…eyeshades that analyze health insurance data. They recently released an issue paper on the future of the individual health insurance market. Actuaries play a critical role in the insurance world. Insurance functions as a way to protect consumers from financial risk (and in the case of health insurance, health risk). In order to sustain that protection, insurance companies also need…
…maintain (or, if they have not yet done so, adopt) some of the ACA’s market reforms, many of which continue to be viewed favorably even across party lines. Because Congress has not yet enacted or even coalesced around a single federal replacement plan, state policymakers should exercise caution before making changes in state law. Read more in The Commonwealth Fund’s…
…services, and connect enrollees to other services in the community. CMS has also launched an initiative to encourage states to develop innovative service delivery Section 1115 demonstration projects to address SUD that also promote care coordination, integrated care, and comprehensive strategies that provide a “full continuum of care” for persons with SUD. The ACA’s Medicaid expansion also represents the first…
…prices (Tennessee also raised concerns about the lack of regulation of pricing for air ambulance services). New Hampshire and Utah highlighted the value of their all-payer claims databases and asked Congress to require self-funded employer plans to contribute claims data. Many called for greater transparency of the pricing for health care goods and services. On the other hand, proposals from…
…there is no legal requirement for private insurance companies to participate. We recently reached out to executives with 13 insurance companies participating in the marketplaces in 28 states and asked how they would respond to different potential scenarios for ACA repeal. We document our findings from those interviews in a new report for the Urban Institute, funded by the Robert…
…alternative remain highly uncertain. What happens if portions of the ACA are repealed without timely replacement? Independent quantitative analyses find millions of Americans would lose coverage. The resulting regulatory landscape would look like what several states had in place prior to the ACA. Their experiences were similarly grim. In a new study for The Commonwealth Fund, Justin Giovannelli and Kevin…
Before the Affordable Care Act (ACA), what state you lived in determined how easily you could purchase a health plan, the price, and what the plan would cover in the individual market. Rules varied by state, but one common fact was that insurers could use your health status to deny coverage, to exclude coverage or to charge you more in…
…has made changes to the risk adjustment program, which aims to encourage insurers to compete on plan design and value rather than risk avoidance. For 2017, the administration changed the payment methodology to include partial-year enrollees. For 2018, plans will be able to include data on prescription drug use for assessing individual enrollee risk. Both of these changes were sought…
By Sabrina Corlette, Emily Curran and Justin Giovannelli The Affordable Care Act (ACA) created health insurance marketplaces to make it easier for consumers to shop for and compare plan options in one place. As of December 24, 2016, over 11.5 million people had signed up for coverage through the marketplaces, and the U.S. Department of Health and Human Services projects…
…replace” the ACA are those enrolled in employer-sponsored health plans — the primary source of coverage for people under 65. Job-based plans offered to employees and their families cover 150 million people in the United States. If the ACA is repealed, they stand to lose critical consumer protections that many have come to expect of their employer plan. It’s easy…
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.
