Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces

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After the Biden administration issued the proposed 2023 “Notice of Benefit and Payment Parameters,” several hundred stakeholders provided feedback on the new set of rules governing the ACA’s marketplaces and health insurance standards. To better understand the impact of the proposed rules, CHIR reviewed a sample of stakeholder comments. For the third blog in our series, Rachel Schwab summarizes comments submitted by state departments of insurance and state-based marketplaces.

February Research Roundup: What We’re Reading

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In honor of Black History Month, for the February edition of CHIR’s monthly research roundup we reviewed new health policy research centering the experiences of Black people in the U.S. health care system, including structural racism in health care policy, the impact of state Affordable Care Act (ACA) implementation on racial and ethnic minority populations, and trends in coverage, care access, and health outcomes among Black Americans.

Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: Consumer Advocates

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In the recently released 2023 “Notice of Benefit & Payment Parameters,” the Biden administration is proposing significant changes to the Affordable Care Act marketplaces. In the first of a three-part series, CHIR’s Emma Walsh-Alker and JoAnn Volk reviewed public comments from multiple consumer advocacy organizations about the impact of the new policies on marketplace beneficiaries. Reviews of comments from insurers and state marketplaces and insurance departments will follow.

New Data Show Medical Debt Disproportionately Affects the Most Vulnerable Populations

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Unpaid medical bills are among the largest contributors to personal debt in the United States. Evidence indicates that medical debt disproportionately affects people of color and individuals with lower incomes. CHIR’s Maanasa Kona reviews new data from the Census Bureau and state court records that demonstrate the disparate impact of medical debt on vulnerable populations, and explores what policymakers can do to protect consumers from aggressive debt collection.

PrEP Coverage Obstacles Highlight Challenges Implementing the ACA Preventive Services Requirement

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The ACA requires coverage of recommended preventive services without cost-sharing for consumers enrolled in most private health plans. But even with these protections in place, some insurers improperly impose cost sharing for preventive services. Recently, this problem hit consumers who use pre-exposure prophylaxis (PrEP), a medication that can prevent contraction of HIV.

Questionable Quality Improvement Expenses Drive Proposed Changes to Medical Loss Ratio Reporting

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Under the Affordable Care Act, insurers must provide rebates to enrollees when their spending on clinical services and quality improvement, as a proportion of premium dollars, falls below a minimum threshold. Federal regulators have discovered some insurers are gaming the system by misallocating expenses or inflating their spending on providers. Karen Davenport takes a look at how this practice impacts consumers, and explains a new federal proposal to crack down on it.

Ensuring the Adequacy of ACA Marketplace Plan Networks

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Following the Trump administration’s decision to roll back federal network adequacy standards for Affordable Care Act marketplace plans, the Biden administration signaled it will soon resume oversight, proposing new, quantitative standards as well as proactive compliance procedures. In a new post for the Commonwealth Fund’s To the Point blog, CHIR’s Justin Giovannelli examines current state and federal approaches to network adequacy, and what would change under the new standards proposed by the Biden administration.

New CHIR Report Assesses the Effectiveness of Policies in Improving Access to Primary Care for Underserved Populations

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It is hard to overstate the importance of primary care in ensuring robust health outcomes at the population level. In a new report supported by the National Institute for Health Care Reform, CHIR experts reviewed research to assess whether policy initiatives targeting primary care access have been effective in reducing health care disparities.

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.