The Biden administration is poised to finalize new rules governing the Affordable Care Act Marketplaces and insurance reforms for plan year 2024. In its annual review of how key stakeholders are responding to the proposed policy changes, CHIR will be publishing a three-part series focused on insurance company, consumer advocate, and state comments on the proposed rule.
Nearly half of U.S. residents are enrolled in employer-sponsored health insurance. Many of these plans use third-party administrators (TPAs), intermediaries—frequently insurance companies themselves—that help build provider networks, design benefit packages, and adjudicate claims, among other responsibilities. But a TPA’s interests may not align with those of their employer clients. CHIR’s Christine Monahan highlights several examples of questionable insurer-TPA practices uncovered in recent years.
The Affordable Care Act is now 13 years old. To celebrate this milestone, CHIR takes a look at the law’s big accomplishments and its impact on American families.
As states resume conducting Medicaid and CHIP re-determinations of eligibility, the U.S. faces the most dramatic shift in coverage since implementation of the Affordable Care Act. As millions of people transition from Medicaid to private insurance coverage, they could experience disruptions in critical health care services. In their latest post for the Commonwealth Fund, Sabrina Corlette and Maanasa Kona review state-level continuity of care protections and actions states can take to preserve access to life-saving services for our most medically vulnerable.
Last month, the Biden administration proposed new rules to restore access to free contraceptive services under the Affordable Care Act. In the wake of severely restricted access to reproductive health care, the stakes of the Biden administration’s proposals are high. With comments due on April 3, CHIR’s Rachel Schwab provides an overview of the Biden administration’s proposals and key considerations for consumers’ access to contraceptive services.
Along with “Health Policy Valentines,” February brought a host of new health policy research. This month, we read about trends in medical and pharmacy spending, the relationship between health systems’ financial performance and amounts paid by commercial plans, and mental health provider network adequacy.
High and rising health care prices are a key driver of increased cost sharing in employer plans. A significant contributor to rising prices is the consolidation in health care provider markets. In the third post of a series on policy options to improve the affordability of employer-sponsored insurance, CHIR’s Maanasa Kona and Sabrina Corlette explore strategies to limit provider consolidation and anti-competitive behavior.
Washington State’s “public option” program is now in its third year. After initial cost and access challenges hindered the program’s reach, growing insurer participation and recent enrollment data suggest meaningful progress is being made. CHIR’s Christine Monahan and Madeline O’Brien provide an update on how Washington’s public option plans performed in the recently concluded open enrollment period, outlining key issues to watch as Washington moves forward with its first-in-the-nation program.
States have begun conducting Medicaid redeterminations and renewals after an almost 3-year pause, a process that is being called the “Unwinding.” In their latest article for the State Health & Value Strategies program, Sabrina Corlette, Jason Levitis, and Tara Straw outline strategies state Marketplaces and insurance departments can implement to reduce coverage disruptions and ensure continuity of care.
After a three-year pause on Medicaid redeterminations, states can begin the process of removing residents from their rolls beginning on April 1. Many people who are terminated from Medicaid will be eligible for free or low-cost plans through the Affordable Care Act’s Marketplaces. To help consumers and enrollment assisters during this nationwide coverage event, we’ve updated our Navigator Resource Guide with new content about transitioning between Medicaid and private health insurance.
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.
