Tag: aca implementation

Little Known Provision Keeps Kids From Slipping Through Cracks Due to Differences in Eligibility Rules

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For the most part, the ACA tries to align the ways that Medicaid and the health insurance marketplaces determine eligibility for their respective programs. But every once in a while, there’s a risk that someone might fall through the cracks. This initially appeared to be the case when our colleague Tricia Brooks was asked to help with a complex family situation in which a child seemed to be caught between the differences between each program’s rules, putting him at risk of being uninsured. Fortunately, Tricia was able to unearth a little known but important rule that helps kids get the coverage they’re entitled to.

A Look at Proposals for Improving Health Coverage Affordability

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Welcome to 2016. With first votes being cast in the 2016 election cycle less than two weeks away and House Speaker Paul Ryan (R-WI) promising to unveil an ACA replacement plan to steer the 2016 party agenda, the policy debate on health reform is far from over. We here at CHIR are keeping an eye on reform proposals, and in this post, CHIR’s Hannah Ellison examines various proposals to improve affordability of coverage under the ACA.

The Failure of the ACA’s Health CO-OPs: Lessons for Policymakers

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The failure of 12 of the Affordable Care Act’s CO-OP plans reveals much about the huge barriers facing new companies entering the highly concentrated health insurance market. Sabrina Corlette takes a look at some of the lessons that policymakers – and regulators with oversight over the proposed mergers in the health insurance industry – can draw from the CO-OPs’ experiences.

What About “Don’t Discriminate Against Sick People” Do You Not Understand?

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Although it’s a complicated law, there’s one thing about the ACA that’s not at all complicated: the requirement that insurers stop discriminating against sick people. Yet some insurance companies still appear confused by this rule. Sabrina Corlette looks at recent insurer attempts to discourage sicker, older people from enrolling in their plans – and the efforts of at least one state to combat them.

Deadline for January 1, 2016 Coverage Approaching: What to Do

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The deadline for having health insurance starting on January 1, 2016 is quickly approaching. Consumers who want marketplace coverage must enroll by December 15, 2015 for a January 1, 2016 effective date. CHIR summarizes what to do and highlights Frequently Asked Questions related to open enrollment.

No QHPs Comparable to CHIP, Says (Delayed) HHS Certification

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The U.S. Department of Health and Human Services has finally released a long-awaited study comparing coverage in CHIP plans to qualified health plans offered through the Affordable Care Act marketplaces. Our colleague from Georgetown University’s Center for Children and Families, Elisabeth Wright Burak, takes a look and shares the (not altogether surprising) findings.

Filing Fee and External Appeals

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One of the most significant consumer protections in the Affordable Care Act (ACA) is the right to appeal a denied claim, including the right to take your appeal to an independent, third-party reviewer. Although the ACA guarantees this right, recent federal rules have codified barriers to the process that still exist in some states, such as filing fees. Sandy Ahn provides a short summary of this issue.

Feds Propose Changes – and an Expanded Role – for Marketplace Navigators

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A new proposed rule from the Obama Administration contains wide-ranging new requirements for insurance companies and marketplaces under the Affordable Care Act, including changes that expand the role of marketplace navigators. CHIR’s Sabrina Corlette shares some highlights.

States Revisit Essential Health Benefit Requirements, but Have Little Data on Consumers’ Experiences

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Federal Affordable Care Act rules require the states to revisit the standard scope of benefits for individual and small business health plans – called essential health benefits or EHB – and determine whether revisions are needed. In a new blog post for the Commonwealth Fund, CHIR experts examine how the states approached this task, and what it might mean for consumers.

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.