…benefit requirements and premiums that do not vary based on gender or health status. These proposals would loosen rules for Association Health Plans (AHPs), eliminate state oversight of stop-loss plans, thus encouraging greater use of self-funded plans with this protection against high expenses (known as level funded products) among small employers instead of state-regulated insurance plans, and permit employers to…

An estimated 41 percent of adults in the US are in medical debt because of unpaid medical or dental bills. Medical debt can profoundly disrupt lives; it can lead to bankruptcies and loss of homes or wages and force difficult choices between basic needs and medical bills. As of 2023, 19 states and the District of Columbia have stepped in…

…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…

…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…

…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…