Direct Primary Care Arrangements Raise Questions for State Insurance Regulators

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Over the past year, new health coverage products that are not subject to the consumer protections of the Affordable Care Act have hit the individual market. One type of limited health-insurance-like offering that was already available but is now gaining attention is a direct primary care arrangement. For Commonwealth Fund’s To the Point blog, experts at CHIR took a closer look at state law to understand how states regulate these entities and highlight some of the concerns that state insurance regulators might want to consider going forward.

States Opt to Run their Own Exchanges to Save Money, Reclaim Autonomy

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Last month, the Board of New Mexico’s health insurance exchange voted to transition from HealthCare.gov to a state-based exchange. The state will undertake the task of building its own eligibility and enrollment platform with the hopes of launching a website in time for the 2021 plan year. This is the same exchange that, in 2015, called the federal platform HealthCare.gov the “safest, most risk-free way to proceed.” So, what changed? CHIR’s Rachel Schwab looks at the reasons behind the growing call to leave HealthCare.gov.

What’s New for 2019 Marketplace Enrollment? Get Ready for Updated, Improved Navigator Resource Guide

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On November 1, the sixth open enrollment period begins for marketplace coverage under the Affordable Care Act. We at CHIR will soon re-launch our updated Navigator Resource Guide, which provides information on recent policy changes, a list of enrollment tools for consumers and assisters, and answers to hundreds of frequently asked questions. To learn what’s new for 2019, read our CHIRBlog summarizing the major policy changes consumers might encounter this year.

The Trump Administration’s Association Health Plans Emerge: What Early Announcements Tell Us About this New Market

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This past summer, the Department of Labor (DOL) finalized a regulation calling for the expansion of association health plans (AHPs) for small businesses and self-employed individuals. There continue to be significant questions about the impact of the rule, including how many associations will form, the role major medical insurers will play in AHP administration and marketing, and the extent to which AHPs can offer cheaper premiums than plans that must meet federal and state consumer protection standards. Now, with the rule for fully insured AHPs effective on September 1, we are starting to see AHPs emerge as groups take advantage of the relaxed requirements.

Proposed “Public Charge” Rule Risks Immigrants’ Access to Private Coverage, Too

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A federal proposal would make it more difficult for immigrants to obtain a green card if they’ve received certain public benefits like Medicaid. Although the policy doesn’t include the Affordable Care Act’s premium tax credits in its list of public benefits, there are several ways the proposed rule could place immigrants’ access to private coverage at risk. Sabrina Corlette takes a look.

September Research Round Up: What We’re Reading

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This September, CHIR’s Olivia Hoppe focuses in on health care spending and costs with new studies on how consolidation impacts individual market premiums, spending under employer-sponsored health insurance, the effects of removing financial incentives for quality, and pharmaceutical reference pricing. With health care costs at the forefront of consumers’ minds, these new studies shed light on what contributes to America’s exorbitant health spending.

New Report Shows Role of Medicaid Expansion in Rural Area, Small Town Health Coverage

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Under the Affordable Care Act, 33 states and the District of Columbia expanded Medicaid, greatly increasing coverage under the public program. In a new report, our sister center,
the Center for Children and Families, examines the impact of Medicaid expansion on health coverage in rural areas and small towns, communities that for many years have faced high premiums and limited choices on the private insurance market.

House Farm Bill Supports AHPs with Federal Grants—Following in the Footsteps of the ACA’s CO-OP Program

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The Farm Bill currently being debated in a House-Senate conference committee enables the Secretary of Agriculture to create a loan and grant program to assist in the establishment of agricultural association health plans (AHPs). The bill’s injection of federal funding for the purpose of creating new health insurance options is strikingly reminiscent of the ACA’s CO-OP Program. As Congress considers directing federal dollars into AHPs, we look back at the experience of the CO-OP program, which demonstrates just how difficult it is to build a new insurance company.

Federal Flexibility Grants Highlight State Priorities for Market Stability

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Last month, the Department of Health & Human Services awarded $8.6 million in grants to 30 states and the District of Columbia to provide additional support to implement certain ACA market reforms, including guaranteed issue, guaranteed renewal, and the Essential Health Benefits. CHIR’s Rachel Schwab took a look at how states plan to use the federal funding, and what tops the list of state market stabilization and consumer protection priorities.

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.