…officials are already preparing for 2023. In a new post for the Commonwealth Fund’s To the Point blog, Katie Keith explains why there is urgency for Congress to extend these enhanced marketplace subsidies sooner rather than later. If Congress does not act by August, changes will be more challenging to implement and could lead to disruption and consumer confusion. If…
…2020 federal No Surprises Act adds protections for self-funded employer plan enrollees. After Rutledge, states can likely strengthen surprise billing protections like enforcing surprise billing requirements against third-party administrators of self-funded plans. Robust demographic data collection is an important baseline practice for states pursuing reforms, particularly when it comes to identifying health equity concerns. For instance, an all-payer claims database…
…patients. The case study finds that policy interventions and stakeholder efforts have had a promising impact on primary care access for the population of Grant County. The federally qualified health center and school-based health center models have been invaluable in Grant County, creating a robust network of safety net primary care providers. State and local leadership has also enabled Grant…
By Andy Schneider and Alexandra Corcoran, Georgetown University Center for Children and Families* The Centers for Medicare & Medicaid Services (CMS) has issued final rules for provider network adequacy in Qualified Health Plans (QHPs) offering coverage in the marketplaces that the federal government operates through HealthCare.gov. Under these rules, which come with the snappy title, “Notice of Benefit and Payment…
…reduction targets (or the law’s culturally responsive network requirements) because of a failure to come to agreement with certain hospitals or providers, the insurance commissioner can hold a public hearing and ultimately require participation in Colorado Option plan networks at specified reimbursement rates (subject to legislatively established floors). Premium Rate Reduction Targets Colorado officials recently adopted rules establishing how the…
On April 28, 2022, the Centers for Medicare & Medicaid Services (CMS) released its final Notice of Benefit & Payment Parameters for plan year 2023. This annual regulation governs core provisions of the Affordable Care Act (ACA), including operation of the health insurance marketplaces, standards for insurers, and the risk adjustment program. In her latest Expert Perspective for the State…
…ensure that brokers and enrollment assisters are doing all they can to help those losing Medicaid eligibility understand their coverage options and enroll in a plan that suits them. However, there are warning signs suggesting consumers in some states will find help harder to come by, with several insurers eliminating broker commissions for mid-year marketplace enrollment. In a new Expert…
…abortion the U.S., but access to abortion has long been a story of the haves and have-nots. Current restrictions such as the Hyde amendment and required waiting periods for abortion patients disproportionately impact people of color, low-income individuals, and other marginalized communities. There are pathways for policymakers to increase abortion access, including making it more affordable and accessible. Medication abortion,…
…dedicated, independent source of unbiased and comprehensive information on public health insurance options and related proposals that promote affordability and contain costs. Leveraging our experience advising state and federal regulators on private health insurance regulation, our goal is to help policymakers protect consumers, promote affordability, and contain costs. Under this project, CHIR is offering: Comprehensive Online Resources. Our new online…
…healthy a life as possible. Federal and state-based marketplaces can take actions to increase health equity by implementing new policies such as requiring insurers to contract with essential community providers, requiring preventive care coverage, and prohibiting discriminatory health benefit design and other forms of discrimination. In their latest brief for the Commonwealth Fund, CHIR’s Dania Palanker and Nia Denise Gooding…
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.
