In the proposed Notice of Benefit and Payment Parameters for 2023, the Centers for Medicare & Medicaid Services asked for feedback on how to promote health equity through ACA marketplace operations and plan certification standards. CHIR’s Rachel Swindle reviewed comments from states, insurers, and consumer advocates to see how they responded.
Under the Affordable Care Act, insurers must provide rebates to enrollees when their spending on clinical services and quality improvement, as a proportion of premium dollars, falls below a minimum threshold. Federal regulators have discovered some insurers are gaming the system by misallocating expenses or inflating their spending on providers. Karen Davenport takes a look at how this practice impacts consumers, and explains a new federal proposal to crack down on it.
The Supreme Court has required the federal government to reimburse health insurers for an estimated $12.3 billion in unpaid risk corridor funds and the Trump administration recently published guidance to insurers that affects the amount to be returned to policyholders. In an Expert Perspective for the State Health & Value Strategies program, Sabrina Corlette and Jason Levitis consider the effects of this guidance and state options for redirecting insurers’ extra cash to benefit policyholders and the public.
While the COVID-19 pandemic has prompted financial catastrophe across the country, the private health insurance industry appears to be thriving. CHIR researchers Megan Houston and Sabrina Corlette consider whether the traditional use of these extra funds is the best way to spend them and discuss opportunities that states may have to redirect money towards COVID-19 testing.
The Trump administration recently issued a proposed regulation that could significantly impact how much of consumers’ premium dollars are spent on their health care needs. CHIR expert Kevin Lucia assesses the proposed relaxation of the Affordable Care Act’s “80-20” or medical loss ratio standards and outlines policy options for states wishing to maintain them.
A recent study documents major savings for consumers, thanks to the ACA's medical loss ratio rules. Sabrina Corlette takes a look.
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.
