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The Affordable Care Act prohibits discriminatory benefit design, but how is that enforced?

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…discriminatory; Lack of clinical expertise among insurance regulators; Lack of access to comprehensive information from insurers about their plans’ benefit designs; and Lack of a regulatory infrastructure for ongoing oversight, such as monitoring consumer complaints. Three years later, many of these same challenges remain. Regulating discriminatory benefit design – where are we today? In the fall of 2016, state and…

In the Midst of Federal ACA Woes, States Play an Important Consumer Protection Role

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…federal government’s progress, twenty states received funding to expand and improve department training, compliance tools, and outreach efforts to protect consumer access to mental health and substance use disorder services. Some states, like California, plan to use the grant money to enhance and automate analysis templates to improve the evaluation process for insurer compliance with mental health parity requirements. The…

Definition of Insanity? Trump Transition Team Proposals for “Replacing” the Affordable Care Act

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…Galen Institute, which wrote back in February: “Any candidate that suggests such a scheme only shows how unsophisticated he and his advisers are when it comes to understanding how the insurance markets really work––or could work.” At Georgetown, we did a study of states that had enacted across state line legislation on their own, to find out if those laws…

Soldiering On

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By Sabrina Corlette, Kevin Lucia and JoAnn Volk This past week we’ve been thinking about Senator Ted Kennedy. Although the Affordable Care Act ultimately came to be called “Obamacare,” its primary advocate and visionary was probably the late Senator. He passed away before he could see his dream of comprehensive health reform come into fruition, but no person did more…

How Could a New Administration Tackle Affordable Care Act Challenges? Look to Medicare

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…also establish their own reinsurance programs, as Alaska has done. In that state, simply setting up the program brought proposed premiums down from a projected 40 percent increase to just over 7 percent for 2017. However, reinsurance funds must come from somewhere. Currently the funds for the ACA program come from an assessment on all health plans, including group and…

Consumer Shopping on Healthcare.gov During Open Enrollment 4

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…compare up to three plans, but unlike last year, the comparison will be on one screen so consumers can do a true side-by-side comparison. Another feature for plan comparison that’s new this year are Simple Choice plans, which are standardized plan designs with fixed cost-sharing amounts. The availability of these plans, however, vary by state, which we blog about here….

Simple Choice Plans Debut on Healthcare.Gov

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…a light blue colored “Simple Choice” label, allowing consumers to easily identify them and make plan comparisons when assessing benefits. Though it’s still unclear how many Simple Choice plans are offered on the 2017 market overall, we performed an analysis using zip codes from the three most populated counties and the least populated county in each Healthcare.gov state, in order…

Health Plan Restrictions on Contraceptive Coverage: It’s like asking people to “renew their seat belt each month”

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The Affordable Care Act (ACA) has lowered financial barriers to birth control by requiring health plans to cover contraceptives at no cost sharing, but restrictions limit the availability and affordability of certain methods. While we’ve come a long way in ensuring access to this essential service, one hundred years after Margaret Sanger opened the first Planned Parenthood clinic in Brooklyn,…

New Marketplace Research: Off-Marketplace Consumers and How Marketplace Enrollees Fare in Expansion and Nonexpansion States

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By Karina Wagnerman, Georgetown University Center for Children & Families Two new reports released this month on the Marketplace have sparked our interest. The first, a brief from the Office of the Assistant Secretary for Planning and Evaluation, examined the population currently purchasing off-marketplace coverage. The authors estimate that about 6.9 million individuals purchase health insurance in the off-Marketplace individual…

New and Improved Navigator Resource Guide

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…and Health Insurance Marketplaces. Developed with the support of the Robert Wood Johnson Foundation, the Guide offers close to 300 searchable commonly asked questions and answers about shopping for and enrolling in health insurance coverage. The Guide is a hands-on, practical resource for navigators and anyone who needs to communicate with consumers about applying for financial assistance, eligibility for a…

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.