…approval from the Biden administration, made changes to its Essential Health Benefits (EHB) benchmark plan, affirming and clarifying coverage requirements for gender-affirming care. In a new post for the Commonwealth Fund’s To the Point blog, Katie Keith reviews the history and current landscape of coverage for gender-affirming care, including improvements made to transgender health under the ACA, persistent disparities, and…
By Madeline O’Brien, Jack Hoadley, and Maanasa Kona In January, the No Surprises Act (NSA) will provide landmark protections against surprise billing by shielding patients from expensive bills that typically occur after receipt of unanticipated out-of-network care, which is charged at a higher rate than in-network services. While the NSA applies to services provided by physicians, hospitals, ambulatory care centers,…
By JoAnn Volk and Jack Hoadley On October 7th, the U.S. Departments of Health and Human Services (HHS), Treasury, and Labor (DOL) and the Office of Personnel Management (OPM) published a third rule implementing the No Surprises Act (NSA), the comprehensive federal law banning balance bills in emergency and certain non-emergency settings beginning January 1, 2022. The interim final rule…
…of at least twenty group health plans each year, and report annually on audits that identify noncompliant plans as well as the corrective actions the plans must take to come into compliance. The Centers for Medicare and Medicaid Services (CMS) must similarly request and audit the NQTL analyses for at least 20 insurers in states where the federal agency directly…
…find more information about qualifying statuses here. If you are not lawfully present in the U.S., you are not eligible to buy a plan on the health insurance marketplace. However, you can shop for individual health insurance outside of the marketplace. To obtain coverage, contact a state-licensed health insurance company or a licensed agent or broker. Your state Department of…
…enrollment. While states on the federally facilitated marketplace rely on national marketing campaigns to encourage enrollment, SBMs can tailor outreach and messaging to the communities in their state. They can also use data about the demographics of state residents who are eligible for tax credits but uninsured to design and implement targeted, community-based marketing and assistance efforts. Similarly, SBMs can…
…and lots more. In addition to searchable FAQs, the Guide includes a “What’s New in 2022″ section, state-specific fact sheets, and an “Ask an Expert” feature. This year, we’ve also added new content to spotlight successful and innovative outreach and enrollment strategies for communities of color, LGBTQIA+ individuals, people with disabilities, and immigrant communities. Explore the Navigator Resource Guide here….
By Madison Berry* Halloween has come and gone, but October health policy researchers have left us plenty of sweet treats. This month, we reviewed studies about the impact of a permanent extension of the American Rescue Plan Act’s (ARPA) subsidy expansion, COVID-19’s effect on health spending, and the importance of continuous marketplace coverage for pregnant people. Stacey McMorrow, Jessica Banthin,…
On October 28, the House Rules Committee released its draft of H.R. 5376, the “Build Back Better Act.” The language represents weeks of negotiations among members of Congress and the White House. While the media has focused on the provisions that party leaders were forced to drop from the package (drug pricing reform, I weep for you), policymakers’ commitment to…
By Dania Palanker and JoAnn Volk Millions of Americans are eligible for health insurance plans with low or no premiums and significantly reduced cost-sharing this coming open enrollment period thanks to enhanced marketplace subsidies under the American Rescue Plan (ARP). But misleading marketing practices may direct some consumers to alternative plans that lack the Affordable Care Act’s (ACA) protections. Researchers…
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.
