Tag: aca implementation

Accessing Provider Directories and Formularies: CHIR Goes Sleuthing

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We’re counting down again to Open Enrollment 3 and this year, all health plans must make accessing provider directories and formularies, or the list of covered prescription drugs, easy for consumers. This means consumers should be able to find this information on insurer website sites without creating an account or entering a policy number. CHIR’s Sandy Ahn flexes her investigative skills and looks to see how accessible this information really is.

The Next Big Thing in Network Adequacy: The NAIC Model Act

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In November, the National Association of Insurance Commissioners (NAIC) will finalize the Network Adequacy Model Act – a draft bill designed to be used by states to enact provider access standards for private health insurance plans. Consumer representative Claire McAndrew explores what the act includes as well as areas for improvement.

Who’s got the Best Crystal Ball? Estimates for 2016 ACA Enrollment

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Experts and prognosticators have given widely different estimates for total enrollment through the Affordable Care Act’s marketplaces for 2016. Sabrina Corlette offers her take on those projections and what they mean for assessing the law’s impact.

Half of the Uninsured are Eligible for ACA Coverage

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A recent Kaiser Family Foundation reports finds that 49 percent of the remaining uninsured in our country are eligible for either Medicaid or marketplace coverage under the Affordable Care Act. Graduate researcher Jordan Messner unpacks the data.

Big Data and Baby Steps: Two Very Different Approaches to Data Collection

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Most Americans see the need for more data about health insurance and how it’s working for consumers, and the insurance industry itself seems to recognize the importance of collecting and analyzing data. But it’s not clear that our government regulators do. JoAnn Volk looks at the mismatch between what insurers are undertaking and what federal rules will require for data collection.

The Experiences of State-Run Insurance Marketplaces That Use HealthCare.gov

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Whether their exchange is state-based or federally facilitated, many state policymakers are seeking ways to realize the advantages of a state-run marketplace model while minimizing, so far as possible, the financial and operational burdens of building or maintaining one. In a new issue brief for The Commonwealth Fund, CHIR researchers explore the experiences of four states that established their own exchanges but have operated them with support from the federal HealthCare.gov eligibility and enrollment platform.

Why ACA Marketplaces Should Report Comprehensive Enrollment Data

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The Affordable Care Act’s new health insurance marketplaces could be critical sources of data about how people access and use coverage. Yet, to date, the marketplaces have released varying degrees of information, with little uniformity or consensus over what data should be collected and how. In our latest post for The Commonwealth Fund, CHIR researchers Sean Miskell, Justin Giovannelli and Kevin Lucia examine data collection and reporting by the health insurance marketplaces.

More than 400,000 Lose Marketplace Coverage: Let’s Fix This and Keep People Covered

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This week federal officials released an updated marketplace enrollment report. While close to 10 million were enrolled in coverage as of June 2015, 400,000 people lost coverage because of citizenship data matching problems. In this blog post our colleague at Georgetown’s Center for Children and Families, Sonya Schwartz, notes that many who lost coverage are likely eligible but fell victim to marketplace system problems. She shares insights on how they could be fixed.

Affordable Care Act Legislation Affecting Small Employers Sparks Rare Bipartisanship

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Yesterday, the Health subcommittee of the House Energy and Commerce Committee had a hearing on H.R. 1624, a bill that if enacted, would repeal an ACA provision changing the definition of small employer to 1-100 employees. The bill would also allow states to determine the definition of the small group market; all states currently define the small group market as employers with 1-50 employees. CHIR’s Sandy Ahn shares highlights of the hearing and the debate over the impact on small businesses.

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.