Substantial Marketplace Coverage Gains for Communities of Color Threatened Again

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The Affordable Care Act (ACA) marketplaces have become vital lifelines for millions, especially for communities of color, significantly reducing the uninsured rate and expanding access to affordable coverage. However, the future of these marketplaces hangs in the balance, with political priorities influencing their stability and funding, particularly regarding federal subsidies. As the 2024 election cycle approaches, the choices voters make could reinforce the progress achieved or risk undoing critical health care coverage advancements.

September Research Roundup: What We’re Reading

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While the weather may be cooling down, the research is not! This month we read about Medicare Advantage quality bonus payments, out-of-pocket drug costs for consumers, effects of enhanced premium tax credits on older adults, and strategies to increase eligibility verification and receipt of Marketplace subsidies.

CHIR Expert Testifies About Facility Fees Before Texas House Insurance Committee

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CHIR expert Christine Monahan recently testified before the Texas House Insurance Committee regarding outpatient facility fee billing. Her research highlights how facility fees contribute to significantly higher healthcare costs. In her testimony, she discussed measures to curtail hospital billing tactics that inflate costs and ways to mitigate financial burdens on patients.

Current Considerations for State Reinsurance Programs

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Reinsurance has been a popular mechanism to stabilize insurance markets and reduce premiums. However, some argue that it could negatively affect affordability and enrollment for low-income individuals. In a new article for the State Health & Value Strategies program, Jason Levitis, Sabrina Corlette, and Claire O’Brien review the evidence and discuss considerations for state reinsurance programs.

How Oregon’s Merger Review Law Combats Consolidation and What Other States Can Learn From It

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Since the early 1990s, health care provider consolidation in states like Oregon has led to higher prices, reduced access, and worsened health inequities. In response, Oregon established the Health Care Market Oversight Program in 2022 to review major health care transactions, aiming to ensure they reduce costs and improve care access, especially for underserved populations. While the program has approved most transactions so far, concerns about transparency, resource adequacy, and high profit thresholds for review persist. CHIR’s Nadia Stovicek discusses the need for ongoing evaluation and improvement, and how other states can learn from Oregon.

August Research Roundup: What We’re Reading

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More hot days mean more hot research! This month we read about the growing divergence between Medicare Advantage bids and payments, the impact of enhanced premium tax credits by race and ethnicity, and about how narrow or broad ACA marketplace physician networks really are.

U.S. House Education and Workforce Committee Moves Telehealth Billing Legislation

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Recently, the U.S. House Education and Workforce Committee approved the Transparency Telehealth Bills Act, which standardizes billing for telehealth services and eliminates extra facility fees, ensuring consumers receive only one bill for their telehealth care. CHIR’s Christine Monahan discusses what this bill means for simplifying costs and protecting consumers from unexpected out-of-pocket expenses.

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.