…federal mandate of distinguishing among insurance options—noting that there was no way for plaintiffs to comply with both state and federal law without suffering “irreparable harm.” The decision ultimately lifts what many referred to as the “gag rule” and comes as a victory to advocates who are working to create sustainable programs that will aid and educate consumers. The decision…
…a broken arm and providing preventive screenings that are traditionally considered to be gender-specific (such as prostate exams or mammograms). These denials occur even though these services are not unique to transgender individuals and are routinely covered for non-transgender people on the same plan. Transgender exclusions are still common in state-regulated plans: they were included in the 2017 essential health…
…can help test whether concerns about price increases and self-funding will come to fruition. As part of an ongoing project monitoring state action on private insurance reforms for the Commonwealth Fund, Georgetown researchers examined action in the states to either expand their small business insurance market to 100, or keep it at 50. Their complete analysis can be found here….
…found in a report published for the Robert Wood Johnson Foundation, some states have already taken steps to address the problem of surprise billing, but the approach and comprehensiveness of consumer protections vary. For example, Colorado requires that a health plan hold a consumer harmless in a surprise billing situation; California and Florida prohibit balance billing in emergency situations. Balance…
…these calls to update their models and price targets—for the health policy community, these calls can provide useful insight into a company’s strategic thinking, which cannot otherwise be found in forecast or projection filings. Comments made on the calls often shed light on what companies perceive are emerging market trends and they introduce perspectives on how companies may be faring…
…of children, who often require more specialized care than adults. Further, the federal government should conduct more research of its own comparing how well different sources of coverage meet the needs of children, and they should fully release the results of these studies. Readers may remember how long we waited for the Congressionally mandated report comparing CHIP and QHP coverage,…
…until March 31, 2016. For answers to other questions related to enrollment, coverage, and post-enrollment issues, check out our complete Guide, which was developed in collaboration with staff from Georgetown’s Center for Children and Families, the Kaiser Family Foundation, and the Center on Budget and Policy Priorities and made possible thanks to a grant from the Robert Wood Johnson Foundation….
In its design, the Affordable Care Act (ACA) includes several benefits and provisions intended to assist small businesses with providing health care coverage. Still, a recent survey of small business owners found that a majority believe the ACA is bad for their business and more than 80 percent want more government help staying compliant with the law’s regulatory framework. With…
By Tricia Brooks, Georgetown University Center for Children and Families At last, we have IRS guidance informing consumers and tax preparers about issues with overlapping coverage through Medicaid and the Marketplace. I described this problem in a recent blog, highlighting the confusion that could result from 1095 forms showing dual coverage in Medicaid and the Marketplace. We have been concerned…
…cutting funding for the CO-OP program, there are no additional federal funds coming to save these companies. Without much of a financial cushion, it’s hard to see how they can sustain these losses much longer. State and federal insurance regulators are undoubtedly watching closely. Should any of them fail, let’s hope that the state, federal officials and company executives can…
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.
