Tag: risk pool

Stakeholders Weigh in on the Risk Corridor Litigation: Are Public-Private Partnerships At Risk?

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On December 10, the U.S. Supreme Court will hear oral arguments in Maine Community Health Options v. U.S., a case concerning the Affordable Care Act’s risk corridors program. This month, nine stakeholders filed amicus briefs in preparation of the arguments and we reviewed these briefs to identify common themes. One key theme emerged from the stakeholders reviewed: that the Court’s decision could negatively impact public-private partnerships.

Cities File Suit Against the Administration for Deliberately Failing to Enforce the ACA

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On August 2, a coalition of cities filed a federal lawsuit against President Trump and the Department of Health and Human Services, alleging that the administration has “intentionally and unconstitutionally” sabotaged the Affordable Care Act. The complaint alleges that the President has increased the cost of health coverage by discouraging enrollment, stoking uncertainty in the insurance markets, and reducing consumer choice. CHIR’s Emily Curran breaks down their complaint and evidence of alleged harm.

New Report Examines State Options for Oversight of Risk-Bearing Provider Organizations

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Value-based payment models are promoted as a way to transform our health care system from one that rewards value rather than the volume of health care services delivered. These models require providers to accept the risk of financial losses should spending on patients in their care exceed targeted levels. A new brief from State Health and Value Strategies, authored by researchers at Bailit Health and CHIR, explores potential state approaches to oversight of provider organizations that accept financial risk.

Health Care Sharing Ministries: What Are the Risks to Consumers and Insurance Markets?

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Health Care Sharing Ministries (HCSMs) are a form of health coverage in which members – who typically share a religious belief – make monthly payments to cover expenses of other members. HCSMs do not have to comply with the consumer protections of the ACA and may provide value for some individuals, but pose risks for others. We interviewed officials in 13 states and analyzed state laws in all states to better understand state regulators’ perspectives on regulation of HCSMs.

July Research Round Up: What We’re Reading

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Health policy researchers are keeping busy, assessing the impact of recent and potential state and federal actions. CHIR’s Olivia Hoppe digs into new research on how interruptions in insurance coverage impact chronic disease management, the debate over the Affordable Care Act’s (ACA) employer mandate, the innovative ways that California is keeping its risk pool healthy, characteristics of the uninsured in the U.S., and the coverage and premium effects of state-based individual mandates.

Stakeholders Respond to the Proposed Short-Term, Limited-Duration Insurance Rule. Part II: Major Medical Insurers

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The Departments of Labor, Health and Human Services, and Treasury received over 9,000 comments on their proposed rule, which aims to expand the availability of short-term, limited duration insurance. CHIR reviewed comments submitted by health care stakeholders to better understand industry reactions to the proposal. In part two of this four-part series, CHIR’s Emily Curran analyzes comments from nine major medical insurers and associations.

Proposed Pre-Verification Process for Special Enrollment Periods: Policy Goals, Potential Impact, and the need for State Flexibility

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In the wake of failed congressional attempts to repeal and replace the Affordable Care Act, we turn back our focus on the administration and its approach to the marketplaces. The proposed market stabilization rule would require a pre-verification process for special enrollment periods for all marketplaces, including states operating their own. This move is largely in response to insurer concerns, indicating an interest in working with participating marketplace insurers. But how does this fare with states that have their own special enrollment processes? CHIR’s Sandy Ahn 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.