Tag: essential health benefits

Enhancing Essential Health Benefits: How States Are Updating Benchmark Plans to Improve Coverage

The Affordable Care Act mandates that health plans in the individual and small-group markets cover essential health benefits (EHB), with states setting the scope through a benchmark plan. A new brief for the Commonwealth Fund by CHIR faculty explores how states have used recent flexibility to expand EHB, address consumer needs, and advance health policy, while highlighting ongoing challenges

Federal Court Decision Threatens the ACA’s Preventive Services Benefit: State Options to Mitigate Harm to Consumers

A federal judge in Texas has ruled that Affordable Care Act requirements that insurers cover and waive cost-sharing for preventive services is unconstitutional. While the case is likely to be appealed, states can act now to preserve residents’ access to affordable and often life-saving preventive care. In a new Expert Perspective for the State Health & Value Strategies project, Sabrina Corlette and Justin Giovannelli outline how.

Amidst Rising Overdose Deaths, Policymakers Look for Ways to Expand Access to Proven Opioid Use Disorder Treatment

As the number of opioid-related overdose fatalities remains alarmingly high, access to medication-assisted treatment (MAT) is inconsistent. Private insurance does not always cover the full range of MAT options, and when it does provide coverage cost sharing can be prohibitive. CHIR’s Rachel Swindle takes a look at state and federal reforms that can help lessen private insurance related barriers to treatment.

State and Federal Policies to Increase Access to Medication Abortion

A leaked draft of an impending Supreme Court decision has previewed the potential for states to prohibit and even criminalize abortion. Access to abortion has long been a story of the haves and have-nots. Medication abortion can improve access to this basic health care service, but the delivery and coverage of medication abortion are subject to numerous restrictions and requirements, creating multi-faceted obstacles for patients seeking care. CHIR’s Rachel Schwab looks at several policy actions that can reduce barriers to medication abortion.

Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces

After the Biden administration issued the proposed 2023 “Notice of Benefit and Payment Parameters,” several hundred stakeholders provided feedback on the new set of rules governing the ACA’s marketplaces and health insurance standards. To better understand the impact of the proposed rules, CHIR reviewed a sample of stakeholder comments. For the third blog in our series, Rachel Schwab summarizes comments submitted by state departments of insurance and state-based marketplaces.

Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: Consumer Advocates

In the recently released 2023 “Notice of Benefit & Payment Parameters,” the Biden administration is proposing significant changes to the Affordable Care Act marketplaces. In the first of a three-part series, CHIR’s Emma Walsh-Alker and JoAnn Volk reviewed public comments from multiple consumer advocacy organizations about the impact of the new policies on marketplace beneficiaries. Reviews of comments from insurers and state marketplaces and insurance departments will follow.

The Proposed 2023 Notice of Benefit & Payment Parameters: Implications for States

The Biden administration has proposed a range of new standards and policies for the Affordable Care Act’s health insurance marketplaces. In her latest Expert Perspective for the Robert Wood Johnson Foundation’s State Health & Value Strategies project, Sabrina Corlette breaks down provisions that are of particular importance to states.

Navigator Guide FAQs of the Week: What Does My Marketplace Plan Cover?

Enrolling in coverage on the marketplace requires comparing different health plans and decide which one best fits their needs for the upcoming year. To avoid unwelcome surprises, it’s crucial that consumers have an accurate understanding of plan options will and will not cover. This week, we highlight FAQs from CHIR’s updated Navigator Resource Guide about marketplace plans’ coverage standards.

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.