The Biden administration has proposed new rules for the Affordable Care Act’s (ACA) marketplaces in 2024, which are expected to be finalized any day. In the final installment of our annual NBPP stakeholder comment series, CHIR’s Rachel Schwab reviews state responses to the proposed rule.
Happy New Year! The holiday season may be over, but health policy researchers continue to bestow gifts onto our field. In December, we read about disruptions in health insurance coverage, the uninsured population, and gaps in provider network oversight. This roundup will highlight key findings of these articles, as well as their significance for our work.
Several insurers have eliminated broker commissions for mid-year marketplace enrollment. In a new Expert Perspective for the State Health & Value Strategies project, CHIR’s Justin Giovannelli looks at the consequences of cutting broker commissions for special enrollment periods, including risk of coverage losses, market instability, and potential violations of federal nondiscrimination rules.
During February’s State of the Union address, President Trump touted his administration’s efforts to expand access to short-term health plans that do not comply with any of the ACA’s consumer protections. Short-term plans are often cheaper than ACA-compliant plans because they can deny coverage to people and exclude entire categories of services. In a recent post supported by The Commonwealth Fund, we reviewed 12 short-term plans to determine what coverage consumers would have if they needed treatment for COVID-19. We found that consumers in short-term plans are likely to have less financial protections than those enrolled in ACA plans.
Over the last few months, state officials have increasingly acted to warn consumers about the potential risks of enrolling in health care sharing ministries (HCSMs). These efforts have ranged from educating consumers on HCSMs to initiating legal action against fraudulent practices. While some consumers may find value in HCSMs, recent actions by Aliera Healthcare provide one example of how entities may use HCSMs’ unregulated status to skirt oversight and take advantage of consumers.
In July, a federal district court judge upheld the Trump administration’s rule expanding availability of short-term, limited duration insurance, or short-term plans, which do not have to comply with the Affordable Care Act’s consumer protections. With the help of CHIR experts, Community Catalyst has published another resource for state advocates and policymakers, providing an overview of short-term plans, insight on unscrupulous sales practices that leave consumers at risk, and state regulatory options.
A 2018 federal rule changing the definition of short-term limited-duration insurance (STLDI) has created a new marketing opportunity for insurance companies and brokers. In a new study, CHIR experts assess short-term plan insurers’ marketing tactics in the wake of the new federal rules and how regulators have prepared for this new market.
Last month, the Department of Health & Human Services awarded $8.6 million in grants to 30 states and the District of Columbia to provide additional support to implement certain ACA market reforms, including guaranteed issue, guaranteed renewal, and the Essential Health Benefits. CHIR’s Rachel Schwab took a look at how states plan to use the federal funding, and what tops the list of state market stabilization and consumer protection priorities.
In June, the U.S. Department of Labor issued a final regulation that implements President Trump’s executive order encouraging the expansion of association health plans for small businesses and self-employed individuals. Under these rules, professional or trade associations will be permitted to sell health plans that are exempt from many Affordable Care Act protections as early as September 1, 2018. To better understand how these new rules will affect states, CHIR experts interviewed six state regulators.
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.
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.
