In November, the National Association of Insurance Commissioners (NAIC) will finalize the Network Adequacy Model Act – a draft bill designed to be used by states to enact provider access standards for private health insurance plans. Consumer representative Claire McAndrew explores what the act includes as well as areas for improvement.
Experts and prognosticators have given widely different estimates for total enrollment through the Affordable Care Act’s marketplaces for 2016. Sabrina Corlette offers her take on those projections and what they mean for assessing the law’s impact.
A recent Kaiser Family Foundation reports finds that 49 percent of the remaining uninsured in our country are eligible for either Medicaid or marketplace coverage under the Affordable Care Act. Graduate researcher Jordan Messner unpacks the data.
Most Americans see the need for more data about health insurance and how it’s working for consumers, and the insurance industry itself seems to recognize the importance of collecting and analyzing data. But it’s not clear that our government regulators do. JoAnn Volk looks at the mismatch between what insurers are undertaking and what federal rules will require for data collection.
As we draw nearer to the start of Open Enrollment 3, a new resource is available from the Centers for Medicare and Medicaid Services (CMS), the FFM and FF-SHOP Enrollment Manual. A complete guide of policy and operational information, the new Manual covers all topics related to eligibility and enrollment in the FFM and FF-SHOP. CHIR’s Sandy Ahn provides a quick summary of the new CMS resource.
The year 2015 marks the 10-year anniversary of the Medicare prescription drug benefit program, known as Medicare Part D. Our colleague Jack Hoadley looks back at the rocky early beginnings of that program and shares lessons for the Affordable Care Act.
The Affordable Care Act includes a number of market reforms affecting small business health insurance. CHIR researchers, in partnership with the Urban Institute and funded by the Robert Wood Johnson Foundation, interviewed stakeholders in 5 states about how the ACA is changing the small group market. In this blog post the authors discuss their findings.
Whether their exchange is state-based or federally facilitated, many state policymakers are seeking ways to realize the advantages of a state-run marketplace model while minimizing, so far as possible, the financial and operational burdens of building or maintaining one. In a new issue brief for The Commonwealth Fund, CHIR researchers explore the experiences of four states that established their own exchanges but have operated them with support from the federal HealthCare.gov eligibility and enrollment platform.
Although Maryland is among the handful of states that regulate balance billing for out-of-network situations, as we discuss in a previous report, the state’s law does not address air ambulance charges. Balance billing for air ambulances remain a problem in Maryland and its insurance department held a public meeting last Friday to discuss the issue. CHIR’s Sandy Ahn provides highlights of the meeting and other state efforts to address this consumer problem.
The Affordable Care Act’s new health insurance marketplaces could be critical sources of data about how people access and use coverage. Yet, to date, the marketplaces have released varying degrees of information, with little uniformity or consensus over what data should be collected and how. In our latest post for The Commonwealth Fund, CHIR researchers Sean Miskell, Justin Giovannelli and Kevin Lucia examine data collection and reporting by the health insurance marketplaces.
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.
