Search Results for: stop-loss

What’s New for 2021 Marketplace Enrollment?

…to face the loss of employment, income, and/or their source of health insurance. There are a number of policy changes related to the pandemic that can impact enrollment and affordability on the marketplace. Some states that run their own marketplace may have established additional special enrollment periods due to the COVID-19 pandemic, so check with your state marketplace to see…

What’s at Stake: The World of Health Insurance for People with Pre-Existing Conditions before the ACA

…do not stop at private health insurance. The expansion of Medicaid, which provides free health coverage for low income people expanded coverage to 12 million low income adults. Cuts to this program would send these individuals back to the individual market where they would almost certainly not be able to afford the premiums. As many as 3 million children who…

Children Are Losing Health Insurance

…the period with an estimated 243,000 more children living without health coverage. Florida has the next biggest loss, adding about 55,000 children to the uninsured count over the three-year period. As a consequence, 41 percent of children’s coverage losses during the Trump Administration occurred in Texas and Florida. The only state that bucked national trends and significantly reduced its number…

As Insurers Return to ACA Marketplaces, SCOTUS Case Looms Large

…that could overturn the ACA, and rising uninsured rates are insurers flocking back to the individual marketplace? A Sicker-than-expected Risk Pool, Policy Uncertainty Drove Insurer Exits in 2017 By 2017, many insurers had experienced significant losses in the individual market. Nationwide, insurers selling in the individual market lost $2.5 billion in 2014 alone. The following year was little better. Competitive…

Where’s the Plan? Trump Executive Order Fails to Include any Policy to Protect Health Care if the ACA is Struck Down

…health plans. Nothing about how they will stop the projected 82 percent increase in uncompensated care costs for providers. In short, the Trump administration has no plan, or even a semblance of a plan. The only thing they appear to have is the cynical belief that, unlike the lady from the Wendy’s ad, most Americans won’t check under the bun….

Aggressive Medical Debt Collections: COVID-related Consumer Protections Could be a Model for Long-term Relief

…pushed some into poverty. Medical debt: a symptom of a broken health care system Unpaid medical bills can either be a product of lack of health insurance coverage or having health insurance coverage that does not adequately protect from financial risk. Given the job losses we have seen during this pandemic, an estimated 3.5 million people will join the ranks…

August Research Roundup: What We’re Reading

…in the uninsured rate, with more participants reporting coverage after a job loss (77.6 percent, up from 76.2 percent before job loss) than in the pre-ACA period, with Medicaid and marketplace coverage almost fully offsetting loss of employer-based coverage. There was a 6.0 percentage point decrease in net coverage reduction among participants following a job loss in the post-ACA period…

Partial Vindication for Insurers in Cost-sharing Reduction Litigation: Implications for State Insurance Regulation

On August 14, 2020, the Court of Appeals for the Federal Circuit affirmed a lower court ruling that the federal government is liable to insurers selling marketplace health plans for the loss of cost-sharing reduction (CSR) reimbursements mandated under the Affordable Care Act (ACA). However, the court determined that the federal government could reduce the damages it owes to insurers…

As Insurers Sit on Extra Cash, Are Premium Relief and MLR Rebates the Best Use of Funds?

…than anticipated. Fortunately, for consumers, the Affordable Care Act prevents insurers from pocketing all of this windfall. First, the law limits the portion of premium dollars that insurers can translate into profits, administration, and marketing (called the “medical loss ratio” or MLR). For individuals and small employers, this means insurers must spend at least 80 percent of their premium revenue…

Getting It Done: Consensus On Surprise Billing Protections

…and the White House for a solution to surprise billing. In an era when consensus on so many issues is blocked by partisan rancor, action to address surprise medical bills should transcend, and congressional leaders should resolve the modest disputes that remain. Failure to do so will be a true loss for consumers in the midst of a global pandemic….

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.