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Is There Really A Question? Intervenor States Have Clear Interest in Defending the Affordable Care Act

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By Dania Palanker, Georgetown University Center on Health Insurance Reforms and Edwin Park, Georgetown University Center for Children and Families The Fifth Circuit Court of Appeals has asked the parties in Texas v. United States to file supplemental briefings on the issue of whether the defendant states attorneys generals and the U.S. House of Representatives have standing to appeal. Standing…

June Research Round Up: What We’re Reading

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…in part due to a greater chance of OON emergency professional charges for inpatient admissions. Surprise bills vary across states: For available data on in-network inpatient visits, the percentage of in-network inpatient hospital stays resulting in at least one OON charge ranged from 2 percent in South Dakota to 33 percent in New York. For available data on care in…

New Trump Executive Order Could Expand Enrollment in Health Care Sharing Ministries, Direct Primary Care Arrangements

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…the EO appears to encourage Treasury to expand the eligible expenses to include consumers’ payments to HCSMs and DPCAs. What’s a Health Care Sharing Ministry? We’ve written about HCSMs in this space before. Under federal law, HCSMs are non-profits with members who “share a common set of ethical religious beliefs and share medical expenses among members in accordance with those…

States Leaning In: Washington Doubles Down on Efforts to Shore up Market, Protect Consumers

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…market reforms, Washington embraced the landmark legislation, expanding Medicaid and running a state-based marketplace. Since the ACA went into effect, 800,000 Washington residents have found coverage through Medicaid expansion and commercial plans. Fast forward to recent years and Washington is still taking steps to protect and expand access to affordable and comprehensive health insurance. In the wake of federal actions…

Are the Affordable Care Act Markets “Stabilizing”? Early 2020 Rate Filings Give Little Cause for Celebration

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…far less rosy picture than the surface-level reports about premium trends. The bottom line for 2020 is that premiums will be far higher than they should be, and many insurers are gloomy about long term enrollment and health status trends in the ACA-compliant market. Five states – Maryland, New Mexico, Oregon, Vermont, Washington – and the District of Columbia (D.C.)…

May Research Round Up: What We’re Reading

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…the playing field between insurers and providers. Hayes, S, et al. How Much U.S. Households with Employer Insurance Spend on Premiums and Out-of-Pocket Costs: A State-by-State Look, Commonwealth Fund; May 23, 2019. Following up on a previous study on the cost of employer insurance, researchers at the Commonwealth Fund evaluated the total cost of premiums and out-of-pocket (OOP) expenses for…

2019 Insurer Participation: A “Quieter” Year As Companies Maintain, Expand Their Presence

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…be costly for insurers, particularly if there is a scarcity of providers who can use their clout to command high prices. The companies must weigh whether the investment is worth the possibility of gaining only a few hundred additional enrollees. For example, in one state, an insurer withdrew from a county because it perceived the costs charged by dialysis centers…

Coming up Short: The Problem with Counting Short-Term, Limited Duration Insurance as Coverage

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In August, the Trump administration adopted a rule to expand access to short-term, limited duration insurance (STLDI). The rule allows STLDI plans to extend up to a full year, along with other changes that allow consumers to purchase STLDI as an alternative to comprehensive insurance products currently sold on the individual market. STLDI does not have to comply with the…

Can States Fill the Gap if the Courts Overturn Preexisting-Condition Protections?

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The Fifth Circuit Court of Appeals will hear oral arguments in Texas v. Azar the week of July 8, 2019. The case, which challenges the constitutionality of the Affordable Care Act (ACA), would have dramatic repercussions if the plaintiffs are ultimately successful. As many as 20 million people nationwide would lose their coverage, while millions more could face insurance company…

Most Stakeholders Oppose Expanding the Sale of Coverage Across State Lines: Reactions to HHS’ Request for Comments

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…consumer advocacy groups, insurers, state-based marketplaces, and state regulators. This is not intended to be a comprehensive report of all comments on every element in the RFI, nor does it capture every component of the reviewed comments. Additionally, a portion of submitted comments were not available for our review at the time of publication. For more stakeholder comments, 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.