In mid-April, the Trump administration announced it would stop monitoring marketplace plans for compliance with several important federal protections and instead defer to states. In their latest blog post for The Commonwealth Fund, Justin Giovannelli and Kevin Lucia explain the new changes to insurance oversight, and assess the potential impact of this federal deregulation for states and consumers.
In a soon to be finalized “market stabilization” rule, the Trump Administration has proposed a new approach to the oversight of health plan network adequacy. Sabrina Corlette reviews the administration’s revised stance and what it could mean for state-level enforcement, and for the consumers enrolled in marketplace plans.
State leaders have been heartened by statements from the new President and Congressional leaders that ACA replacement plans will give them more autonomy over their health insurance markets. But is that really true? In a post for the Health Affairs blog, CHIR experts Sabrina Corlette and Kevin Lucia examine the fine print of House and Senate replacement plans and find that they broadly preempt state authority.
Narrow network plans, or plans with a limited network of providers, present problems for consumers across the various coverage programs. In May, the Centers for Medicare & Medicaid Services released the final rule setting network adequacy standards for Medicaid and CHIP managed care plans. The new rule requires states to set quantitative standards for network adequacy; but since these standards don’t apply uniformly to other federal programs, network adequacy – and access to essential health services – varies greatly for consumers based on what program they fall under.
The Obama Administration has delayed a promised rollout of a new network size rating system on healthcare.gov. Sabrina Corlette takes a look at the proposed ratings, the reasons for delay, and what it all means for consumers.
Technology is transforming how we access and receive health care through the use of telemedicine. As we previously reported, telemedicine can fill gaps in access to providers. But questions on whether and how insurers can use telemedicine to meet network adequacy standards continue to exist. CHIR’s Sandy Ahn provides a short summary of the issues.
Last week the Centers for Medicare and Medicaid Services released a much-anticipated final rule on Medicaid managed care, marking the first update to the rules governing Medicaid MCOs in over a decade. Our colleague with Georgetown’s Center for Children and Families, Kelly Whitener, takes a look.
Health plans have been increasingly narrowing their provider networks, raising concerns about gaps in access to services for consumers, particularly in areas with provider shortages. Could telemedicine be used to help fill those gaps? CHIR authors say not yet and summarizes key findings from a new report published in partnership with the Urban Institute and with funding from the Robert Wood Johnson Foundation.
President Obama’s 2017 budget includes a new proposal to help protect consumers from unexpected charges by out-of-network providers. In a recent blog post for Health Affairs, Sandy Ahn, Jack Hoadley and Sabrina Corlette discuss the proposal in the context of recent state actions to counter balance billing.
At the NAIC’s most recent meeting, two issues stood out: the long-coming Network Adequacy Model Act was finally adopted, and regulators took another look at how insurers count costs for the Medical Loss Ratio. JoAnn Volk provides a summary of the action.
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.
