The ACA established new appeal rights for consumers facing a denial of a benefit or service from their health plan. As consumers start to use their new Marketplace coverage, JoAnn Volk takes a look at the health plan appeals process required of all new plans, and what these new rights mean for patients.
There are reports that at least some formerly reluctant states are thinking of moving from a federally facilitated to a state-based health insurance marketplace. Our colleague at Georgetown’s Center for Children and Families, Sonya Schwartz, walks us through what states need to do to make the transition.
In January, a federal court in Missouri became the first to rule on whether states have the legal authority to restrict the work of the Affordable Care Act’s consumer assistance “navigators.” In a new post for The Commonwealth Fund, Justin Giovannelli, Kevin Lucia, and Sabrina Corlette discuss the decision and explore its significance for Missouri and the other states that have adopted restrictions on navigators and consumer assisters.
The ACA’s essential health benefits and metal tier coverage standards, guaranteed issue, and community rating requirements help level the playing field among insurers. To compete on price, many are turning to limited network products. CHIR experts David Cusano and Amy Thomas discuss insurers’ approaches to the development of plan networks in the post-ACA era in a new blog post originally published by Health Affairs.
A number of states recently filed amicus briefs in a court battle over whether federally facilitated exchanges can provide premium tax credits to low- and middle-income consumers. Because the Affordable Care Act’s employer mandate penalties are contingent on employees accessing subsidized coverage through an exchange, the states are asserting that they purposefully opted for federally run exchanges so employers would not face this burden. In a guest post, former CHIR researcher Christine Monahan assesses the veracity of this claim.
The Administration recently released updated federal poverty level thresholds for 2014. With eligibility for Medicaid, CHIP and premium tax credits under the Affordable Care Act at stake, consumers and those assisting them need to understand what these new thresholds mean. Here to explain is our colleague at Georgetown University’s Center for Children and Families, Martha Heberlein.
New improvements to healthcare.gov are making it easier for consumers to report life changes, correct errors, and change plans. Recent guidance from the federal Center for Consumer Information and Insurance Oversight details the site’s new functionality. Sabrina Corlette takes a look.
Now that 2014 is here, the ACA’s individual mandate is in effect. In the last few months the Administration has issued some more guidance about how the mandate works, and our colleague Joe Touschner at Georgetown University’s Center for Children and Families provides this update.
States have taken substantially varying actions to implement and enforce the Affordable Care Act’s three major components designed to expand health insurance coverage and protect consumers—health insurance market reforms, health insurance marketplaces, and Medicaid expansion—according to a new report prepared for The Commonwealth Fund. Kevin Lucia summarizes the findings and what states’ varying approaches to implementation means for consumers.
Opponents of the Affordable Care Act are latching onto the law’s “3Rs” (risk corridors, risk adjustment, and reinsurance) as a “bailout” for insurers. Yet one of the models for the 3Rs is the Medicare Part D drug benefit, where these programs have been working for years to help stabilize premiums. Georgetown University Health Policy Institute’s Jack Hoadley provides some context – and strong evidence that the 3Rs are in place to protect beneficiaries and taxpayers – not bail out health plans.
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.
