Search Results for: stop-loss

Enhanced Premium Tax Credits Provide an Early Opportunity for Addressing Affordability Issues

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…to millions of low- and moderate-income enrollees, but the looming sunset of these more generous premium subsidies threatens family budgets and economic security, while foreshadowing dramatic coverage losses and higher premiums for enrollees who do not receive PTCs. Permanently authorizing enhanced PTCs is an immediate and impactful step on affordability that policymakers of all persuasions can make a shared priority….

The Work Goes On: Preserving Equitable Access to Affordable, High Quality Health Insurance in Challenging Times

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…as the elimination of critical protections for LGBTQ+ people, pregnant individuals, and those who have had abortions or miscarriages. These proposals, if implemented, would result in a significant loss of health care access and an increase in health care costs for millions of Americans. Over the coming weeks and months we will learn more about the new administration’s health care…

The Incursion Of Profit-Enhancing Middlemen In US Health Care

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…as an investigation of Cigna revealed – use their own or contractor created AI-based systems. Research indicates that these AI-based programs are often missing important information, and they are highly likely to reflect societal biases and perpetuate existing inequities as they incorporate the particular values and incentives of the systems’ designers. In turn, many providers hire firms to limit their financial losses from such high…

Proposed 2026 Payment Notice: Marketplace Standards And Insurance Reforms

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…Marketplace may provide a notice to the taxpayer warning of immediate eligibility loss and explaining the reason, or a more general notice warning of potential eligibility loss for one of several reasons and explaining FTR rules, without specifying the reason. The proposed rule also notes that Marketplaces on the federal platform will, and state-based Marketplaces are encouraged to, provide additional…

If Expanded Federal Premium Tax Credits Expire, State Affordability Programs Won’t Be Enough to Stem Widespread Coverage Losses

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…of the looming expiration of expanded federal PTCs. The issue brief describes how none of these programs are a substitute for the expanded PTCs and no state will be insulated from coverage losses should the expanded federal credits expire, nor would states be shielded from premium increases as their risk pools worsen. You can read the full issue brief here….

Substantial Marketplace Coverage Gains for Communities of Color Threatened Again

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…in Health Programs and Activities final rule. Reducing bureaucratic burdens to renew coverage. Looking Forward  Political threats to the ACA and its marketplaces this election season could lead to sizable coverage losses and decreased access to care across the country, and these deleterious impacts will disproportionately hit communities of color. Both Congress and the new president will determine whether the expanded…

CHIR Expert Testifies About Facility Fees Before Texas House Insurance Committee

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…the population who do not have enough cash to pay typical private plan cost-sharing amounts, this is a really big deal. At the same time, the system-wide savings from such a reform likely will be relatively muted in the longer term, as market powerful hospitals renegotiate their contracts and increase other prices to make up for the loss of revenue…

High-Risk Pools: A High Risk Proposition for People with Pre-Existing Conditions

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…in their high-risk pools in order to limit losses. And all of them experienced losses, even though they received billions in government subsidies. In 2011, net losses for the 35 state high-risk pools were over $1.2 billion. There is no question that high-risk pools provided a source of coverage to a set of very vulnerable, high-need people in the days…

Delays In Extending Enhanced Marketplace Subsidies Would Raise Premiums And Reduce Coverage

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…2022. The enhancements are now set to expire after 2025. It has been widely reported that expiration jeopardizes health coverage for millions of Americans. But there has been less discussion of when the enhancements must be extended to avert these losses. Given that Congress commonly extends tax rules just before or even after expiration, observers may believe that extending the enhancements to 2026 and beyond…

Biden Administration Proposes Rule To Ban Medical Debt From Credit Reporting

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By, Sheela Ranganathan and Maanasa Kona Amidst the growing interest among policymakers to protect patients from medical debt and its negative downstream effects, in April 2023, the three credit reporting agencies (CRAs)—Equifax, Experian, and TransUnion—voluntarily agreed to stop reporting any medical debt under $500. This April, the Consumer Financial Protection Bureau (CFPB) found that, despite these changes, 15 million Americans still have…

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