…coverage, while millions more could face insurance company denials, premium surcharges, or high out-of-pocket costs because of their health status. In an attempt to blunt the potential fallout, several states have enacted legislation to ensure that the ACA protections become part of state law. In their latest post for the Commonwealth Fund’s To the Point Blog, CHIR’s Sabrina Corlette and…
…provide the same services in the same geographic area. Insurance companies and employers who self-fund insurance plans are thus forced to include high cost Sutter facilities in their network even in communities with competitive provider markets, because Sutter has a monopoly in another community and is thus a “must have” provider for local residents. The plaintiffs argued that this tactic…
It has been two years since President Trump issued an executive order aimed at promoting and expanding skimpy health coverage products as an alternative to comprehensive health insurance. These products typically fail to provide the comprehensive coverage guaranteed in plans compliant with the Affordable Care Act (ACA). In some cases, people are left burdened with high medical bills or find…
…paying for an emergency situation or treatment for an unforeseen diagnosis without coverage. To ensure that an insurance product provides comprehensive coverage and adequate financial protection, and to see if you qualify for premium tax credits, visit HealthCare.gov. Where should I buy coverage? First, you should visit HealthCare.gov to see if you qualify for premium tax credits based on your…
…seeking public comment. Instead, they can implement the new rules while taking comments from the public at the same time. Even those who are unfamiliar with the ins and outs of administrative procedure can see why it is irresponsible to move forward with yet another public charge rule while the first rule has been blocked and without letting the public…
…we’re ever to truly tackle out-of-control health care costs in this country, the employer community needs to take the lead. A newly released report from Georgetown CHIR finds, however, that there are significant challenges facing insurers and employers who seek to constrain the rising provider prices that have driven the annual family premium above $20,000 this year. In six market-level,…
…is sent to HealthCare.gov for a determination of eligibility for financial assistance, and is then returned to the broker/insurer’s website to complete enrollment. With EDE, individuals can enroll in coverage and receive an eligibility determination for financial help through a broker/insurer’s website without being directed to HealthCare.gov. For 2020, HHS will perform compliance reviews of DE brokers to determine whether…
…Centers for Medicare & Medicaid Services, “Health Insurance Exchanges 2019 Open Enrollment Report,” March 25, 2019, accessed at https://www.cms.gov/newsroom/fact-sheets/health-insurance-exchanges-2019-open-enrollment-report. A recent study published in JAMA Internal Medicine highlights why automatic re-enrollment is critical to maintaining marketplace signups. Researchers at the University of Pittsburgh and Duke University evaluated enrollment data from the California marketplace, finding that between 2014 and 2017, losing…
…to reduce the number of uninsured and make health care more affordable. As one respondent put it: “States do this transition because they’re committed and want to help people have coverage.” All eyes are on Nevada—the first state making the transition back to a state technology platform—as an indicator of whether a stable and more efficient marketplace is a viable…
…their families are hit by rising costs, suggests that these private market negotiations have had limited effectiveness keeping cost growth in check. Sinaiko, A, et al. Marketwide Price Transparency Suggests Significant Opportunities for Value-Based Purchasing. Health Affairs; September 1, 2019. Recently, the Massachusetts Center for Health Information and Analysis created a dataset including prices paid for 291 in-network outpatient medical…
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.
