…ACA, such as collecting quality data or making quality information public. However, we also learned that using health insurance marketplaces as a vehicle for achieving better, more affordable care is easier said than done. In their latest blog post for the Commonwealth Fund, CHIR experts Sabrina Corlette and Sarah Dash assess the opportunities and challenges facing states as they pursue…
Pharmacy benefit designs that place drugs on tiers based on cost sharing and authorization requirements are not a recent development. These designs started in the 1990’s as simple, two-tiered benefit structures with a tier for generic drugs and a tier for brand name drugs. In recent years, however, tiered benefit designs have become more complicated, as insurers look to them…
We at the Center on Health Insurance Reforms are excited to share the first of an upcoming video series on timely health insurance topics. In our debut video, CHIR experts Sabrina Corlette, JoAnn Volk, and Dave Cusano provide a preview of upcoming action at the National Association of Insurance Commissioners‘ (NAIC) national meeting to address concerns about network adequacy of…
…federal marketplace have choices they can make, now, that can help ensure their residents maintain access to affordable private health coverage. In a new post for The Commonwealth Fund, Kevin Lucia and Justin Giovannelli explore the options available for these states to transition to a state-based marketplace model, thereby avoiding Halbig’s adverse effects. You can read the full post here….
…later this year that will incorporate many of the questions we’ve received. In the meantime, we’ve put together a compilation of some of the questions we’ve been getting from the field, chosen because assisters in other states are likely to receive similar questions. In it, we provide answers on: Student health insurance and premium tax credits Non-ACA-compliant plans that fall…
…Medicaid managed care plans and Co-op plans who entered the commercial market via the marketplaces and the ACA, the small group and individual markets are small potatoes for commercial insurers. The fully insured large group markets and self-insured are where the bulk of their commercial business exists. Insurers will presumably coordinate their pricing strategies across these markets, and it will…
…on quality and value, set common quality improvement requirements for participating health plans, and collect quality and cost data to inform improvements. These important activities are in addition to the other essential marketplace functions outlined under the law: running an eligibility and enrollment system, providing certification and oversight of health plans, and ensuring financial accountability. So it’s not surprising that…
By Tricia Brooks, Georgetown University Center for Children and Families In recent guidance, CMS revealed its plan for the first round of financial eligibility redeterminations and marketplace plan renewals for the millions of people who enrolled in a qualified health plan (QHP) through Healthcare.Gov. A companion notice of proposed rulemaking would provide both the federal and state-based marketplaces additional flexibility…
On July 16, the Obama Administration issued guidance for insurers in the federally facilitated marketplaces (FFMs), clarifying a requirement to provide policyholders receiving premium subsidies with a grace period of up to 90 days if they fail to pay their premiums. How does the grace period work? Under federal rules, insurance companies participating on the FFMs can drop policyholders if…
…for assisters, community organizations (whether LGBT or not), and policymakers as stakeholders prepare for the 2015 open enrollment period and make efforts to engage the LGBT community. To learn more about Out2Enroll, visit www.out2enroll.org or contact Katie Keith at katie@out2enroll.org. Editor’s Note: Katie Keith is a former Research Fellow at Georgetown University’s Center on Health Insurance Reforms. She is currently…
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.
