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An Opportunity to Protect Consumers and Ensure a Level Playing Field: Reversing Trump-era Rules on Association Health Plans

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…economies of scale and purchasing power with insurance companies. However, their primary advantage has been that, prior to the ACA, many states exempted AHPs from rules and standards that applied to commercial insurers, such as filing requirements, underwriting restrictions, benefit mandates, and solvency standards. This enabled them to offer a cheaper price to healthy groups and individuals, but the looser…

Workplace Wellness Programs Have Overlooked Health Equity

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By Julie Zuckerbrod* In 2017, many food service and maintenance staff at Yale University received a notice about a mandatory health screening and “coaching” program. These employees and their spouses were automatically enrolled in the Yale Health Expectations Program (HEP), which required them to complete a series of health services like physical exams, blood tests, and cancer screenings. The data…

Federal Policy Priorities for Preserving and Improving Access to Coverage: Perspectives from State-Based Marketplaces

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…and Congress have opportunities to implement and advocate for policies that strengthen state-based marketplaces (SBMs) to ensure they continue to serve as a coverage safety net. In a new issue brief for the Commonwealth Fund, CHIR experts assessed how federal policy decisions have impacted SBMs and the consumers they serve by interviewing directors and officials from 17 SBMs. The authors…

January Research Roundup: What We’re Reading

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…B. et al. Arbitration Over Out-Of-Network Medical Bills: Evidence From New Jersey Payment Disputes, Health Affairs, January 2021 In this article, Health Affairs researchers assess outcomes from New Jersey’s first full year of arbitration decisions by linking this data to Medicare and commercial insurance claims data. Over 2,000 disputes filed between January 1 and December 31, 2019 are analyzed. What…

Health Insurance Companies Spent Millions to Defeat the Affordable Care Act. Now They’re Embracing Policies to Expand It.

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Amidst a number of national crises, the Biden Administration has hit the ground running in its first few weeks in office. The administration has prioritized efforts to combat the COVID-19 pandemic, but it is also working to strengthen the Affordable Care Act (ACA) by improving access and affordability of health insurance. Biden was one of the few Democrats in the…

FTC’s Opportunity to Protect Consumers from Deceptively Marketed Alternative Coverage Arrangements

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After the Trump administration loosened the requirements for and promoted the use of non-ACA compliant short-term plans as cheaper alternatives to comprehensive health insurance, a U.S. House of Representatives Energy & Commerce Committee Report found that enrollment in these plans had increased about 27 percent, bringing the number up to at least 3 million Americans. Another 1 million people were…

Expanded Coverage For COVID-19 Testing Must Include Limits On Costs

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By Loren Adler and Sabrina Corlette* On January 21, President Biden kicked off his administration by outlining a new strategy to combat COVID-19. As part of this strategy, Biden issued an Executive Order that appears aimed at revisiting Trump administration guidance that exempted health plans from having to cover without cost-sharing COVID-19 testing for individuals who lack symptoms, a doctor’s…

Georgia’s ACA Waiver Flouts Federal Law, Drawing a Legal Challenge

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…to COVID-19 and doggedly pursued as the pandemic raged, will fragment Georgia’s individual market and almost certainly make it harder for residents to find and enroll in affordable, comprehensive coverage. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Justin Giovannelli, JoAnn Volk, and Kevin Lucia assess the potential impact if Georgia is able to implement…

Many States with COVID-19 Special Enrollment Periods See Increase in Younger Enrollees

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By Rachel Schwab, Sabrina Corlette and Kevin Lucia In one of his first acts in office, President Joe Biden signed an executive order to reopen the federal health insurance marketplace, creating additional access to comprehensive coverage and financial assistance. Last year, in response to the COVID-19 pandemic, most state-based marketplaces (SBMs) opened a special enrollment period (SEP) to allow people…

Stakeholder Perspectives on CMS’s 2022 Notice of Benefit and Payment Parameters. Part 3: Consumer Advocates

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…This blog is intended to provide a summary of comments submitted by some consumer advocates. This is not intended to be a comprehensive report of all comments on every element in the 2022 Notice of Benefit and Payment Parameters proposed rule, nor does it capture every component of the reviewed comments. To view more stakeholder comments, please visit http://regulations.gov.  …

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.