Filing Fee and External Appeals

One of the most significant consumer protections in the Affordable Care Act (ACA) is the right to appeal a denied claim, including the right to take your appeal to an independent, third-party reviewer. Although the ACA guarantees this right, recent federal rules have codified barriers to the process that still exist in some states, such as filing fees. Sandy Ahn provides a short summary of this issue.

Feds Propose Changes – and an Expanded Role – for Marketplace Navigators

A new proposed rule from the Obama Administration contains wide-ranging new requirements for insurance companies and marketplaces under the Affordable Care Act, including changes that expand the role of marketplace navigators. CHIR’s Sabrina Corlette shares some highlights.

Paying for Miracles – The High Cost of Cures

It is every patient’s dream to hear the words, “You’re cured.” Yet the ability to cure can come with a high cost, one that health insurers are often reluctant to cover. Georgetown University medical student Joshua Barrett examines recent proposals for unique payment mechanisms for high-cost interventions that could perhaps change the way they are priced and financed.

State Efforts to Reduce Consumers’ Cost-Sharing for Prescription Drugs

High drug prices have been in the news lately, and consumers are bearing an ever-greater burden of those drug prices through health plan cost-sharing. In their latest post for the Commonwealth Fund, CHIR researchers Sabrina Corlette, Ashley Williams and Justin Giovannelli analyze state policies to try to protect consumers from high drug costs.

Shop to Renew During Open Enrollment

While many consumers with marketplace coverage will be eligible for automatic renewal, there are many reasons for all consumers to shop to renew this year. For example, price changes to health plans as well as changes to the health plans themselves will impact the amount of premium tax credits and coverage for many consumers. We go over the reasons why all consumers should shop to renew this open enrollment.

Health Care Cost Considerations in Medical Education

Medical students are taught to care for the whole person. Shouldn’t that include care for the patient’s wallet, as well? As insurers increasingly shift costs to enrollees, Georgetown University medical student Joshua Barrett considers the role of the physician – and medical education – in helping patients stay both physically and financially healthy.

States Revisit Essential Health Benefit Requirements, but Have Little Data on Consumers’ Experiences

Federal Affordable Care Act rules require the states to revisit the standard scope of benefits for individual and small business health plans – called essential health benefits or EHB – and determine whether revisions are needed. In a new blog post for the Commonwealth Fund, CHIR experts examine how the states approached this task, and what it might mean for consumers.

Updated Navigator Resource Guide

CHIR is pleased to release an updated online Navigator Guide on Private Health Insurance and Health Insurance Marketplaces with searchable frequently asked questions (FAQs) and easy-to-read background information on key health insurance and marketplace issues. With Open Enrollment just a few days away, get your Guide on!

Wondering What Marketplace Rate Increases Mean for Consumers?

The third open enrollment season for the Affordable Care Act’s health insurance marketplaces begins on Sunday, November 1. The administration has released new data showing average health plan rate changes, with an average increase nationwide of 7.5 percent compared to 2015. Our colleague Tricia Brooks breaks down what these rate changes mean for consumers.

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.