Search Results for: stop-loss

Insurers, State Regulators Avoid Bare Counties in 2018, but Seek Long-Term Solutions

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…contributor to decreased insurer participation in individual markets. Good longstanding relationships between regulators and the industry were an important foundation for negotiations over filling bare counties. Although an insurer’s decision ultimately needed to align with the company’s business strategy, state actions also helped prevent bare counties through assurance from state regulators of protection from financial losses resulting from unexpected policy…

Proposed 2019 Affordable Care Act Payment Rule: A Big Role for States

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…comes to implementing (or not implementing) the ACA. The proposed rule would defer additional decision making and oversight to state insurance regulators. This blog highlights some of the major decisions that states would be tasked with under the proposed rule, including in the areas of essential health benefits, qualified health plan (QHP) certification standards, rate review, medical loss ratio (MLR)…

It’s Not Time to Give Away Consumer Protections for Cost-Sharing Reduction Reimbursements

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…financial losses associated with the end of CSR payments, many may question their long-term commitment to the marketplaces. Some may worry about the loss of healthy, unsubsidized enrollees. Others may be concerned about a continued partnership with a federal government that appears committed to the market’s demise. Ultimately, it will be federal taxpayers hurt the most by the government’s decision…

A Blow to Working Class Coverage

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…health services. The administration cannot repeal Obamacare’s insurance protections – those are written into law – but many insurers could likely stop offering plans that comply with them. Why would they? Those plans, which are not allowed to underwrite and must offer a comprehensive set of benefits, will be the coverage of last resort for people with pre-existing conditions. Few…

Trump’s New Rule on Birth Control is Basically Discrimination Against Women

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…health. What does this mean for women? It means their employer or school can drop birth control coverage from their health plan. The result is that these women will have to pay hundreds of dollars a year if they continue using birth control. Some women, who cannot afford the cost, will stop using birth control. Others will have to choose…

In the Aftermath of a Natural Disaster and Have Questions about your Health Insurance Coverage? CHIR Experts Answer Some Frequently Asked Questions

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…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 period an…

Graham-Cassidy’s Waiver Program Allows States to Erase Protections for People with Pre-existing Conditions

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…in their insurance markets. Their experience was not pretty. Looking Ahead Senate Majority Leader Mitch McConnell has said the Graham-Cassidy bill will be brought up for a vote in the Senate next week. CBO’s estimates of the bill’s impact on cost and coverage may not be available for weeks, but it’s likely to show coverage losses at least as great…

State Options Blog Series: Federal Regulators Relax ACA Health Plan Oversight, Creating Opportunities and Challenges for States

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…18 states declined to provide marketplace plan oversight, lack the authority, and/or have extremely limited staff and expertise to do the job. HHS under the Obama administration conducted plan management in order to fill gaps in state authority or oversight. The removal of a federal regulatory backstop could mean that key criteria for plan certification could receive little or no…

Recent and Potential Regulatory Actions to Roll Back the ACA: State Options Blog Series

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…benefits, Medical loss ratio rebate program, Direct enrollment through web-based brokers, and Minimum essential coverage Many states will have an interest in picking up a greater role in health plan enforcement and oversight of federal protections in order to ensure that consumers continue to receive the benefits promised under the ACA, as well as to promote stable, well-functioning insurance markets….

Future of Health Reform: A prescription for individual market stability

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…include: An uncertainty that the cost sharing reduction subsidies (CSRs), which reduce out of pocket expenses for eligible enrollees, will be honored.Corlette says that a loss of subsidies could be a factor in significant premium increases for those who purchase insurance on their own. The potential lack of IRS enforcement of the individual mandate, an additional tax that must be…

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.