…to cover a minimum set of essential health benefits. These rules were designed to improve people’s access to coverage and are applicable to all individual market insurers in order to ensure fair competition and maintain a level playing field for insurers to set premiums. Since 2014, insurers that have participated in Tennessee’s ACA marketplace, such as Humana, Community Health Alliance,…
…the ACA’s approach would encourage states to set up their own, interstate compacts, several pending Congressional proposals would effectively preempt states’ ability to regulate their markets. In their latest article for the Commonwealth Fund’s To The Point blog, Sabrina Corlette and Kevin Lucia examine the two approaches to “across state lines” sale of insurance, and what they mean for states…
…sharing data on consumer complaints. Potential Impact and Issues for States and Marketplace Enrollees While the future of the ACA’s marketplaces remains uncertain, insurers are likely to continue to push the envelope towards narrower provider networks in order to deliver more competitive premiums for consumers. And while many consumers have shown willingness to trade a broad choice of providers for…
…on recent findings that advertising efforts correlated with enrollment outcomes during the ACA’s first open enrollment, a comprehensive and well-funded consumer outreach and education campaign would be necessary to generate robust enrollment. However, in the wake of failed legislative efforts to repeal and replace the ACA, the Trump administration has promised to let the ACA marketplaces “explode,” suggesting that HHS’…
…federal subsidies to reduce cost-sharing for low-income enrollees. The Trump administration has the authority to stop federal payments to insurance companies that fund cost-sharing reductions (CSRs), which reduce the burden of things like copayments and deductibles for eligible consumers. Pulling the plug on these federal payments would force carriers to foot the bill, which could throw the individual market into…
…common qualifying events (loss of qualifying coverage, permanent move, birth, adoption or court order, and marriage) or other events the marketplace deems necessary after enrolling through SEP. If documentation not received within 30 days of notice, marketplace to terminate coverage at the end of the month. Note that a pre-verification proposal is currently out for public comment to adopt. District…
…compete in underserved markets, such as by relaxing network adequacy standards, supporting the use of telemedicine for some services, or offering temporary relief from the medical loss ratio requirement if an insurer had an unexpectedly bad year. Other thoughtful analyses of the ACA’s individual markets, and prescriptions for improvement, are discussed in briefs by the Commonwealth Fund, the Urban Institute,…
…Despite its name, the bill would have a considerable and likely detrimental impact on the private health insurance market and undermine the ability of states to protect small employers and their employees. In their most recent post for the Commonwealth Fund’s To the Point blog, CHIR experts Kevin Lucia and Sabrina Corlette review the policy goals behind the association health…
…requiring that state-based marketplaces implement a pre-verification process. To better understand stakeholder concerns and recommendations to these proposals, we pulled a sample of comments submitted by health insurers, consumer advocates, and state-based marketplace officials. The first two are summarized in Parts 1 and 2 of this series. This blog, Part 3, summarized responses from the state-based marketplaces. In Part 3…
…of comments from the array of consumer advocacy groups, as follows: Families USA Center on Budget and Policy Priorities American Cancer Society Cancer Action Network National Association of Insurance Commissioners – Consumer Representatives Community Catalyst American Diabetes Association American Association on Health and Disability American Association of Retired Persons American Heart Association Comments addressed a number of provisions of the…
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.
