Search Results for: stop-loss

New Rules Pending on Short-Term Health Plans: Impacts for Consumers, Markets and Potential State Responses

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…coverage; and require nonrenewable short-term coverage to be discontinued at the end of the calendar year. Allowing the sale of short-term coverage but reducing the risk of market segmentation. State policymakers could assess insurers that offer short-term coverage; require short-term policies to meet a minimum medical loss ratio; and require consumers to have a marketplace eligibility determination before an insurer…

State Options Blog Series: Implications of Weakening the 80-20 Rule for States and Consumers

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The Trump Administration recently issued a proposed regulation that could have significant implications for consumers on a number of fronts, including how much of their premium is actually spent by insurers on their health care needs. The ACA requires insurers to meet a minimum medical loss ratio (MLR). The MLR, often called the “80/20 Rule,” measures how much a health…

When the Individual Market Dies, Where will People Go? A Eulogy

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…market and raise prices. Then, there were the Trump administration’s repeated threats to cut off cost-sharing reduction reimbursements to insurers. Insurers factored the loss of those funds into their 2018 rates, resulting in projected premium increases averaging 20 percent. Insurers also had to price for the real risk that the Trump administration would not enforce the individual mandate or invest…

Shopping Tips for 2018 Open Enrollment

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This year’s open enrollment is different from previous years. First, the time to shop and enroll in a plan is cut in half; open enrollment this year is from November 1 to December 15. Second, the Trump administration’s recent decision to stop repayments for plans with reduced cost-sharing has caused some unexpected consequences for plan premiums and tax credits for…

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…

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.