Search Results for: stop-loss

House Hearings Shed Light on a Key Policy Priority: Protecting People with Pre-Existing Conditions

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Recently, House Minority Leader Kevin McCarthy attributed Republican losses in the midterm elections to GOP efforts to repeal the Affordable Care Act (ACA). In particular, McCarthy pointed to a provision of the House-passed American Health Care Act that would have permitted states to waive pre-existing condition protections, which he argued, “put [the] pre-existing condition campaign against us” in a debate…

Efforts to Protect Workers with Pre-existing Conditions

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…2017. Congress rejected it because repealing the ACA without replacing it would: Result in 32 million Americans losing their insurance. Double premiums for people in the individual insurance market. Leave an estimated ¾ of the nation’s population in areas without an insurer. Cause significant financial harm for hospitals and other providers due to uncompensated care costs Cause the loss of…

Translating Coverage into Care: Answers to Common Post-Enrollment Questions

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…1-800-318-2596 (TTY: 1-855-889-4325) as soon as possible to terminate your coverage and if applicable, stop receipt of any premium tax credits. You should also contact your health insurance company to ensure your health plan is terminated. Make sure to document the dates of your contacts with the marketplace and the insurer. Recent federal guidance allows insurers to extend the grace…

Texas Court Ruling Throws Future of ACA’s Pre-existing Condition Protections, Coverage Gains into Doubt

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…space for new mothers to pump breast milk. The judge’s ruling does not stop the government from carrying out the law, and the Trump administration announced over the weekend that they would continue to do so. Further, legal experts on both sides of the political spectrum argue the judge’s decision is on shaky legal ground and predict that it will…

October Research Round Up: What We’re Reading

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…the 2017 policy changes. What It Finds Medical Loss Ratios (MLR), or the percentage of premiums insurers spend on medical claims, saw continued improvement mid- 2018, down to an average of?? 69 percent as compared to a peak of 93 percent in 2015, indicating an increase in insurer profitability. When measuring performance of an insurer by gross margins, or by…

States Lean In as the Federal Government Cuts Back: Navigator and Advertising Funding for the ACA’s Sixth Open Enrollment

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By Sabrina Corlette and Rachel Schwab On November 1, the Affordable Care Act’s (ACA) insurance marketplaces will launch their sixth enrollment season. This year, the challenges they face may be greater than laster year, with the loss of the individual mandate penalty as an enrollment incentive and the emergence of a parallel, unregulated market that could siphon away healthy enrollees….

What’s New for 2019 Marketplace Enrollment? Get Ready for Updated, Improved Navigator Resource Guide

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…eligible for a SEP in the 60 days prior to loss of CHIP coverage until 60 days after the loss of CHIP coverage. Proposed Public Charge Rule: The Department of Homeland Security released a proposed rule that would broaden the types of public benefits that would count against an immigrant’s application for admission to the U.S. or permanent residency to…

Proposed “Public Charge” Rule Risks Immigrants’ Access to Private Coverage, Too

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…these hard working families access to health coverage is good public policy. Even DHS itself admits that the proposed rule could increase poverty, and that immigrants who don’t enroll in benefits for which they’re eligible could experience a loss in productivity, adverse health effects, higher medical expenses, and reduced educational attainment. Comments on the rule are due December 10, 2018….

Lawmakers had a Chance to Provide Relief from Surprise Medical Bills – and Whiffed It

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…ambulance providers clearly disclose charges for transportation and non-transportation services and “provide other consumer protections for customers of air ambulance operators.” While this provision would not have given states the clear authority to step in and stop egregious balance billing, it would have required a clear separation of medical and transport charges, with the potential that states could regulate the…

House Farm Bill Supports AHPs with Federal Grants—Following in the Footsteps of the ACA’s CO-OP Program

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…In its first year, the CO-OPs attracted 500,000 enrollees and almost immediately began to lose money. By the end of their first year, the CO-OPs had aggregate losses of $376 million, and by the end of 2015, half of the plans had shut down. Today, only four of the CO-OPs remain. Among other funding and political considerations, the CO-OPs struggled…

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