Tag: essential health benefits
More Trouble than it’s Worth? The Affordable Care Act’s Redefinition of the Small Group Market
The Affordable Care Act includes a reform of the health insurance market that has received relatively little attention, but that’s likely to change. The provision requires a change in the definition of small group health plan, and it could have a significant impact on premiums and offers of coverage by employers. Sabrina Corlette takes a look.
HHS Proposes EHB Rule Changes
The federal Department of Health and Human Services recently published a proposed regulation that signals some potentially helpful changes to the requirement that health insurers cover a set of essential health benefits. Our colleague at Georgetown University’s Center for Children and Families, Joe Touschner, offers this overview.
Implementing the Affordable Care Act: Revisiting the ACA’s Essential Health Benefits Requirements
Within the next several months, federal officials must decide whether to maintain or modify their “transitional” approach to implementation of the Affordable Care Act’s essential health benefits (EHB) requirements. In a new issue brief for the Commonwealth Fund, CHIR researchers examine how states have exercised their flexibility under the current EHB rules.
New Issue Brief Examines Specialty Drugs in Tiered Pharmacy Benefit Structures
Health plans have been increasingly using tiered pharmacy benefit designs. These new designs raise challenges for consumers and the state insurance regulators responsible for reviewing and approving plans for sale. CHIR faculty members Sally McCarty and David Cusano explore these issues in a new brief for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network.
Washington Eliminates Waiting Period for Transplant Coverage
Discover Mid-Year Your Health Plan Doesn’t Cover Maternity Services? You May be Out of Luck
Now that open enrollment into the new health insurance marketplaces has ended, options for consumers seeking to change plans are more limited, even for those enrolled in plans that don’t cover essential health benefits, such as maternity services. Sabrina Corlette tackles one such situation in her latest blog post.
New Federal Guidance Helps Protect People from Discrimination in Benefit Design
In response to actions by some health plans to impose benefit-specific waiting periods for coverage of serious health conditions, such as organ transplants, the Obama Administration recently issued guidance to prohibit the practice and protect consumers from discriminatory benefit design. Georgetown Law Center’s Sandy Ahn reviews the new guidance and the impact for consumers in this guest post.
More New Resources Available to State Regulators
A set of new tools for state insurance regulators, as well as updated versions of some older resources, have recently been posted on the Robert Wood Johnson State Health Reform Assistance Network (State Network) web site. CHIR faculty Sally McCarty, David Cusano, and Max Farris, who serve as technical assistance professionals (TAPS) in the State Network Program, developed the new resources. Sally McCarty describes them here and provides information about an upcoming Webinar to introduce them and demonstrate their use.
Time for a Dental Check Up
One challenging question for families as they enroll in health insurance coverage on the new Marketplaces is what to do about kids’ dental coverage. Our colleague at Georgetown’s Center for Children and Families, Joe Touschner, has the skinny and links to some helpful resources to better understand this complex policy area – and how things might change for 2015.