Before the Affordable Care Act (ACA) was enacted, one of the primary ways insurance companies deterred less healthy people from enrolling was to charge them a higher premium based on their expected health risk. The ACA prohibited this practice beginning in 2014. Health insurers in the individual market can now adjust premium rates solely based on a person’s age, family…
…participate in the marketplace on the promise of receiving reimbursements, “only to directly compromise these companies’ financial condition once they committed.” ACAP agreed, writing that “an entire industry had relied on [this promise,]” and allowing the government to walk away from this commitment would serve as an “enormous cautionary tale about why the business community cannot trust the United States…
…years. Conversely, competing legislation reported out by the House Energy & Commerce and Senate Health, Education, Labor & Pensions (HELP) Committees, which follow a California model, are projected to save an estimated $20 billion over the next decade. For background on the issue of surprise medical bills and policy approaches to protecting consumers, visit Georgetown CHIR’s new website: https://surprisemedicalbills.chir.georgetown.edu/ Competing…
…for instance — is out of network. During the 116th Congress, at least six bills have been introduced to address surprise medical bills; four have bipartisan support. In their latest post for the Commonwealth Fund’s To The Point blog, CHIR experts analyze advancing federal legislation and share an updated comparison of key provisions. You can access the full post here….
…have launched a new project to provide policymakers with a dedicated, independent resource for unbiased and comprehensive information on the issue of surprise medical bills. Leveraging our experience advising state insurance regulators and monitoring surprise medical bill legislation in all 50 states and before Congress, our goal is to help policymakers protect consumers, promote affordability, and adopt comprehensive surprise medical…
…SBMs were more likely than FFM states to ban the Obama administration’s so-called “grandmothered” plans, which kept healthy people out of the ACA-compliant market. More recently, SBM states have been more likely to implement a state-level individual mandate and a state-based reinsurance program. Additionally, states can regulate their individual markets to steer consumers to ACA-compliant comprehensive health insurance plans through…
…the feasibility, scope, and design. The final policy proposal will be submitted to the state legislature by mid-November. Harnessing a Communities’ Purchasing Power to Lower Costs: The Peak Health Alliance Colorado’s mountain communities have faced high health care prices, owing to a lack of competition and the high cost of providing care in rural areas. To address this issue, a…
…August 14, 2019. Researchers with the Kaiser Family Foundation’s Peterson-Kaiser Health System Tracker analyzed health benefit claims to see how rising premiums and cost-sharing affects employers and employees of large companies. What It Finds Employees’ financial responsibility for health coverage – a combination of worker premium contributions and cost-sharing for employees and their families – has increased 18 percent over…
…activities, the company is not the only HCSM-related entity that has come under fire recently. According to some sources, Ohio’s Department of Insurance and Attorney General’s Office has received over 30 complaints this year regarding Liberty HealthShare – another HCSM. Many of the complaints suggest that consumers’ bills “aren’t being addressed quickly or paid at all [.]” In fact, based…
…upend our system of employer-based coverage – the primary source of insurance for approximately 158 million people. DOJ’s Remedy Would Undermine the Purpose of ERISA & Create a Race to the Bottom The Employee Retirement Income Security Act, commonly known as ERISA, is a federal law that sets certain minimum standards for most retirement and employee welfare benefit plans, including…
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