posted August 14, 2013 by

As part of a Robert Wood Johnson Foundation-funded project to monitor implementation of the Affordable Care Act in 11 states, Georgetown’s Center on Health Insurance Reforms and the Urban Institute have published a series of papers identifying key issues and challenges. Their most recent brief examines the development and review of health plans that meet the new essential health benefit standard. Sabrina Corlette provides us with some key takeaways.

When One Young Person’s Life Took a Detour, the ACA Provided Help along the Way

Posted August 13, 2013 by JoAnn Volk

An energetic college senior found himself on a life detour when he was diagnosed with stage 3 Hodgkin’s Lymphoma – and almost immediately confronted with a maze of insurance denials and medical bills, until he was able to enroll in one of the high risk pools created under the Affordable Care Act. JoAnn Volk documents the story of Kalwis Lo, now 24 and looking forward to a lifetime of secure, meaningful coverage, thanks to the ACA.

A Story of Promise and Peril: OIG’s Review of the new CO-OPs

Posted July 30, 2013 by

The Department of Health and Human Services’ Office of Inspector General recently examined the progress of the new Consumer Operated and Oriented Plans (CO-OPs), created under the ACA. Their report shows that the CO-OPs are mostly meeting key milestones, but also face some tough challenges. Sabrina Corlette takes a closer look.

New Report on State Approaches to Nondiscrimination under the Affordable Care Act

Posted July 29, 2013 by Katie Keith

Today, CHIR released a new report exploring how private insurers and state regulators are incorporating and enforcing new nondiscrimination standards under the Affordable Care Act. Katie Keith, one of the report’s authors, has highlights from the report and discusses what the findings mean for these new protections.

Why Should Health Insurance Exchanges Drive Higher-Quality Health Care?

Posted July 29, 2013 by CHIR Faculty

The Affordable Care Act requires the Qualified Health Plans (QHPs) participating in health insurance exchanges to report on quality measures and implement quality improvement strategies. In December, HHS issued a Request for Information Regarding Health Care Quality for Exchanges in preparation for implementing these initiatives. In this blog, Sarah Dash provides a real-life illustration of why these quality improvement efforts are needed.

Shining a Light on Health Insurance: Senate Commerce Committee Examines Progress, Challenges

Posted July 28, 2013 by CHIR Faculty

Health insurance is a complicated product that consumers have difficulty understanding, a common theme throughout Wednesday’s Senate Commerce Committee hearing on “The Power of Transparency: Giving Consumers the Information They Need to Make Smart Choices in the Health Insurance Market.” Fortunately, new tools are already available to help consumers shop for and compare coverage, and more will become available as Affordable Care Act implementation continues to roll out.