Stakeholder Perspectives on CMS’s 2024 Notice of Benefits and Payment Parameters: Consumer Advocates

The Biden administration is poised to finalize new rules governing the Affordable Care Act Marketplaces and insurance reforms for plan year 2024. In the second installment of our annual review of key stakeholder responses to the proposed policy changes, CHIR’s Kristen Ukeomah and Karen Davenport focus on consumer advocate comments on the proposed rule.
Biden’s Budget Sets Up a Spending Showdown, With ACA Subsidies in the Crosshairs

President Biden released his Fiscal Year 2024 budget earlier this month, outlining the administration’s spending and policy priorities for a number of key programs, including the Affordable Care Act (ACA) Marketplaces. However, with a sharply divided Congress, consumers who rely on Medicaid and the ACA’s Marketplaces are likely in the crosshairs of an upcoming spending showdown. CHIR’s Emma Walsh-Alker examines the potential impact of cutbacks to the ACA’s Marketplace subsidies on low- and moderate-income families.
Stakeholder Perspectives on CMS’s 2024 Notice of Benefit and Payment Parameters: Health Insurers

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.
Questionable Conduct: Allegations Against Insurers Acting as Third-Party Administrators

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.
Happy 13th Birthday, ACA!
The State of State Protections: Maintaining Access to Services after Transitioning from Medicaid

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.
Proposed Rules on the ACA’s Frequently Litigated “Birth Control Mandate” Aim to Close Gaps in Coverage

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.
February Research Roundup: What We’re Reading

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.
Can Employer-Sponsored Insurance Be Saved? A Review of Policy Options: Limiting Provider Consolidation and Anti-Competitive Behavior

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.