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Bridging the Gap: Oregon’s Proposal to Ease Coverage Transitions at the End of Public Health Emergency

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…(recently extended by the Inflation Reduction Act), states have implemented and explored public options, state-funded financial assistance, Medicaid innovation waivers, and other policies to expand access to affordable, comprehensive health insurance. The BHP allows states to leverage federal funding to offer affordable and comprehensive coverage to lower income residents, but like all of these policies, the feasibility and effectiveness of…

Value for Whom? HHS Office of Civil Rights Seeks Input on the Impact of Payers’ Value Assessments on Health Equity

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…communities. Some commenters suggested alternative methodologies, such as multi-criteria decision analysis (MCDA), arguing that this approach better captures the complexity of coverage decisions. MCDA applies a range of criteria to potential alternatives, according to stakeholder and decision-maker preferences. Other commenters endorsed the inclusion of patient perspectives and preferences in the conceptual framework and methods that guide this analysis. Potential implications…

New and Improved Navigator Resource Guide Answers Common Enrollment Questions and Reflects Policy Changes for 2023

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…on topics such as marketplace eligibility, premium and cost-sharing assistance, comparing plan benefits and costs, and post-enrollment issues, including: Who is eligible for marketplace premium tax credits? How can I find out if my doctor is in a health plan’s network? Is an insurer allowed to ask me about my health history? I was denied coverage for a service my…

State-Based Marketplace Outreach Strategies for Boosting Health Plan Enrollment of the Uninsured

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…in 2022, but because many people qualifying for free or low-cost plans are unaware of their eligibility or face barriers to completing the sign-up process, this historic enrollment required substantial outreach. In a new issue brief for the Commonwealth Fund, CHIR experts Rachel Schwab, Rachel Swindle, and Justin Giovannelli detail innovative outreach strategies employed by state-based marketplaces (SBMs) during the…

The GOP’s Plans for Health Care if they Take Control of Congress: A Mixed Bag for Consumers

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…competition in the health care market to reduce costs. Codifying the rules into legislation would make the transparency requirements more durable, but baking in the current regulations would not solve the present compliance and access issues that have made price data less than useful. Stakeholders have identified several ways to improve the transparency rules; simply codifying existing regulations would not…

New CHIR Report Examines Federal-State Partnership in No Surprises Act Implementation

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By Jack Hoadley, Madeline O’Brien, and Kevin Lucia The No Surprises Act (NSA), effective as of January 2022, aims to protect consumers facing surprise medical bills after receiving care from out-of-network providers under circumstances beyond their control. In a new report for the Commonwealth Fund, CHIR’s Jack Hoadley, Madeline O’Brien, and Kevin Lucia examine how states are working with the…

New Georgetown Report Reviews State Efforts to Enforce Mental Health Parity

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…treatment, but inadequate compliance has raised questions about health plan enrollees’ ability to access these crucial services. In a new issue brief supported by the Robert Wood Johnson Foundation, CHIR experts review MHPAEA oversight and enforcement in five states—Arizona, Nebraska, Pennsylvania, Virginia, and Washington—to understand the challenges states face and identify opportunities for improvement. The brief focuses on enforcement of…

September Research Roundup: What We’re Reading

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…gastroenterology, and ophthalmology) before and after acquisition, and compared PE-acquired practices with independent practices. What it Finds PE-acquired practices charged a mean additional amount of $71 per claim after acquisition compared to the control practices (a 20 percent difference) and saw an increase of $23 in allowed amount per claim (an 11 percent difference). Although charges trended upward across all…

What’s New for 2023 Marketplace Enrollment?

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…on helping traditionally underserved communities access affordable Marketplace coverage. A portion of federal funding is also earmarked for assisting eligible Medicaid beneficiaries transition to Marketplace coverage. Price Comparison Tools: Beginning January 1, 2023, federal law will require health plans to develop and maintain an online price comparison tool for plan enrollees. This new tool will allow enrollees to compare the…

Nevada Actuarial Study Projects Significant Savings from Public Option Plans

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…that they will face minimal impact. (To ensure adequate access to care, Nevada requires that any providers who participate in the state public employee benefits program, Medicaid program, or workers compensation program, must participate in at least one public option plan network.) The individual health insurance market accounts for approximately 3 to 4 percent of health care providers’ payor mix…

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.