The faculty and staff of CHIR wish a fond farewell to their retiring colleague, Sally McCarty. Sally is leaving CHIR on a high note, having had a successful career as an academic expert, state and federal insurance regulator, and tireless advocate for consumers.
In the wake of the Supreme Court’s decision in King v. Burwell, our colleague at Georgetown University Law Center’s O’Neill Institute, Tim Westmoreland, considers the case. He finds that, for all the accompanying politics and drama, it never passed the laugh test.
The Affordable Care Act’s Summary of Benefits and Coverage – standardized, easy-to-use summaries of health plan benefits got an update last week with new regulations out from the Obama Administration. CHIR’s JoAnn Volk provides an overview – as well as a preview of some likely additional upgrades.
A new report from Georgetown University researchers examines the phenomenon of surprise bills for out-of-network medical services, often called “balance billing.” These unexpected charges can often be significant and cause great stress for patients. Several states have implemented consumer protections, but they take different approaches with varying effectiveness. Jack Hoadley provides the highlights.
There’s been some renewed attention to the status and future of the small business health insurance market, particularly as an Affordable Care Act reform scheduled to go into effect in 2016 could cause some disruption. Last week CHIR researchers contributed to three great new resources to help policymakers and others understand changes in the market and some of the challenges ahead.
Beginning in 2016, the Affordable Care Act requires states to change the definition of “small employer” from one with up to 50 employees to up to 100 employees. Such a change could affect health insurance coverage and prices for small businesses and their workers. However, many states are taking advantage of a transition period offered by the Obama Administration that would delay this change. Ashley Williams and Sabrina Corlette, in their latest blog post for the Commonwealth Fund, report on the results of a 50-state survey and the implications for the small group insurance market.
Some states are making policies related to the emergence of telemedicine or the delivery of health care services through telecommunication technology. While states are taking varying approaches, telemedicine can increase access to specialty services such as mental health services and help address network adequacy concerns. CHIR’s Sandy Ahn highlights some of the issues related to telemedicine.
The Centers for Medicare and Medicaid Services (CMS) recently released draft regulations governing Medicaid managed care plans. In setting standards for network adequacy, the agency looked to both the Medicare Advantage program and the health insurance marketplaces created under the Affordable Care Act. Sabrina Corlette examines approaches to ensuring adequate plan networks across the three programs.
The Affordable Care Act requires most health plans to cover preventive services without cost sharing and enables consumers to access evidence-based medical care such as cancer screenings and immunizations for children. Implementation of this requirement, however, has raised questions and caused confusion among insurers, providers and consumers. Sandy Ahn reviews the Administration’s most recent guidance on this critical ACA provision, designed to clarify for insurers what they must do to comply and ensure that consumers receive the benefits they are promised under the law.
Health care policy debates can often be confusing but the rapidly shifting positions in the latest tempest on Medicaid and the Affordable Care Act are harder to follow than a ping-pong ball. Our colleague at Georgetown’s Center for Children and Families, Adam Searing, attempts to make sense of all the contradictions.
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.
