Compendium of Policy Proposals for Medicare Advantage and Part D
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CHIR Welcomes New Staff
We are delighted to welcome Sloane Daly as a Research Assistant.
CHIR Welcomes New Faculty
We are delighted to welcome two new faculty members: Madison Harden and Abigail Knapp.
May Research Roundup: What We’re Reading
In May, we welcomed spring blooms and warm weather, while staying engaged with the latest health pol...
The Reconciliation Bill Eliminates Long-Standing State Flexibility to Operate Marketplaces and Regulate Private Health Insurance
The budget reconciliation bill passed by the U.S. House of Representatives would eliminate much of t...
New Administration Plans to Reinstate Cuts to Funding for ACA Outreach and Enrollment Assistance
By Rachel Swindle, Jalisa Clark, and Justin Giovannelli One of the first actions by the Centers for ...
A New Rule to Limit ACA Enrollment Periods May Deter Sign-Ups and Worsen Risk Pools
Recent proposals from the Trump administration and Congress would shorten or eliminate the windows o...
The Sleeper Provision in the Reconciliation Bill That Could Hobble the ACA Marketplaces
An obscure provision in the U.S. House reconciliation bill could have major consequences for the Aff...
Death by Slow Strangulation: New Tactics in Longstanding Efforts to Repeal the Affordable Care Act
The U.S. House of Representatives is poised to take up legislation that, if enacted, would be tantam...
Stakeholder Perspectives on CMS’ Proposed “Marketplace Integrity” Rule: Consumer and Patient Advocate Organizations
The Trump administration’s proposed “Marketplace Integrity” rule has generated almost 26,000 p...
Stakeholder Perspectives on CMS’ Proposed “Marketplace Integrity” Rule: State Insurance Departments and Marketplaces
The Trump administration’s proposed “Marketplace Integrity” rule has generated almost 26,000 p...
Stakeholder Perspectives on CMS’ Proposed “Marketplace Integrity” Rule: Health Care Providers
The Trump administration’s proposed “Marketplace Integrity” rule has generated almost 26,000 p...
Stakeholder Perspectives on CMS’ Proposed “Marketplace Integrity” Rule: Health Insurers and Brokers
The Trump administration's proposed "Marketplace Integrity" rule has generated almost 26,000 public ...
Dental Coverage Through the Marketplace: A 2024 Snapshot of Enrollment, Market Participation and Premiums
A new CHIR report offers a snapshot of the dental coverage landscape on the ACA Marketplaces in 2025...
Old Diseases, New Threats: Are You Still Protected – and What Will Your Health Plan Cover?
With infectious diseases such as measles on the rise, many Americans are wondering what they can do ...
March Research Roundup: What We’re Reading
In March, we anticipated sunshine and warmer days while keeping up with the latest health policy res...
In Latest Policy Change for DACA Recipients, Trump Administration Proposes Elimination of Marketplace Insurance Eligibility
By Karen Davenport In recently-proposed regulatory changes to Affordable Care Act (ACA) marketplace ...
In Latest Policy Change for DACA Recipients, Trump Administration Proposes Elimination of Marketplace Insurance Eligibility
In recently proposed regulatory changes to marketplace coverage, the Trump Administration intends to...
State Flexibility To Add Adult Dental Care to Essential Health Benefits: An Update on State Action
By Madeline McBride, Elizabeth Bielic, Zeynep Celik, JoAnn Volk, and Kevin Lucia The Affordable Care...
State Flexibility To Add Adult Dental Care to Essential Health Benefits: An Update on State Action
CMS recently finalized a change in the 2025 Notice of Benefit and Payment Parameters, granting state...
CHIR Welcomes New Faculty and Staff
We are delighted to welcome three new members to the CHIR team: Karen Handorf, Julia Burleson, and A...
A blast from the past: Dusting off ACA Section 1333 compacts
Peter Nelson, the new director of the Center for Consumer Information and Insurance Oversight (CCIIO...
Here’s Something to Celebrate: The Affordable Care Act Just Turned 15!
On March 23, 2025, we celebrated the 15th anniversary of the Affordable Care Act (ACA). In this post...
Recent Federal Marketplace Proposal Imposes New Requirements for States and Consumers
On March 10, 2025, the Trump administration released draft rules with policy changes for the Afforda...
February Research Roundup: What We’re Reading
In February we stayed out of the cold and bundled up with the latest in health policy research. We r...
Policymakers Can Protect Against Fraud in the ACA Marketplaces Without Hiking Premiums
Last year, reports emerged of unscrupulous health insurance brokers enrolling people in marketplace ...
Coverage Matters: Enduring and Recent Evidence
As the federal budget reconciliation process heats up, Congressional committees will soon be draftin...
Protecting Access to Preventive Services: A State Roadmap
A case before the Supreme Court and a new Secretary of the U.S. Department of Health & Human Service...
Final 2026 Notice of Benefit & Payment Parameters: Marketplace Standards And Insurance Reforms
The Notice of Benefit & Payment Parameters prescribes standards and rules that govern insurers and M...
January Research Roundup: What We’re Reading
Since the snow shows no sign of stopping, we might as well stay cozy inside and read up on the lates...
How HHS and DOL Can Deliver Price Relief to American Families
President Trump’s price relief memorandum calls for reducing unnecessary administrative costs and ...
Early Signals from Executive Orders and Congressional Budget Proposals Bode Ill for Marketplace Enrollees
Right before an early executive order signaling the Trump Administration's interest in reducing acce...
December Research Roundup: What We’re Reading
A snowy first week of January gave us plenty of time to read some of the last research from 2024. Th...
Georgetown CHIR & Association of Health Care Journalists Release Update to Health Insurance Tool
The Association of Health Care Journalists has released an updated, interactive 50-state Media Guide...
HHS’s Competition Officer Offers Healthcare Cost Containment Opportunities for the Trump Administration
The Biden administration has advanced several pro-competition reforms aimed at lowering health care ...
November Research Roundup: What We’re Reading
In November, CHIR was thankful for the latest health policy research. We read about charity care pro...
New York Legislature Seeks to Control Outpatient Spending through Site-Neutral Payment and Rate Cap Proposal
A new proposal in New York State seeks to reduce rising outpatient care costs by implementing site-n...
Biden Administration Proposal to Improve Access to Free Preventive Services Faces Uncertain Future
The Biden Administration has proposed a rule to expand coverage of preventive services, including ov...
Enhancing Essential Health Benefits: How States Are Updating Benchmark Plans to Improve Coverage
The Affordable Care Act mandates that health plans in the individual and small-group markets cover e...
Medicare Advantage and Medicare Part D: A New Compendium of Policy Proposals
In 2023, for the first time, more than half of Medicare beneficiaries were enrolled in Medicare Adva...
Improving Health Care Transparency: Federal and State Perspectives
On November 20, CHIR hosted an all-star lineup of speakers to discuss how increased transparency can...
States Have New Flexibility to Add Adult Dental Care to Essential Health Benefits
The Centers for Medicare & Medicaid Services (CMS) has introduced a new option for states to update...
Enhanced Premium Tax Credits Provide an Early Opportunity for Addressing Affordability Issues
Enhanced premium tax credits (PTCs) have significantly reduced health insurance premiums and expande...
October Research Roundup: What We’re Reading
The leaves are falling but the latest health policy research is evergreen! Last month we read about ...
Advancing Health Care Transparency: A Menu of Options for State Policymakers
Many Americans struggle with high healthcare costs, leading state policymakers to explore transparen...
Revisiting Federal Price Transparency Proposals as the End of Congress’ Session Nears
In recent years, federal price transparency rules have required hospitals and health plans to public...
The Work Goes On: Preserving Equitable Access to Affordable, High Quality Health Insurance in Challenging Times
The 2024 election results will require concerted and aggressive efforts to preserve gains in insuran...
The Incursion Of Profit-Enhancing Middlemen In US Health Care
The U.S. health care system's lack of regulation over provider pricing and insurer claims has led to...
Proposed 2026 Payment Notice: Marketplace Standards And Insurance Reforms
CMS recently released their draft Notice of Benefit & Payment Parameters (NBPP) for plan year 2026. ...
If Expanded Federal Premium Tax Credits Expire, State Affordability Programs Won’t Be Enough to Stem Widespread Coverage Losses
The 2021 expansion of federal premium tax credits (PTCs) drove uninsured rates to a record low in 20...
What’s New for the 2025 Plan Year Open Enrollment
Open enrollment for the Affordable Care Act Marketplaces begins on November 1. We review several imp...
Substantial Marketplace Coverage Gains for Communities of Color Threatened Again
The Affordable Care Act (ACA) marketplaces have become vital lifelines for millions, especially for ...
September Research Roundup: What We’re Reading
While the weather may be cooling down, the research is not! This month we read about Medicare Advant...
CHIR Expert Testifies About Facility Fees Before Texas House Insurance Committee
CHIR expert Christine Monahan recently testified before the Texas House Insurance Committee regardin...
Current Considerations for State Reinsurance Programs
Reinsurance has been a popular mechanism to stabilize insurance markets and reduce premiums. However...
How Oregon’s Merger Review Law Combats Consolidation and What Other States Can Learn From It
Since the early 1990s, health care provider consolidation in states like Oregon has led to higher p...
August Research Roundup: What We’re Reading
More hot days mean more hot research! This month we read about the growing divergence between Medica...
High-Risk Pools: A High Risk Proposition for People with Pre-Existing Conditions
J.D. Vance, candidate for Vice President of the United States, has called for replacing the ACA's in...
U.S. House Education and Workforce Committee Moves Telehealth Billing Legislation
Recently, the U.S. House Education and Workforce Committee approved the Transparency Telehealth Bill...
Delays In Extending Enhanced Marketplace Subsidies Would Raise Premiums And Reduce Coverage
A debate is looming for the U.S. Congress - whether or not to extend enhanced premium tax credits fo...
Taking a Look at California’s Program to Assist People Losing Medi-Cal Enroll in Marketplace Coverage
A recently enacted law creates a streamlined pathway to health insurance for individuals who are fou...
Unpacking the Unwinding: Medicaid to Marketplace Coverage Transitions
As Medicaid unwinding draws to a close, millions of people have had to find new health coverage opti...
2023 Data From The Independent Dispute Resolution Process: Select Providers Win Big
The No Surprises Act (NSA) protects consumers from unexpected medical bills, with disputes between p...
July Research Roundup: What We’re Reading
Last month CHIR stayed cool indoors to catch up on the latest in health policy research. In July, we...
New Georgetown CHIR Report Examines State Reforms of Prior Authorization
Health insurers use of prior authorization appears to be on the rise. A recent report by CHIR resear...
State And Federal Efforts To Improve Ownership Transparency
While there is some movement toward improved health care provider ownership transparency at the fede...
It’s Still the Prices: Looking Under the Hood at Proposed 2025 Premiums
July is rate review season for state insurance departments. Proposed premiums for 2025 can help reve...
June Research Roundup: What We’re Reading
Last month CHIR soaked up the sun and the latest in health policy research. This month we read studi...
Insurers Eye ICHRAs: Implications For the Small Group and Individual Markets
Two national health insurers recently discussed their plans to invest in "ICHRAs," tax advantaged ac...
How States Can Use Tax and Unemployment Filings to Sign People Up for Health Insurance
Easy-enrollment programs offer states an efficient, low-cost mechanism for connecting residents with...
New Nationwide Data on Outpatient Facility Fee Reforms
As hospitals and health systems expand their ownership and control of ambulatory care practices, the...
New Georgetown CHIR Report on the Federal and State Tools for Responding to Provider Consolidation and Recommendations for Strengthening Them
Over the past 30 years, hospitals and physician practices have been merging at an accelerated pace, ...
States Increasingly Use Power Over Commercial Health Insurance to Boost Primary Care Investment
The U.S. significantly under-invests in primary care, even though the benefits of primary care acces...
CBO Projections Are Not Destiny: Policies, ACA Investments Can Change Trajectory
The Congressional Budget Office has released its 10-year projections for the country's health insura...
Understanding Hospital Financing: Takeaways from the CHIR Webinar Series
Over the last several months, CHIR hosted the webinar series "Understanding Hospital Financing." CHI...
May Research Roundup: What We’re Reading
The days are heating up and so is the summer research! This month we read about the effects of healt...
New Rule Opens the Affordable Care Act Marketplaces to DACA Recipients
The U.S. Department of Health & Human Services has released a final regulation allowing people who r...
Facility Fee State Legislative Roundup: 2024 Session
With more outpatient care being delivered in hospital outpatient departments (HOPDs) than in previou...
Raise the Bar: State-Based Marketplaces Using Quality Tools to Enhance Health Equity
In a new post for the Commonwealth Fund's To The Point blog, CHIR's Jalisa Clark and Christine H. Mo...
Improving Health Care Competition: Federal and State Perspectives
On Tuesday, May 21st, Georgetown University's Center on Health Insurance Reforms held the final of t...
Final Rule Rescinds Trump-Era Association Health Plans
The US Department of Labor recently finalized regulations governing the formation of Association Hea...
The Final 2025 Notice of Benefit and Payment Parameters: Implications for States
The Centers for Medicare & Medicaid Services have recently finalized rules and standards governing h...
Short-Term, Limited Duration Insurance Final Rule: Considerations for States
Recent federal rules will limit the marketing and use of short-term limited duration health insuranc...
Consumer Protections Meet Political Pushback: Lessons from States Studying Facility Fees
A growing number of states are taking action to reform facility fee billing practices, but oppositio...
April Research Roundup: What We’re Reading
April showers bring…cozy rainy days to catch up on the latest health policy research. This month w...
CHIR Welcomes Two New Faculty Members, Amy Killelea and Leila Sullivan
CHIR is delighted to welcome two new faculty members: Amy Killelea and Leila Sullivan.
Ensuring Access to Behavioral Health Providers
Lack of access to care for behavioral health conditions is a longstanding issue. In a recent post fo...
Evidence On Private Equity Suggests That Containing Costs And Improving Outcomes May Go Hand-In-Hand
A growing body of evidence suggests private equity investments in health care have raised provider p...
State Efforts To Improve Price Transparency
Federal regulations require hospitals and insurers to publish negotiated prices. States are also pla...
Final 2025 Payment Notice: Marketplace Standards And Insurance Reforms
The U.S. Department of Health & Human Services recently released a final rule setting standards for ...
Biden Administration Finalizes Limits On Junk Health Plans
Last month the Biden administration finalized rules establishing new standards and disclosure requir...
Health Savings Accounts: Robin Hood in Reverse
As another tax filing season comes to a close, millions of Americans have reduced their taxable inco...
March Research Roundup: What We’re Reading
Thanks to daylight savings in March, CHIR had more time to keep up with the latest health policy res...
CHIR Experts Testify About Facility Fees Before Maryland General Assembly
Last month, CHIR experts Rachel Swindle and Karen Davenport shared findings from CHIR’s research o...
Stakeholders Weigh in on a Proposal that Could Expand Adult Dental Coverage
The final Notice of Benefits and Payment Parameters for plan year 2025 is expected soon. The propose...
States Expand Access to Affordable Private Coverage for Immigrant Populations
In the United States, immigrants are disproportionately likely to be uninsured. This disparity stems...
State Options for Making Hospital Financial Assistance Programs More Accessible
According to recent estimates, almost 100 million people have debt because of medical or dental bill...
February Research Roundup: What We’re Reading
In February, CHIR used Leap Day to catch up on the latest health policy research. This month we read...
No Surprises Act: Exploring the Impact on Employees, Employers and Costs
On March 7, CHIR hosted the second event in a series of policy briefings on the future of employer-s...
Report Shows Dispute Resolution Process in No Surprises Act Favors Providers
Last month, the Biden administration reported on independent dispute resolution (IDR) cases resolved...
Health Care Sharing Ministries Leave Consumers with Unpaid Medical Claims
Last year, Colorado became the first state to require comprehensive data from all health care sharin...
Stakeholder Perspectives on CMS’s 2025 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces
In November, the Biden administration released the proposed Notice of Benefits and Payment Parameter...
Stakeholder Perspectives on CMS’s 2025 Notice of Benefits and Payment Parameters: Consumer Advocates
The Biden administration will soon finalize its annual rulemaking for the Affordable Care Act Market...
December–January Research Roundup: What We’re Reading
This winter, CHIR curled up with some good reads: the latest in health policy research. In December ...
CHIR Welcomes Two New Faculty Members, Stacey Pogue and Kennah Watts
CHIR is delighted to welcome two new faculty members: Stacey Pogue and Kennah Watts.
Dental Coverage under the ACA: Marketplace Rule Would Give States the Opportunity to Expand Coverage
Dental care is an important element of comprehensive health care. The Affordable Care Act (ACA) requ...
State Public Option Plans Are Making Progress on Reducing Consumer Costs
States remain motivated to adopt reforms that improve affordability and expand access to coverage fo...
Stakeholder Perspectives on CMS’s 2025 Notice of Benefit and Payment Parameters: Health Insurers and Brokers
The Biden administration will soon finalize its annual rulemaking for the Affordable Care Act Market...
Policy Innovations in the Affordable Care Act Marketplaces
The Affordable Care Act's Marketplaces have seen record signups for 2024. Marketplaces can pursue in...
Looking Under the Hood: “Enhanced” Rate Review to Improve Affordability
A handful of states are working to improve health insurance affordability by boosting their insuranc...
Navigator Guide FAQs of the Week: Post-Enrollment Issues
Open enrollment for the Affordable Care Act’s Marketplaces has ended in most states, with a record...
Proposed Rule Would Roll Back Expansion Of Association Health Plans
Last month, the U.S. Department of Labor proposed a rule rescinding a Trump-era regulation that expa...
A Wolf in Sheep’s Clothing: The Pitfalls of Treating Telehealth Coverage as an “Excepted Benefit”
Congress is considering legislation that would make telehealth coverage an "excepted benefit." CHIR ...
Step-by-Step: Congressional Proposals Could Help Unlock Information Key to Curbing U.S. Health Care Spending
In recent years, outpatient care has contributed considerably to growth in U.S. health care spending...
Navigator Guide FAQs of the Week: Wrapping Up Open Enrollment
Open enrollment for the Affordable Care Act’s Marketplaces is coming to a close. In most states, J...
Implementing the No Surprises Act: What We Know from Early Complaint Data
The No Surprises Act (NSA) provides comprehensive protections from many of the most prevalent forms ...
Proposed 2025 Payment Rule: Marketplace Standards And Insurance Reforms
Last month, the Biden administration proposed changes to Affordable Care Act (ACA) Marketplace polic...
Navigator Guide FAQs of the Week: The Risks of Buying Coverage Outside the Marketplace
As 2023 comes to a close, it’s time to think about health insurance for 2024. Consumers searching ...
What States Are Doing to Keep People Covered as Medicaid Continuous Coverage Enrollment Unwinds
Several state-based Marketplaces have deployed innovative programs to keep people covered during the...
Navigator Guide FAQs of the Week: Marketplace Coverage Issues for LGBTQI+ Individuals
It’s time to sign up for 2024 coverage on the Affordable Care Act’s Marketplaces. This week, the...
Navigator Guide FAQs of the Week: Comparing Plans
The deadline to sign up for Marketplace coverage that begins January 1 is fast approaching. This wee...
In An Era Of Premium And Provider Price Increases, State Employee Health Plans Target Key Cost Drivers
It's open enrollment season for many employer health plans, and the rising cost of care may increase...
Navigator Guide FAQs of the Week: Health Coverage for Small Business Owners and Employees
The Affordable Care Act’s Marketplaces are a critical source of health insurance for small busines...
The Impact of Unions on Employer-Sponsored Health Insurance
In just the first eight months of 2023, over 323,000 workers engaged in a labor action against their...
Navigator Guide FAQs of the Week: Financial Assistance Available Through the Marketplace
Open Enrollment for 2024 is in full swing, and thanks to a temporary expansion of federal premium su...
October Research Roundup: What We’re Reading
In preparation for Health Policy Halloween, CHIR read up on the latest health policy research. In Oc...
Navigator Guide FAQs of the Week: Who is Eligible for Marketplace Coverage?
November 1 marked the first day of the Marketplace Open Enrollment Period in most states. CHIR recen...
Facility Fees 101: What is all the Fuss About?
Consumers are facing higher out-of-pocket costs when they receive outpatient care due to hospital ...
New Federal Rules Seek To Strengthen Mental Health Parity
The comment period recently ended for the Biden administration's proposed a rule to bolster enforcem...
State Health Equity Initiatives Confront Decades of Racism in the Insurance Industry
As another Marketplace Open Enrollment Period begins, millions of Americans will turn to insurance b...
Uneven Ground: Differences in Language Access Across State-Based Marketplaces
The annual Marketplace Open Enrollment Period is just around the corner. Enrolling in health insuran...
What’s New for 2024 Marketplace Enrollment?
The annual open enrollment period for Affordable Care Act (ACA) Marketplace coverage kicks off Novem...
September Research Roundup: What We’re Reading
As we fall into autumn weather, CHIR continues to keep up with the latest health policy research. In...
Policy Experts Discuss Strategies to Keep Employer-Sponsored Health Insurance Afloat
On October 3, CHIR held the first in a series of in-person policy briefings on the future of employe...
State Protections Against Medical Debt: A Look at Policies Across the U.S.
Medical debt is one of the leading causes of bankruptcy in the United States. Though federal law pro...
CHIR Welcomes New Faculty, Billy Dering
CHIR is excited to welcome Billy Dering, M.P.H., as our newest faculty member.
State Action to Protect and Promote Abortion Access in State-Regulated Health Plans
In the wake of the Supreme Court’s decision overturning Roe v. Wade, states have taken action to p...
Reforming Abusive Billing Practices, One Step At A Time
As hospitals expand and take over outpatient care settings, consumers are facing additional charges ...
Oregon Advances Basic Health Program: Considerations for States
A September 12 vote in Oregon would make it the third state to establish a Basic Health Program, aft...
August Research Roundup: What We’re Reading
As summer was winding down, CHIR was reading up on the latest health policy research. In August, we ...
CHIR Welcomes New Faculty, Nadia Stovicek
CHIR is delighted to welcome Nadia Stovicek (she/her), M.P.P., as our newest faculty member.
Colorado Option: Increasing Transparency and Driving Down Costs Through Enhanced Rate Review
The "Colorado Option" - a unique state effort improve health insurance affordability - is underway. ...
Biden Administration Sets Limits on Use of Short-Term Health Insurance Plans, But States Can Do More to Protect Consumers
A recently proposed federal rule aims to mitigate the harm of short-term insurance plans, products e...
The Perfect Storm: Misleading Marketing of Limited Benefit Products Continues as Millions Losing Medicaid Search for New Coverage
A massive coverage transition is underway for millions of people who have relied on Medicaid through...
Health Care Sharing Ministry Data Point to Problems for Consumers, Regulators
Millions of Americans rely on Health Care Sharing Ministries (HCSM) in lieu of insurance to provide ...
Surprise Billing: Volume Of Cases Using Independent Dispute Resolution Continues Higher Than Anticipated
The No Surprises Act is largely working as intended to protect patients from unexpected medical bill...
July Research Roundup: What We’re Reading
CHIR’s summer reading list includes the latest health policy literature. In July, we read about th...
Early Rate Filings Show Premium Increases, Rising Costs of Care
The Centers for Medicare & Medicaid Services has published proposed rate changes for 2024 Marketplac...
Tackling Another Public Health Emergency: Recent State and Federal Policies to Increase Opioid Use Disorder Treatment Access
While the federal COVID-19 Public Health Emergency (PHE) ended in May, the PHE declaration for the o...
New CHIR Case Study Examines Policies to Expand Primary Care Access in West Virginia
In a new case study, published in collaboration with the Milbank Memorial Fund, CHIR researchers exa...
The Biden Administration Takes Aim At Medical Financing Products
This month, the Biden administration issued a Request for Information (RFI) on “the scope, prevale...
An Historic Event: A Summary of CMS’s Inaugural Health Equity Conference
Last month, the Centers for Medicare & Medicaid Services (CMS) held the first ever CMS Health Equity...
The One Year Anniversary of 988: A Roadmap for States Seeking to Expand Access to Behavioral Health Crisis Services
One year ago, the U.S. transitioned to a new, three-digit nationwide number for suicide prevention a...
New Georgetown Report and Issue Brief on Outpatient Facility Fee Billing and State Policy Responses
Consumers are increasingly being exposed to a new expense when they seek outpatient medical care: ho...
Administration Takes Action To Limit Junk Health Insurance
The Biden administration has proposed a new rule limiting insurance products that are largely exempt...
June Research Roundup: What We’re Reading
As we splashed into summer, CHIR soaked up the latest health policy research along with some rays. I...
Mixed Results: Efforts of State Health Plans to Combat Cost Growth Reveal Broader Challenges for Employer-based Insurance
State employee health plans are uniquely situated to tackle the health care cost growth that is redu...
Can Employer-Sponsored Insurance Be Saved? A Review of Policy Options: Price Transparency
The rising costs of employer-sponsored insurance are placing financial pressure on employers and wor...
Health Policy Pride: An Overview of Private Coverage Issues Impacting the LGBTQ+ Community
Happy Pride Month from CHIR! Each June, Pride is an opportunity to celebrate the LGBTQ+ community an...
Competition and Transparency: The Pathway Forward for a Stronger Health Care Market
The U.S. House of Representatives Education and Workforce Health Subcommittee held a hearing on heal...
May Research Roundup: What We’re Reading
April showers bring May flowers, and May was abloom with health policy research. Last month, we read...
Proposed Expansion of Self-funding for Small Employers Would Roll Back Affordable Care Act Protections, Pre-empt State Insurance Oversight
The U.S. House of Representatives' Education & Workforce Committee is poised to advance H.R. 2813, l...
CHIR Welcomes New Faculty, Hanan Rakine
CHIR is thrilled to welcome Hanan Rakine, M.P.H., as our newest faculty member.
Preserving the ACA’s Preventive Services Protections in the Wake of Braidwood v. Becerra: A Checklist of State Options
On May 15, 2023, the 5th Circuit Court of Appeals temporarily paused the Braidwood v. Becerra ruling...
More Than a Website: Should the Federal Government Establish Additional Minimum Standards for the ACA’s Health Insurance Marketplaces?
The Affordable Care Act established health insurance Marketplaces to facilitate enrollment in compre...
The Health Plan Price Transparency Data Files Are a Mess – States Can Help Make Them Better
The transparency of health care prices can help policymakers, employers, and researchers identify th...
April Research Roundup: What We’re Reading
For our monthly research roundup, we reviewed studies on a public option proposal for California, ho...
States Move Forward with Public Option Programs, but Differ in How They Select Insurance Carriers
Washington, Colorado, and Nevada are partnering with private health insurance carriers to offer new ...
Searching for a New Normal: How Expiration of the Federal Public Health Emergency Impacts Access to Health Care Services
After more than three years, the federal COVID-19 public health emergency (PHE) is set to expire on ...
Reducing Health Care Costs For Working Families
The U.S. House of Representatives' Education & Workforce Committee is considering several bills affe...
Final 2024 Payment Rule, Part 1: Insurance Market Rules And Consumer Assistance
The Biden administration has published its rules for the ACA's insurers and Marketplaces for plan ye...
March Research Roundup: What We’re Reading
Winter is finally over, and health policy research is in full bloom. In March, we read about dispari...
Providers Challenge Payments In ‘No Surprises’ Act Dispute Resolution Process
Under the No Surprises Act, consumers are held harmless beyond in-network cost sharing when they rec...
A World Without The ACA’s Preventive Services Protections: The Impact Of The Braidwood Decision
The U.S. Department of Justice has requested that a Texas district court suspend its decision to str...
Coverage of Preventive Services Without Cost Sharing in Jeopardy as Texas Court Strikes Down ACA Protection
At the end of March, a federal judge in Texas partially invalidated one of the ACA’s most popular ...
Stakeholder Perspectives on CMS’s 2024 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces
The Biden administration has proposed new rules for the Affordable Care Act’s (ACA) marketplaces i...
Stakeholder Perspectives on CMS’s 2024 Notice of Benefits and Payment Parameters: Consumer Advocates
The Biden administration is poised to finalize new rules governing the Affordable Care Act Marketpla...
Biden’s Budget Sets Up a Spending Showdown, With ACA Subsidies in the Crosshairs
President Biden released his Fiscal Year 2024 budget earlier this month, outlining the administratio...
Stakeholder Perspectives on CMS’s 2024 Notice of Benefit and Payment Parameters: Health Insurers
The Biden administration is poised to finalize new rules governing the Affordable Care Act Marketpla...
Questionable Conduct: Allegations Against Insurers Acting as Third-Party Administrators
Nearly half of U.S. residents are enrolled in employer-sponsored health insurance. Many of these pla...
Happy 13th Birthday, ACA!
The Affordable Care Act is now 13 years old. To celebrate this milestone, CHIR takes a look at the l...
The State of State Protections: Maintaining Access to Services after Transitioning from Medicaid
As states resume conducting Medicaid and CHIP re-determinations of eligibility, the U.S. faces the m...
Proposed Rules on the ACA’s Frequently Litigated “Birth Control Mandate” Aim to Close Gaps in Coverage
Last month, the Biden administration proposed new rules to restore access to free contraceptive serv...
February Research Roundup: What We’re Reading
Along with “Health Policy Valentines,” February brought a host of new health policy research. Th...
Can Employer-Sponsored Insurance Be Saved? A Review of Policy Options: Limiting Provider Consolidation and Anti-Competitive Behavior
High and rising health care prices are a key driver of increased cost sharing in employer plans. A s...
A Progress Report on Washington’s Public Option Plans
Washington State’s "public option" program is now in its third year. After initial cost and access...
Secrets to a Successful Unwinding: Actions State-Based Marketplaces and Insurance Departments Can Take to Improve Coverage Transitions
States have begun conducting Medicaid redeterminations and renewals after an almost 3-year pause, a ...
Updates to the Navigator Resource Guide Provide Information for People Transitioning from Medicaid to Private Health Insurance
After a three-year pause on Medicaid redeterminations, states can begin the process of removing resi...
COVID “Long Haulers” Still Struggle with Coverage and Care
The COVID-19 public health emergency expires this spring, bringing an end to pandemic-related fundin...
January Research Roundup: What We’re Reading
Welcome to another year of health policy research. In the first month of 2023, CHIR reviewed studies...
A Midterm Assessment Of President Biden’s Promise To Build On The ACA
As a candidate, President Biden promised to protect and build on the Affordable Care Act. At the hal...
Implementing the Family Glitch Fix on the Affordable Care Act’s Marketplaces
A record number of people have signed up for health insurance through the Affordable Care Act’s ma...
U.S. Health Insurance Coverage and Financing
In a new Perspectives piece for the New England Journal of Medicine, CHIR's Sabrina Corlette and Ch...
The ACA’s Preventive Services Benefit Is in Jeopardy: What Can States Do to Preserve Access?
A federal judge is poised to gut one of the most popular provisions of the Affordable Care Act’s (...
ERISA 101: The United States’ Hands-Off Approach to Regulating Employer Health Plans
Amidst growing health care costs, adequate health insurance coverage is increasingly unaffordable fo...
Navigator Guide FAQs of the Week: Post-enrollment Issues
The open enrollment period has officially ended in most states. After signing up for 2023 coverage, ...
Can Employer-sponsored Insurance Be Saved? A Review of Policy Options: Price Regulation
Health insurance is becoming increasingly unaffordable for employers and workers alike. In the secon...
December Research Roundup: What We’re Reading
Happy New Year! The holiday season may be over, but health policy researchers continue to bestow gif...
Navigator Guide FAQs of the Week: The End of Open Enrollment
In most states, January 15 marks the end of the open enrollment period for 2023 coverage. While taki...
New CHIR Case Study Examines Policies to Expand Primary Care Access in Rural Arkansas
Primary care is a critical tool to prevent illness and death and improve equitable distribution of h...
Navigator Guide FAQs of the Week: Comparing Plans
Open Enrollment is drawing to a close; in most states, consumers only have until January 15 to sign ...
The Proposed 2024 Notice of Benefit & Payment Parameters: Implications for States
The Biden administration released a draft of the annual rule governing the Affordable Care Act marke...
Navigator Guide FAQs of the Week: What to Know About Off-marketplace Plans
Although the deadline to enroll in a marketplace plan beginning January 1 has passed in most states,...
As Ground Ambulance Committee Begins Its Work, New Report on Balance Billing by Ground Ambulance Providers Highlights a Gap in the No Surprises Act
On December 9, the Centers for Medicare and Medicaid Services announced the membership of the Adviso...
Proposed 2024 Payment Rule, Part 1: Insurance Market Reforms And Consumer Assistance
In its 2024 Notice of Benefit & Payment Parameters, the Biden administration has proposed a number o...
Navigator Guide FAQs of the Week: Coverage of Reproductive Health Care
In most states, it’s the last week to sign up for marketplace plan that begins January 1. The Affo...
November Research Roundup: What We’re Reading
CHIR had a lot to be thankful for this November, including new health policy research. For the lates...
Supporting Continuity of Coverage from Medicaid into the Marketplace: Post-PHE Considerations for States
States are expected to resume redeterminations of Medicaid eligibility in early 2023, resulting in a...
Navigator Guide FAQs of the Week: Small Businesses
The marketplaces are critical source of health insurance for small businesses, including small busin...
The Erosion of Employer-Sponsored Health Insurance and Potential Policy Responses
Employer-sponsored insurance (ESI) covers 160 million Americans, but the adequacy of these plans is ...
Congressional Proposals for a Federal Public Health Insurance Option
Democrats in Congress have put forward several proposals to create a public health insurance option ...
Navigator Guide FAQs of the Week: Family Glitch Fix
Open Enrollment for 2023 is in full swing, and our recently updated Navigator Guide has hundreds of ...
October Research Roundup: What We’re Reading
The leaves may be changing, but the importance of health policy research is evergreen. Last month, w...
Navigator Guide FAQ of the Week: Who is Eligible for Marketplace Coverage?
With support from the Robert Wood Johnson Foundation, CHIR recently updated its Navigator Resource G...
Bridging the Gap: Oregon’s Proposal to Ease Coverage Transitions at the End of Public Health Emergency
At the end of the COVID-19 public health emergency, millions of people will lose Medicaid as states ...
Value for Whom? HHS Office of Civil Rights Seeks Input on the Impact of Payers’ Value Assessments on Health Equity
As health care costs continue to rise, stakeholders are looking to innovations in provider payments ...
New and Improved Navigator Resource Guide Answers Common Enrollment Questions and Reflects Policy Changes for 2023
The tenth open enrollment season for the Affordable Care Act’s marketplace is in full swing. With ...
State-Based Marketplace Outreach Strategies for Boosting Health Plan Enrollment of the Uninsured
The tenth annual open enrollment period for the Affordable Care Act’s marketplaces is upon us. In ...
CHIR Welcomes New Staff Member Kristen Ukeomah
CHIR is delighted to welcome a new staff member to our team: Research Associate Kristen Ukeomah.
The GOP’s Plans for Health Care if they Take Control of Congress: A Mixed Bag for Consumers
The midterm elections are upon us, and most voters view health care as a “very important” issue....
New CHIR Report Examines Federal-State Partnership in No Surprises Act Implementation
The No Surprises Act (NSA) aims to protect consumers facing surprise medical bills after receiving c...
New Georgetown Report Reviews State Efforts to Enforce Mental Health Parity
The Mental Health Parity and Addiction Equity Act (MHPAEA) aims to remove insurance-related obstacle...
September Research Roundup: What We’re Reading
It's officially fall, and along with the new season came an autumnal bounty of new health policy res...
What’s New for 2023 Marketplace Enrollment?
The annual open enrollment period for Marketplace coverage is right around the corner, running from ...
Nevada Actuarial Study Projects Significant Savings from Public Option Plans
Last week, the Nevada Department of Health and Human Services released the results of an actuarial s...
Hospital And Insurer Price Transparency Rules Now In Effect But Compliance Is Still Far Away
Hospitals and health insurers are now required to publicly post their prices for health care service...
The Feds Crack Down on Sham Insurance: New Court Order to Protect Consumers from Deceptive Marketing
Last month, the Federal Trade Commission (FTC) took action against Benefytt Technologies, finding th...
Federal Court Decision Threatens the ACA’s Preventive Services Benefit: State Options to Mitigate Harm to Consumers
A federal judge in Texas has ruled that Affordable Care Act requirements that insurers cover and wai...
August Research Roundup: What We’re Reading
For the August edition of our monthly research roundup, CHIR said farewell to summer by reviewing th...
CHIR Welcomes Three New Faculty Members
CHIR is delighted to welcome three new faculty members to our team: Research Professor Linda Blumber...
Third Time is the Charm? Proposed Regulations Strengthen Nondiscrimination Protections for Health Insurance Enrollees
For the third time, the Department of Health and Human Services’ Office of Civil Rights has propos...
The No Surprises Act Final Rule: Implications for State Regulators
The Biden administration has published its final rules governing the independent dispute resolution ...
Using Health Insurance Reform to Reduce Disparities in Diabetes Care
The affordability of diabetes care is a national issue. Even with insurance, diabetic patients can s...
Amidst Rising Overdose Deaths, Policymakers Look for Ways to Expand Access to Proven Opioid Use Disorder Treatment
As the number of opioid-related overdose fatalities remains alarmingly high, access to medication-as...
Healthcare Provisions in the Inflation Reduction Act: Implications for States
Congress is poised to enact the Inflation Reduction Act, a $740 billion reconciliation package that ...
July Research Roundup: What We’re Reading
New health policy research topped CHIR’s list of beach reads this July. For the latest monthly res...
Ensuring Continuity of Care for Individuals Transitioning from Medicaid to Marketplace: Post-PHE Considerations for States
Many of those losing their Medicaid eligibility after the COVID-19 public health emergency will have...
What the Data Say About Offering Public Option Plans to Workers with Employer-Sponsored Insurance
Employer-sponsored insurance is the largest source of health coverage in the U.S., but the employer ...
From Cancer Screenings to Prenatal Care, the Latest Challenge to the Affordable Care Act Threatens Availability of Free Preventive Services
The ACA requires that most insurers and employers cover a set of preventive health services at no co...
Prior Authorization – Boon or Bane? Federal and State Policymakers Seek Reforms to Insurers’ Utilization Management Practices
Utilization management is one tool that insurers can use to help keep premiums in check, but it come...
In a Post-Roe World, Employers Looking to Cover Out-of-State Travel for Abortion Services Have Multiple Options and Plenty of Uncertainty
Following the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, analyses...
HHS Approves Nation’s First Section 1332 Waiver for a Public Option–Style Health Care Plan in Colorado
The U.S. Department of Health and Human Services recently approved a new Section 1332 waiver a...
CHIR Interactive Map Highlights New Details on No Surprises Act Enforcement
The No Surprises Act (NSA) went into effect this year, providing new protections against surprise m...
Party’s Over: Health Plan Premiums Poised to Spike in 2023, After Period of Modest Growth
Health insurers have begun to submit their proposed premium rates for 2023, and they're not looking ...
Delays Extending The American Rescue Plan’s Health Insurance Subsidies Will Raise Premiums And Reduce Coverage
Congress has spent months debating an extension of enhanced premium tax credits enacted under the Am...
June Research Roundup: What We’re Reading
It’s finally summer, and during the latest heat wave, the CHIR team cooled off with new health pol...
Improving Race and Ethnicity Data Collection: A First Step to Furthering Health Equity Through the State-Based Marketplaces
The ACA’s marketplaces are working to advance health equity. State-based marketplaces are uniquely...
Understanding the Role of Private Equity in the Health Care Sector
As private equity involvement in the health care industry increases, policymakers and other stakehol...
Averting Premium Shock for Marketplace Consumers
The American Rescue Plan Act has led to record-high marketplace enrollment and significant savings f...
May Research Roundup: What We’re Reading
This month, the CHIR team celebrated the end of the school year with new health policy research. For...
New CHIR Case Study Report Examines Policies to Expand Primary Care Access in Rural New Mexico
In a new report published in collaboration with the Milbank Memorial Fund, CHIR researchers examined...
Standards for Provider Network Adequacy in Medicaid and the Marketplaces
Beginning in 2023, CMS will require QHP provider networks for plans sold on the federal marketplace ...
Colorado Announces Premium Rate Reduction Targets for Public Option Plans
Colorado is moving quickly to set the rules for state public option-style plans, ahead of their laun...
The Final 2023 Notice of Benefit & Payment Parameters: Implications for States
The Biden administration is advancing new standards and policies for the Affordable Care Act health ...
Broker Commissions for Mid-Year Enrollment in the Marketplaces: Options for State Marketplaces and Insurance Regulators to Prevent Discrimination
Several insurers have eliminated broker commissions for mid-year marketplace enrollment. In a new Ex...
State and Federal Policies to Increase Access to Medication Abortion
A leaked draft of an impending Supreme Court decision has previewed the potential for states to proh...
CHIR Launches New Resource Center for Policymakers on Public Option Proposals
With the generous support of Arnold Ventures, CHIR experts have launched a new resource center and n...
What Four States Are Doing to Advance Health Equity in Marketplace Insurance Plans
The implementation of the Affordable Care Act (ACA) led to historic reductions in racial and ethnic ...
Congress, Administration Work to Meet Growing Need for Behavioral Health Care
The need for mental health and substance use disorder services is substantial and growing. One in fi...
April Research Roundup: What We’re Reading
April brought us a shower of health policy research, including studies on the implications of the Am...
Response to Deceptive Marketing of Limited Plans Shows States Can Take Proactive Steps to Protect Consumers
Last month the Texas Department of Insurance issued a consent order dissolving Texas-based Triada As...
Fixing the Family Glitch: Federal Rules Aim to Improve Coverage Affordability for Working Families
Roughly 5 million people are currently unable to access marketplace subsidies due to a flawed interp...
Mitigating Coverage Loss When the Public Health Emergency Ends: The Role of the Affordable Care Act Marketplaces
As many as 16 million people are expected to lose Medicaid once the COVID-19 public health emergency...
Updated Breast Pump Coverage Guidelines Provide Important Protections for Families but More Guidance May Be Needed to Increase Access
The American Academy of Pediatrics recommends feeding infants breastmilk through their first year. O...
The End of the Public Health Emergency Will Prompt Massive Transitions in Health Insurance Coverage: How State Insurance Regulators Can Prepare
It will be "all hands on deck" for state officials once the public health emergency ends and up to 1...
New Georgetown Report on Medicaid and Marketplace Network Adequacy
A recently published report from Georgetown's Center on Health Insurance Reforms and Center for Chil...
California’s Marketplace Tries New Tactics to Reduce the Number of Uninsured and Underinsured
Despite a significant reduction in the uninsured rate over the last decade, millions of people still...
The Expiration of the Public Health Emergency Also Ends Policies to Lower Health Access Barriers
As we approach the end of the public health emergency, Medicaid will not be the only program affecte...
March Research Roundup: What We’re Reading
Along with the cherry blossoms, new health policy research was in full bloom this month. In addition...
Update on State Public Option-Style Laws: Getting to More Affordable Coverage
While federal health coverage reforms remain stalled in Congress, several states are pushing forward...
Stakeholder Perspectives and Feedback on Health Equity in the 2023 Notice of Benefit and Payment Parameters
In the proposed Notice of Benefit and Payment Parameters for 2023, the Centers for Medicare & Medica...
Preparing for the Biggest Coverage Event Since the ACA: The Role of States as Medicaid Continuous Coverage Comes to an End
CHIR and our colleagues at the Center for Children and Families (CCF) have published two new resourc...
Happy 12th Birthday, Affordable Care Act—You’ve Grown So Much!
The Affordable Care Act was signed into law on March 23, 2010. On the law's 12th birthday, Karen Dav...
Massachusetts Data on Health Care Sharing Ministries Reveal Finances That Put Consumers at Risk
Health Care Sharing Ministries (HCSM) continue to be marketed widely, often as an alternative to th...
Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces
After the Biden administration issued the proposed 2023 “Notice of Benefit and Payment Parameters,...
Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: Insurers and Brokers
The Biden administration has proposed significant changes to the Affordable Care Act's health insura...
February Research Roundup: What We’re Reading
In honor of Black History Month, for the February edition of CHIR’s monthly research roundup we re...
Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: Consumer Advocates
In the recently released 2023 "Notice of Benefit & Payment Parameters," the Biden administration is ...
Where the Bread is Really Buttered: Insurers’ Q4 Earnings Reports Show Heavy Reliance on Government Business
Health insurers reported healthy earnings during the fourth quarter of 2021, thanks in large part to...
New Data Show Medical Debt Disproportionately Affects the Most Vulnerable Populations
Unpaid medical bills are among the largest contributors to personal debt in the United States. Evide...
PrEP Coverage Obstacles Highlight Challenges Implementing the ACA Preventive Services Requirement
The ACA requires coverage of recommended preventive services without cost-sharing for consumers enro...
Questionable Quality Improvement Expenses Drive Proposed Changes to Medical Loss Ratio Reporting
Under the Affordable Care Act, insurers must provide rebates to enrollees when their spending on cli...
Ensuring the Adequacy of ACA Marketplace Plan Networks
Following the Trump administration’s decision to roll back federal network adequacy standards for ...
New CHIR Report Assesses the Effectiveness of Policies in Improving Access to Primary Care for Underserved Populations
It is hard to overstate the importance of primary care in ensuring robust health outcomes at the pop...
January Research Roundup: What We’re Reading
In our newest monthly roundup of health policy research, CHIR’s Emma Walsh-Alker reviews studies o...
Oregon’s Public Option Implementation Report Emphasizes Cost Containment, Health Equity
The Oregon Health Authority recently released its Public Option Implementation Report, stemming from...
Tackling “Analysis Paralysis”: New Federal Proposal Would Bring Standardized Benefit Design Back to the Federally Facilitated Marketplace
The Affordable Care Act’s health insurance marketplaces and consumer protections significantly imp...
Insurers are Now Covering At-Home COVID Tests but Implementation Varies
Private health plans are now required to cover at-home over-the-counter COVID-19 tests. CHIR's Megan...
Adoption of Value-Based, Alternative Payment Models: Where Are We Today and Where Do We Go from Here?
Employer-sponsored health insurance costs had their highest annual increase since 2010 last year, an...
CHIR Welcomes New Faculty & Staff, Jalisa Clark & Emma Walsh-Alker
We're delighted to welcome to the CHIR team our two newest colleagues, Research Fellow Jalisa Clark,...
Fixing the Family Glitch and Other Priorities: The Next Wave of Federal Administrative Action to Enhance the Affordable Care Act
The federal government has taken a series of actions to strengthen the Affordable Care Act (ACA) and...
New Requirements to Cover Over-the-counter COVID Tests: Implications for State Insurance Regulators
New federal rules require health insurers to cover and waive consumer cost-sharing for over-the-coun...
December Research Roundup: What We’re Reading
This month, we’re ringing in the new year with new health policy research. In our final roundup of...
Navigator Guide FAQs of the Week: Answers to Post-Enrollment Questions
As of January 15th, the open enrollment period has ended in most states. A record number of consumer...
Changes to Wellness Programs Suggest Employers are Rethinking Health Promotion
January can feel like a time for new beginnings, and new year's resolutions. In recent years, many e...
The New Year Brings New Protection Against Surprise Medical Bills: What Consumers Need to Know
As we enter 2022, consumers are now protected from many of the worst surprise medical bills. The No ...
The Proposed 2023 Notice of Benefit & Payment Parameters: Implications for States
The Biden administration has proposed a range of new standards and policies for the Affordable Care ...
Navigator Guide FAQs of the Week: Understanding Common Consumer Notices When Applying for Marketplace Coverage
Happy New Year! In most states, consumers have until January 15 to sign up for marketplace coverage ...
ACA Section 1557 as a Tool for Anti-racist Health Care
The Affordable Care Act (ACA) has narrowed racial and ethnic health disparities. But significant gap...
Navigator Guide FAQs of the Week: Will My Plan Deliver the Care I Need?
Provider networks and prescription drug coverage are important consideration for consumers when choo...
Consumers Have More Time to Shop for a 2022 Health Insurance Plan
For the past four years, December 15 has been the deadline for most Americans to enroll in the Affor...
November Research Roundup: What We’re Reading
For November’s monthly roundup of new health policy research, CHIR’s Emma Walsh-Alker reviewed s...
The 6-foot Rope for the 10-foot Hole: The Current U.S. Approach to COVID-19 Testing Won’t Help Us Out of this Pandemic
The Biden administration has announced a new policy to require health plans to pay for at-home COVID...
Navigator Guide FAQs of the Week: What Does My Marketplace Plan Cover?
Enrolling in coverage on the marketplace requires comparing different health plans and decide which ...
Encouraging Signs for the Public Option in Washington State: Improved Availability and Affordability of Plans in 2022
This open enrollment, Washington State residents can once again purchase first-in-the-nation public ...
Navigator Guide FAQs of the Week: What Are the Risks of Buying Off-Marketplace?
Open Enrollment is in full swing, but consumers should beware of “junk plans” when shopping for ...
The State of COVID-19 Testing Coverage and Accessibility
Insurers are still required to fully cover COVID-19 testing, but finding a free test is a lot more d...
Build Back Better Act Clears Major Hurdle
The U.S. House of Representatives has passed the "Build Back Better Act" with provisions that signif...
Navigator Guide FAQs of the Week: Who is Eligible for Financial Assistance on the Marketplace?
As part of CHIR’s weekly series highlighting FAQs from our updated Navigator Resource Guide, we hi...
Unpacking Colorado’s New Guidance on Transgender Health
The Affordable Care Act improved insurance coverage of gender-affirming care, but insurers still imp...
Filling a Gap in the No Surprises Act: What are States Doing to Protect Consumers from Out-of-Network Ground Ambulance Bills?
In January, the No Surprises Act will provide landmark protections against surprise billing, but gro...
The No Surprises Act Interim Final Rule on Dispute Resolution, Uninsured Protections, and External Review: Implications for States
Last month, the Biden administration published a third rule implementing the No Surprises Act, the c...
The Pandemic Exacerbated Gaps in Mental Health Care Access, but State and Federal Enforcement of Parity Requirements Can Help Improve Coverage
The COVID-19 pandemic has brought about a greater need for mental health and substance use disorder ...
Navigator Guide FAQs of the Week: Who is Eligible for Marketplace Coverage?
Open Enrollment is underway, and our newly updated Navigator Resource Guide can help Navigators and ...
Three New State-Based Marketplaces are Up and Running
We’re a week into Affordable Care Act marketplace open enrollment, and it looks like the three new...
New and Improved Navigator Resource Guide Answers Common Enrollment Questions, Spotlights Innovative Outreach for Communities of Focus
Just in time for Open Enrollment, CHIR updated and improved the Navigator Resource Guide, a practica...
October Research Roundup: What We’re Reading
In our newest monthly roundup of health policy research, CHIR intern Madison Berry reviews studies e...
Building on and Strengthening the ACA: Private Coverage Provisions of the Build Back Better Act
The details of President Biden's "Build Back Better" legislation were released on October 28. It con...
Misleading Marketing of Non-ACA Health Plans Continued During COVID-19 Special Enrollment Period
Millions of Americans are eligible for health insurance plans with low or no premiums and significan...
A Long-term Financing Solution for Mobile Crisis Services
Policymakers increasingly recognize the need for alternatives to law enforcement-driven responses to...
What’s New for 2022 Marketplace Enrollment?
Open Enrollment is just around the corner. There are new policies for the marketplace in 2022, inclu...
To Avoid Big Coverage Losses, Marketplaces Need to Prepare for the End of the Public Health Emergency
The resumption of Medicaid eligibility redeterminations at the end of the COVID-19 public health eme...
COVID “Long Haulers” Can Carry Additional Burden of Getting Insurers to Cover Care
COVID-19 survivors may experience new symptoms well after their initial infection. Health systems of...
State Health Care Purchasers Can Push Hospitals To Comply With Federal Transparency Requirements
Federal law now requires hospitals to publish the prices they negotiate with private insurers, yet m...
State-Based Marketplaces Eye Health Equity, Expanding Enrollment Under New Federal Grants
Last month, the Centers for Medicare & Medicaid Services announced $20 million in grant funding for ...
September Research Roundup: What We’re Reading
In our newest monthly roundup of health policy research, CHIR's Rachel Swindle reviews studies on co...
Limited Plans with Minimal Coverage Are Being Sold as Primary Coverage, Leaving Consumers at Risk
People shopping for health insurance online are often directed to websites using misleading or dece...
Final Round of Rulemaking for 2022 Affordable Care Act Marketplaces: Implications for States
The Biden administration continues to put its stamp on the Affordable Care Act marketplaces with new...
The No Surprises Act Proposed Rule on Air Ambulances and Enforcement: Implications for States
This month the Biden administration released a second rule implementing the No Surprises Act, the ne...
Building a Better Transparency Mousetrap: Recommendations to Optimize Hospital and Health Plan Price Disclosures
Amidst high and rising health care costs, recent federal regulations require hospitals and health p...
Public Input on How to Design a Federal Public Option
Congressional leaders requested input from the public on how to design a federal public health insur...
August Research Roundup: What We’re Reading
For the latest monthly roundup of health policy research, CHIR's Rachel Swindle takes a look at stud...
Federal Committee Recommends Airline Deregulation Act Changes to Avoid Conflicts with No Surprises Act
Air ambulances are one of the largest sources of surprise medical bills. While the No Surprises Act ...
Stakeholder Perspectives on Round Three of CMS’s 2022 Notice of Benefit and Payment Parameters. Part 3: Consumer Advocates
The Biden administration has proposed several policy changes designed to boost enrollment in the Aff...
Stakeholder Perspectives on Round Three of CMS’s 2022 Notice of Benefit and Payment Parameters. Part 2: Insurers
In the newly proposed 2022 “Notice of Benefit & Payment Parameters" the Biden Administration is re...
Stakeholder Perspectives on Round Three of CMS’s 2022 Notice of Benefit and Payment Parameters. Part 1: State Insurance Departments and Marketplaces
The Biden administration is signaling significant changes for the Affordable Care Act marketplaces w...
Delta Airlines to Require Unvaccinated Employees to Pay Higher Premiums: Legal? Maybe. Smart policy? Not So Much.
Delta Airlines made headlines by announcing it would charge unvaccinated workers an additional $200 ...
Second Quarter Earnings Bring Profits for Insurers, But Delta Variant Signals Uncertainty
In the second quarter of 2020 insurers made significant profits in the wake of the COVID-19 pandemic...
CHIR Welcomes New Faculty, Rachel Swindle
We're delighted to welcome to the CHIR team our newest colleague, Research Fellow Rachel Swindle, M....
How Insurers Can Advance Health Equity Under the Affordable Care Act
In a new post for the Commonwealth Fund’s To the Point blog, Katie Keith highlights several Af...
State “Easy Enrollment” Programs Gain Momentum, Lay Groundwork for Additional Efforts to Expand Coverage
The American Rescue Plan made health insurance more affordable, but covering the 30 million remain...
Restraining Balance Billing by Air Ambulance Providers: CHIR Keeps Up with Federal Advisory Committee and Regulatory Actions
Air ambulances are the source of some of the largest unexpected medical bills faced by consumers. Be...
July Research Roundup: What We’re Reading
July’s latest health policy research is provided by CHIR’s Nia Gooding in our monthly roundup. S...
The Impact of the COVID-19 Pandemic and Recent Federal Policy on Small Business Health Insurance
CHIR researchers have teamed up once again with the Urban Institute to assess how federal policy is ...
State Efforts to Standardize Marketplace Health Plans Show How the Biden Administration Could Improve Value and Reduce Disparities
The federal government is moving forward with standardized benefit designs via HealthCare.gov, follo...
State Public Option–Style Laws: What Policymakers Need to Know
In recent months, Washington, Colorado, and Nevada, have enacted public option-style laws aimed at c...
States Tackle High Out of Pocket Costs for Insulin but Lack Tools to Bring Rx Prices Down
As Congress considers a variety of proposals to address prescription drug prices, there is a growing...
Putting Surprise Billing Protections into Practice: Biden Administration Releases First Set of Regulations
The Biden administration has issued the first in a series of rules to implement the No Surprises Act...
June Research Roundup: What We’re Reading
For June's monthly roundup of health policy research, Nia Gooding reviewed studies on ground ambulan...
If You Lost Your Job, You May be Newly Eligible for a Lower Cost Health Plan
Starting July 1, those who faced a job loss in 2021 may be eligible for extra financial assistance o...
Banning Surprise Bills: Biden Administration Issues First Rule On The No Surprises Act
When Congress enacted the "No Surprises Act" last year to ban unexpected out-of-network medical bill...
Round III of the 2022 Notice of Benefit & Payment Parameters: Implications for States
The Biden administration has released its first major set of proposed rules governing the Affordable...
“As if COVID-19 Did Not Exist”: Health Plans Prepare for 2022 in Early Rate Filings
Several states ask for – and publicly post – health insurers’ proposed 2022 premium rates in M...
New Georgetown Report: States’ Actions to Expand Telemedicine Access During COVID-19 and Future Policy Considerations
During the COVID-19 pandemic, many states temporarily lowered barriers to using telemedicine for hea...
A Fixer Upper: Washington State Enacts Legislation to Boost its Public Option
Washington State enacted a first-of-its-kind public option, with the state-procured plans available ...
A Great Day for the Affordable Care Act – and the Millions of Americans who Benefit from It
It's three strikes you're out for opponents of the Affordable Care Act. For the third - and hopefull...
New Georgetown CHIR Report: Opportunities for State Employee Health Plans to Drive Improvements in Affordability
A new report from Georgetown University’s Center on Health Insurance Reforms presents first-ever f...
CHIR Welcomes Back New Faculty: Christine Monahan
CHIR is pleased to welcome Christine Monahan, J.D. back to our team as an Assistant Research Profess...
Third Time’s Not the Charm: Connecticut’s Public Option Bill Fails Once Again
Connecticut’s efforts to pass a public option bill for the third year in a row came to an early en...
May Research Roundup: What We’re Reading
With another month comes a new crop of health policy research. This May, Nia Gooding reviewed studie...
Heavily Modified, Colorado Public Option Appears to have Neutralized Industry Opposition
Colorado's legislature is debating a proposal to curb health insurance premiums that some are callin...
A Permanent Boost to Federal Premium Assistance Could Change State Approaches to ACA 1332 Waivers
The American Rescue Plan temporarily increases the availability and generosity of federal premium as...
The Affordable Care Act in the Biden Era: Identifying Federal Priorities for Administrative Action
The Biden administration has pledged to use its executive authority to build on and improve the Affo...
Nevada Jumps Aboard the Public Option Train: Legislative Proposal Aims to Lower Health Care Costs, Expand Coverage Choices
Nevada is the latest state to consider sponsoring a public option plan to compete with private insur...
Figuring out if COBRA Coverage is Right for You
By the end of May, employers must notify eligible employees and former employees about the COBRA sub...
Out of the Fire and Back in Federal Court: This Mother’s Day, Another Challenge to the ACA Puts Access to Preventive Services at Risk
This Mother’s Day, CHIR's Rachel Schwab and Nia Gooding assessed the potential impact of a new leg...
The Final 2022 Notice of Benefit & Payment Parameters: Implications for States
In its first major rulemaking related to the Affordable Care Act, the Biden administration published...
April Research Roundup: What We’re Reading
April's latest health policy research is provided by CHIR's Nia Gooding in our monthly roundup. She ...
States Attempt to Rein in Rising Health Care Costs: Is a Self-Regulating Industry Enough?
Colorado lawmakers recently announced that hospital and health plans had agreed to remain "neutral" ...
Opponents of Fixing the Family Glitch Reveal their Fundamental Misunderstanding
The “family glitch,” a loophole in federal rules, bars millions of people from subsidized covera...
Are Surprise Billing Payments Likely to Lead to Inflation in Health Spending?
Under the No Surprises Act, enacted in December of 2020, federal regulators face a balancing act as ...
ACA “Family Glitch” Increases Health Care Costs for Millions of Low- and Middle-Income Families
The family glitch bars millions of people from accessing reduced premiums and cost-sharing through t...
State-Based Marketplaces Gear Up to Implement the American Rescue Plan
The state-based health insurance marketplaces are taking varied approaches to implementing the enhan...
Minority Health Month: National Latino Week of Action
April is Minority Health Month, a good time to consider ways to reduce the wide disparities in healt...
Hybrid Approach to Resolving Payment Disputes Breaks Legislative Stalemates Over Balance Billing, How Will the No Surprises Act Affect These New State Laws?
Seven states in 2020 were able to break a longstanding stalemate and enact protections against surpr...
March Research Roundup: What We’re Reading
The CHIR team is excited to transition into spring, as with the warmer weather has come some great n...
The No Surprises Act and Preemption of State Balance Billing Protections
The No Surprises Act of 2020 sets up a new national framework to protect patients from surprise out-...
Rookie Report: How did New Jersey and Pennsylvania State Marketplaces Fare in Their Inaugural Enrollment Period?
After seven enrollment cycles on HealthCare.gov, New Jersey and Pennsylvania both launched new state...
The American Rescue Plan: What You Need to Know about Enhanced Premium Tax Credits
President Biden signed the American Rescue Plan Act on March 11, 2021. The bill includes several pro...
New Georgetown CHIR Report: Taking the Disputes out of Dispute Resolution
The U.S. Congress enacted the No Surprises Act in 2020 to protect patients from surprise out-of-netw...
American Rescue Plan Act Will Strengthen Public and Private Health Insurance
The American Rescue Plan Act of 2021 provides the largest expansion of public and private health ins...
Removing Roadblocks: Special Enrollment Period Data Show Increase in Marketplace Signups
Last month, the Biden administration established a temporary special enrollment period (SEP) on the ...
February Research Roundup: What We’re Reading
In the spirit of Valentine’s Day, this February CHIR’s Nia Gooding reviewed some lovely studies ...
Are the Good Times Over for Health Insurers?
Insurer's fourth quarter earnings showed a decline in profits after the surge in COVID-19 hospitaliz...
Navigator Guide FAQs Of The Week: Who is Eligible for Financial Assistance?
President Biden has recently signed an executive order to re-open the federal marketplace for a COVI...
An Opportunity to Protect Consumers and Ensure a Level Playing Field: Reversing Trump-era Rules on Association Health Plans
An executive order from President Biden is likely to prompt a review of Trump administration rules e...
Workplace Wellness Programs Have Overlooked Health Equity
One of President Biden's first executive actions was to require the U.S. Equal Employment Opportunit...
Federal Policy Priorities for Preserving and Improving Access to Coverage: Perspectives from State-Based Marketplaces
The Affordable Care Act’s health insurance marketplaces provide a critical source of coverage and ...
January Research Roundup: What We’re Reading
As the snow continues to fall, the CHIR team has cozied up indoors with new health policy research. ...
Health Insurance Companies Spent Millions to Defeat the Affordable Care Act. Now They’re Embracing Policies to Expand It.
Health insurers spent millions to defeat the ACA in 2010. Ten years later, major insurers are joinin...
FTC’s Opportunity to Protect Consumers from Deceptively Marketed Alternative Coverage Arrangements
Consumers are being bombarded with aggressive and deceptive marketing of short-term and other junk h...
Expanded Coverage For COVID-19 Testing Must Include Limits On Costs
President Biden has issued an Executive Order likely to expand the mandate for private insurers to c...
Georgia’s ACA Waiver Flouts Federal Law, Drawing a Legal Challenge
With the approval of the Trump administration, the state of Georgia is poised to upend the Affordabl...
Many States with COVID-19 Special Enrollment Periods See Increase in Younger Enrollees
President Joe Biden directed his administration to reopen the federal health insurance marketplace,...
Stakeholder Perspectives on CMS’s 2022 Notice of Benefit and Payment Parameters. Part 3: Consumer Advocates
In the third and final part of our blog series reviewing stakeholder comments on the 2022 Notice of ...
Navigator Guide FAQs of The Week: How to Use Your Coverage
Open Enrollment has ended in most states, and many consumers have signed up for a health insurance p...
Stakeholder Perspectives on CMS’s 2022 Notice of Benefit and Payment Parameters. Part 2: State Insurance Departments and Marketplaces
In one of the Trump administration's last acts, the Centers for Medicare and Medicaid Services final...
December Research Roundup: What We’re Reading
We at CHIR are excited to ring in the New Year with new health insurance research! In December we re...
Stakeholder Perspectives on CMS’s 2022 Notice of Benefit and Payment Parameters. Part 1: Insurers
As stakeholders wait for the final 2022 Notice of Benefit and Payment Parameters (NBPP) CHIR's Megan...
The No Surprises Act: Implications for States
In the waning days of 2020, Congress enacted the No Surprises Act, which provides, for the first tim...
Unpacking The No Surprises Act: An Opportunity To Protect Millions
Congress included the No Surprises Act in the omnibus spending bill that was passed and signed into ...
Navigator Guide FAQs of the Week: Who Qualifies for a Special Enrollment Period?
Open Enrollment has ended in most states, and many consumers have signed up for a health insurance...
Surprise Billing Protections: Help Finally Arrives for Millions of Americans
Congress enacted the "No Surprises Act" as part of the $900 billion COVID-19 relief and government s...
2020 – It’s a Wrap. CHIR Takes Stock of a Tumultuous, but Busy Year
We at Georgetown CHIR look back at this tumultuous, tragic, and eventful year and are thankful we ha...
Navigator Guide FAQs of the Week: What to Expect When Expecting Health Insurance
Open Enrollment has ended in most states, and many consumers have signed up for a health insurance...
As the Pandemic Rages on, Insurers Continue to Bring in Cash
As the year comes to a close, CHIR's Megan Houston reflects on the continued financial success of he...
Navigator Guide FAQs of the Week: Covid-19 Pandemic Concerns
Open Enrollment in most states ends on Tuesday, December 15. As consumers finish weighing their cove...
The Benefits and Limitations of State-Run Individual Market Reinsurance
The Affordable Care Act brought about historic coverage gains, providing millions of Americans with ...
The COVID-19 Vaccine is Coming, but Will it Be Paid For? Federal and State Policies to Fill Gaps in Insurance Coverage
Vaccinations against COVID-19 are on their way. For consumers in Affordable Care Act plans, immuniza...
Navigator Guide FAQ of the Week: Coverage Requirements
Open Enrollment in most states ends next week, on December 15. As consumers continue to weigh their ...
The Draft 2022 Notice of Benefit & Payment Parameters: Implications for States
On November 25, the Trump administration released a proposed regulation, the 2022 "Notice of Benefit...
November Research Roundup: What We’re Reading
As the autumn leaves change and the weather gets colder, we at CHIR are thankful for new health poli...
Navigator Guide FAQ of the Week: What Are the Risks of Buying Off-Marketplace?
Open Enrollment in most states ends in just over two weeks, on December 15. While consumers are weig...
Navigator Guide FAQ of the Week: What Does My Plan Cover?
With Open Enrollment now well underway, consumers are weighing their options for 2021 and trying to ...
The Congressional Budget Office Definition of “Health Insurance” Leaves Room for Wide Coverage Gaps, Discrimination
The nonpartisan Congressional Budget Office (CBO) frequently estimates how policy proposals will aff...
Navigator Guide FAQ of the Week: Comparing Plans
With Open Enrollment now underway, consumers are weighing their options for 2021 and trying to find ...
October Research Roundup: What We’re Reading
In honor of Halloween, this October CHIR's Nia Gooding reviewed spooky studies on the projected impa...
Stable Rates Reflect Strength of ACA Marketplaces
At the start of the COVID-19 pandemic, many predicted that insurers would need to dramatically hike ...
Navigator Guide FAQ of the Week: Who is Eligible for Financial Assistance?
Open Enrollment is in full swing across the country. As consumers consider their coverage options, m...
A New Day for Affordable, Comprehensive Health Coverage: 2021 and the Biden Agenda
The results of the 2020 elections will bring a sea of change in federal health insurance policy. CHI...
COVID-19 and MLR Guidance on Risk Corridor Recoveries: State Options for Restoring Funds to Policyholders and the Public
The Supreme Court has required the federal government to reimburse health insurers for an estimated ...
Navigator Guide FAQ of the Week: Who Is Eligible To Purchase Coverage Through the Marketplace?
November 1 marked the first day of open enrollment on the Affordable Care Act marketplaces. To help ...
State Efforts to Protect Preexisting Conditions Unsustainable Without the ACA
On November 10, the Supreme Court will hear oral arguments in a case that could result in the Afford...
Ensuring Access to the COVID-19 Vaccine for Enrollees in Private Health Insurance: A Roadmap for States
States and the federal government are preparing for the approval of a COVID-19 vaccine. But just as ...
Navigator Guide FAQs of the Week: I Need Health Insurance. Where Should I buy it?
Open enrollment for the Obamacare marketplaces begins on November 1. While CHIR has been working har...
What’s New for 2021 Marketplace Enrollment?
On November 1, the eighth open enrollment period begins for marketplace coverage under the Affordabl...
Trump Administration Promotes Coverage That Fails to Adequately Cover Women’s Key Health Care Needs
The ACA expanded women’s access to comprehensive coverage. The Trump administration is seeking t...
What’s at Stake: The World of Health Insurance for People with Pre-Existing Conditions before the ACA
As hearings begin for the nomination of Judge Amy Coney Barrett to the Supreme Court, Senators are u...
Children Are Losing Health Insurance
Georgetown University's Center for Children & Families is out with their annual report on kids' heal...
September Research Roundup: What We’re Reading
This September, CHIR’s Nia Gooding reviewed new studies on state health system performance, differ...
New Report Documents Progress and Remaining Challenges in Ensuring Equal Access to Mental Health and Substance Use Disorder Services in California
California has enacted a law strengthening the state’s mental health parity protections for Califo...
As Insurers Return to ACA Marketplaces, SCOTUS Case Looms Large
The ACA marketplace has seen many disruptions since its implementation but in a sign of greater stab...
Where’s the Plan? Trump Executive Order Fails to Include any Policy to Protect Health Care if the ACA is Struck Down
With the Affordable Care Act now at significantly greater risk in the Supreme Court, the Trump admin...
Updating the Essential Health Benefit Benchmark Plan: An Unexpected Path to Fill Coverage Gaps?
Many feared that Trump administration rules issued in 2018 would result in less-generous benefits in...
Aggressive Medical Debt Collections: COVID-related Consumer Protections Could be a Model for Long-term Relief
A new investigative report shows that even the COVID-19 crisis has not stopped many hospital systems...
August Research Roundup: What We’re Reading
The month of August went by in a flash, or painstakingly slowly, but either way it produced some gre...
Labor Day in a Pandemic: The Varnish of “Gold Standard” Employer Coverage is Wearing Thin
CHIRblog took a break for Labor Day, but in light of the holiday, we continue to think about problem...
CHIR Welcomes Two New Colleagues
We are pleased to welcome to CHIR two new team members, Megan Houston and Nia Gooding. They'll be wo...
Asymptomatic COVID-19 Testing for Essential Workers: Considerations and Challenges for State Policymakers
States are being forced to decide how to target, administer, and finance asymptomatic COVID-19 testi...
Partial Vindication for Insurers in Cost-sharing Reduction Litigation: Implications for State Insurance Regulation
Health insurers won a partial victory against the government in federal court last week, when the Co...
As Insurers Sit on Extra Cash, Are Premium Relief and MLR Rebates the Best Use of Funds?
While the COVID-19 pandemic has prompted financial catastrophe across the country, the private healt...
Getting It Done: Consensus On Surprise Billing Protections
The COVID-19 pandemic has increased the risk that patients will experience surprise bills for out-of...
New Report Provides State Policy Recommendations on How to Protect Consumers, Reduce Disparities During the COVID-19 Pandemic
The COVID-19 pandemic presents unprecedented threats to health and safety, and exacerbates existing ...
July Research Round Up: What We’re Reading
This month, CHIR's Mari Tikoyan read studies on the role of the Affordable Care Act in addressing he...
Imposing The Costs Of Workplace Coronavirus Testing On Group Plan Coverage Would Place An Excessive Burden On Essential Workers
To re-open safely, many employers will need to rely on regular testing for the virus that causes COV...
Comparing Short-term Health Plans is Practically Impossible for Consumers
The Trump administration has promoted short-term health plans as a cheap substitute for comprehensiv...
Limitations of Short-Term Health Plans Persist Despite Predictions That They’d Evolve
The Congressional Budget Office and others predicted that short-term health plans would become more ...
One Victim of the COVID-19 Pandemic? State Health Policy
State legislative sessions are typically a flurry of health policy activity. In recent years, state ...
How much will COVID-19 drive up uninsured numbers? New report underscores how hard it is to know
A new report published by the Urban Institute provides updated estimates on how many people are like...
U.S. House Investigation Offers New Evidence on the Dangers of Short-Term Plans
On June 25, the House Committee on Energy and Commerce released the results of a year-long investiga...
June Research Round Up: What We’re Reading
This month, CHIR's Olivia Hoppe read studies on the novel coronavirus’ potential impact on insuran...
Update on Federal Mandates to Cover COVID-19 Testing Services: New Guidance for States, Plans, and Insurers
The Trump administration recently issued guidance to health insurers, determining that they are not ...
The COVID-19 Pandemic – Insurer Insights Into Challenges, Implications, and Lessons Learned
The novel coronavirus (COVID-19) pandemic has placed enormous pressure on virtually all facets of U....
Effects of Medicaid Health Plan Dominance on the Health Insurance Marketplaces
Medicaid insurers dominate many of the Affordable Care Act health insurance marketplaces. Some healt...
Why We Can’t Rely on Health Insurance Alone to Guarantee Universal Immunization Against COVID-19
Many Americans are pinning their hopes on a vaccine to bring COVID-19 to heel. But, as George Washin...
On the Whole, Health Insurers Aren’t – Yet – Fearing COVID-19 Costs: A Review of 2021 Rate Filings
Several states ask for – and publicly post – health insurers’ proposed 2021 premium rates in M...
Should States’ COVID-19 Insurance Coverage Mandates Be Extended Past the Current State of Emergency?
Many states acted to expand access to health care services as part of the fight against COVID-19, ma...
Instead of Encouraging Enrollment in Comprehensive Health Coverage, New Federal Guidance Requires Taxpayers to Subsidize Health Care Sharing Ministries
In the midst of the COVID-19 pandemic, the IRS has published a proposed rule that would grant tax ad...
May Research Round Up: What We’re Reading
This May, we explored studies assessing COVID-19’s effect on community health centers, data on rac...
Navigators Can Help Close Insurance Gaps Exacerbated by COVID-19
The COVID-19 pandemic has introduced new challenges for Navigators. To learn more about their experi...
A Pledge to Do Better
We at CHIR are reeling and taking stock in the wake of the tragic and callous murder of George Floyd...
During the COVID-19 Crisis, State Health Insurance Marketplaces Are Working to Enroll the Uninsured
As the coronavirus pandemic and economic shutdown continue, the Affordable Care Act’s health insur...
I’ve been calling for greater private insurance coverage of COVID-19 testing. I’ve been wrong
As the nation combats the biggest threat to its public health and economy that any of us have seen i...
Idaho Misses Opportunities to Help Consumers Get Affordable, Comprehensive Health Coverage During COVID-19 Pandemic
Since the COVID-19 pandemic began, states have taken charge of responding to the public health emerg...
The Provider Relief Fund: How Well Does it Protect Patients from Surprise Medical Bills for COVID-19 Related Services?
The $175 billion Provider Relief Fund prohibits participating providers from balance billing COVID-1...
The Final 2021 Notice of Benefit and Payment Parameters: Implications for States
The Trump administration has released the annual rule governing insurance standards and marketplace ...
In the Age of COVID-19, Short-Term Plans Fall Short for Consumers
During February’s State of the Union address, President Trump touted his administration’s effo...
April Research Round Up: What We’re Reading
This April, CHIR's Olivia Hoppe reviews studies focusing on the relationship between increased unemp...
Insurance Companies Are Investing in the Social Determinants of Health, But Widespread Changes in Benefits Remain to be Seen
Federal and state health care policies have begun to encourage greater investments in the social det...
States Can Prevent Surprise Bills for Patients Seeking Coronavirus Care
In their latest post for the Commonwealth Fund’s To the Point blog, Jack Hoadley, Maanasa Kona, an...
Individual Market Insurance Brokers Report Improved Consumer Options, But Also Risks from Short-term and Other Alternative Products
In a new report, CHIR researchers teamed up with the Urban Institute to assess trends in the individ...
Health Insurers Respond to the COVID-19 Outbreak, Prioritizing Support for Providers and Consumers
As the COVID-19 crisis escalates, stakeholders across the health care industry are working to keep c...
State Policy Options to Encourage Greater Use of Telehealth in State-Regulated Health Plans
The COVID-19 pandemic has brought renewed and urgent interest in using telehealth to enable remote a...
COVID-19 Response: States That Run Their Own ACA Marketplace Are Better Positioned to Help Consumers Get Covered
During the current public health and financial crises brought by the COVID-19 pandemic, the ACA’s ...
March Research Round Up: What We’re Reading
This month, CHIR's Olivia Hoppe reviews studies that examine the capacity for states to handle the C...
Expanded Coverage for COVID-19 Testing is an Important Step, But Loopholes Expose All of Us to Greater Risk
Congress has enacted legislation that includes provisions to lower financial barriers to COVID-19 te...
Keeping Surprise Billing Out Of Coronavirus Treatment
Surprise medical bills, which were already a concern for many consumers, are expected to increase be...
States Don’t Know What’s Happening in their Short-term Health Plan Markets and That’s a Problem
In the midst of a global pandemic, consumers continue to be sold skimpy short-term plans that may no...
Navigating Coverage During the COVID-19 Pandemic: Frequently Asked Questions
The novel coronavirus, also known as COVID-19, has been the cause of confusion and anxiety for indiv...
State-Based Marketplaces Find Value, Potential Opportunity for Growth in Small-Business Offering
Small businesses have historically struggled to provide coverage to their workers. The ACA sought ...
On its 10th Anniversary, during a Public Health Crisis, the Affordable Care Act is More Important Than Ever
The past few weeks have tested the U.S. health care system. In a world where we are all at risk of c...
What Are State Officials Doing to Make Private Health Insurance Work Better for Consumers During the Coronavirus Public Health Crisis?
Many people may hesitate to seek coronavirus testing and treatment because they face significant ded...
When Things Fall Apart: A Roadmap for State Regulators Managing Fallout from Provider-Payer Contract Disputes
High profile contract disputes between insurers and providers appear to be on the rise, raising the ...
February Research Round Up: What We’re Reading
This February, CHIR's Olivia Hoppe reviewed new research on health care costs and utilization, surpr...
Coronavirus Exposes Big Gaps in the U.S. System Of Coverage: What Can States Do to Help?
The cost of medical care associated with the novel coronavirus can be a barrier for many people who ...
A Placeholder Won’t Protect People with Pre-Existing Conditions
President Donald Trump has voiced an “ironclad pledge” to protect patients with pre-existing con...
How States Are Using Independent Dispute Resolution to Resolve Out-of-Network Payments in Surprise Billing
As Congress and a number of states craft legislation to protect consumers from surprise out-of-netwo...
Addressing Surprise Billing by Setting Payment Standards for Out-of-Network Providers
The thorniest issue in pending legislation to protect consumers from surprise medical billing is how...
States Take Action on Health Care Sharing Ministries, But More Could Be Done to Protect Consumers
In the last year, state regulators have stepped up their scrutiny of health care sharing ministries ...
Update on Federal Surprise Billing Legislation: New Bills Contain Key Differences
Congressional leaders are racing to meet a self-imposed May deadline for passing legislation to prot...
There Are New Federal “Public Charge” Rules Going Into Effect Next Week: Here’s What You Need to Know
Beginning February 24, 2020, new rules that expand the criteria for determining whether certain immi...
A Mixed Bag for States: The Proposed 2021 Notice of Benefit and Payment Parameters
The Trump administration's proposed rule governing the Affordable Care Act insurance markets for 202...
January Research Round Up: What We’re Reading
To kick off 2020, CHIR's Olivia Hoppe reviews studies on out-of-network billing from hospital-based ...
Payer-Provider Contract Disputes Dominate Headlines in 2019, With No Signs of Slowing Down
For several years, we at CHIR have tracked health insurance industry trends by monitoring trade and ...
The Texas Two-Step: Implementation of State Balance Billing Law Reveals Gaps in Consumer Protections
In Congress and state legislatures across the country, policymakers are debating fixes to surprise m...
The Public Option Plan is Popular, but State Efforts to Enact it Face Challenges
New polling finds the public option plan is popular, but how are such proposals faring in the states...
States Work to Make Individual Market Health Coverage More Affordable, But Long-Term Solutions Call for Federal Leadership
The individual health insurance markets of most states are stable but face ongoing challenges. In a ...
So, You’ve Got Health Insurance. What Now? Frequently Asked Questions on Post-Enrollment Issues
Open Enrollment ended in most states on December 15, 2019. In the remaining states, Open Enrollment ...
Department of Transportation Hosts the Inaugural Meeting of Committee to Advise on Air Ambulance Billing Issues
On January 15th and 16th, 2020, the U.S. Department of Transportation held the inaugural Air Ambulan...
December Research Round Up: What We’re Reading
This month, CHIR's Olivia Hoppe reviews studies about the relationship between insurance and mortali...
Parity in Practice? Examining Requirements and Enforcement of the Mental Health Parity and Addiction Equity Act
Last fall, the Pennsylvania Department of Insurance documented that the UnitedHealthcare Insurance C...
New Resource for Consumer Advocates on Out-of-Network Payment Disputes in Balance Billing Legislation
State lawmakers across the country are are gearing up for a new legislative session. Many will be co...
Our Top Ten Health Insurance Policy Issues to Watch in 2020
CHIR is back from vacation and strapping in for a busy 2020. These are the top ten health insurance ...
Update on Federal Surprise Billing Legislation: Understanding a Flurry of New Proposals
In their latest piece for the Commonwealth Fund's To the Point blog, Jack Hoadley, Beth Fuchs, and K...
5th Circuit Decision in Texas v. U.S. Prolongs Uncertainty for Health Care Consumers, Markets
Perhaps knowing their decision would sow consumer confusion and market uncertainty, the 5th Circuit ...
Updates from the MEWA Files: The Good, the Bad, and the Ugly of Federal Enforcement Efforts
Last week, CHIR alumna Christine Monahan walked through common types of misconduct documented in the...
Insurers Report on Their Q3 Financial Earnings: Marketplace Profitability, Retail Partnerships, and More
Last month, health insurers reported on their third-quarter (Q3) financial earnings, offering insigh...
FAQ of the Week: What to Expect When Expecting Health Insurance
Now that Open Enrollment is over in most states, many consumers have enrolled into a health insuranc...
Protecting Patients from Air Ambulance Surprise Balance Bills – Where Are We Now?
A recently released report by the Health Care Cost Institute finds that the average price of an air ...
FAQ of the Week: Who Qualifies for a Special Enrollment Period?
Open Enrollment in most states ends Sunday, December 15. After the enrollment period ends, in order ...
Updates from the MEWA Files: Self-Dealing, Derelict Administration, and Repeat Players, Oh My!
Last month, CHIRblog released a trove of investigative reports and case files from the U.S. Departme...
November Research Round Up: What We’re Reading
This month, CHIR's Olivia Hoppe dug into studies on health care financing equity, insurer and consum...
Navigator Guide FAQ of the Week: What Are the Risks of Buying Off-Marketplace?
Open Enrollment in most states ends in just about two weeks, on December 15. While consumers are wei...
This Thanksgiving, We’re Thankful for the Affordable Care Act’s Protections
It’s that time of year again. Our team at CHIR is heading far and wide for Thanksgiving, and as we...
October Research Round Up: What We’re Reading
For the October Research Round Up, CHIR's Olivia Hoppe dives into studies on the potential effects o...
Navigator Guide FAQ of the Week: What Does My Plan Cover?
With Open Enrollment now underway, consumers are weighing their options for 2020 and trying to find ...
Navigator Guide FAQ of the Week: Help for Consumers Navigating a Surprise Balance Bill
We are now two weeks into Open Enrollment for 2020 health insurance coverage. As consumer look at pr...
The MEWA Files: Lifting the Curtain on DOL’s Investigation into AHPs and Other Fraudulent Health Plans
CHIR is releasing several thousand pages of Department of Labor (DOL) investigative records regardin...
Navigator Guide FAQ of the Week: Can I Get Help Paying for Coverage and Care?
Open Enrollment is in full swing in all 50 states and Washington, DC. As consumers consider their co...
Can States Fill the Gap if the Federal Courts Overturn Preexisting Condition Protections?
The 5th Circuit Court of Appeals is expected to rule soon on the future of the Affordable Care Act i...
Will Sutter Health Settlement Dampen Provider Systems’ Anti-Competitive Tactics or Prompt More States to Take Action on Costs?
On October 16, Sutter Health announced that it had reached a tentative agreement to settle the class...
Seeing Fraud and Misleading Marketing, States Warn Consumers About Alternative Health Insurance Products
States are warning consumers of fraud and about the inadequate nature of some insurance products bei...
Navigator Guide FAQ of the Week: Am I Required to Get Coverage?
Open Enrollment for marketplace coverage under the Affordable Care Act begins on November 1. To help...
Here are the Facts About Anti-Immigrant Policies Pushed by the Administration and Their Impact on Children and Families
Over the last two years, Georgetown University's Center for Children & Families has tracked harmful...
New Georgetown CHIR Report Finds Ability of Insurers, Employers to Respond to Provider Consolidation is Limited
A new Georgetown CHIR report synthesizing the case studies of 6 health care markets finds that insur...
What’s New for 2020 Marketplace Enrollment?
On November 1, the seventh open enrollment period begins for marketplace coverage under the Affordab...
As Maryland Charts a New Course for Lowering Barriers to Coverage, Feds Could Raise Them
Maryland is implementing a program that offers a new, easy way to enroll in comprehensive and afford...
New Georgetown CHIR Report: In Trump Era, States Revisit the Benefits and Risks of Running Their Own Health Care Marketplace
Half a dozen states have announced they will transition from HealthCare.gov to their own, state-run ...
September Research Round Up: What We’re Reading
For the September Research Round Up, CHIR's Olivia Hoppe dives into studies on trends in employer he...
Trump Administration Launches New Program that Could Undermine ACA Protections
The Trump administration recently announced a new 10-state demonstration project to allow insurers t...
Stakeholders Weigh in on the Risk Corridor Litigation: Are Public-Private Partnerships At Risk?
On December 10, the U.S. Supreme Court will hear oral arguments in Maine Community Health Options v....
Disputes over Dispute Resolution: Analyses of New York & California-style Surprise Billing Protections Offer Divergent Pictures
The U.S. Congressional Budget Office (CBO) has a new analysis of legislation that would protect pati...
Comparing Federal Legislation on Surprise Billing
Legislation to protect consumers from surprise medical bills is advancing on a bipartisan basis in b...
CHIR Launches New Resource Center for Policymakers on Surprise Medical Bills
CHIR experts have launched a new project to provide policymakers with a dedicated, independent resou...
Swimming against the Tide: Policies in State-Based Marketplace States Help Counter Negative Trends in Uninsurance Rates
The latest U.S. Census data show the uninsured rate for nonelderly adults is rising, including amo...
States Leaning In: Colorado
This year several states have taken an increasingly active role in expanding health insurance covera...
August Research Round Up: What We’re Reading
This August, CHIR's Olivia Hoppe summarized helpful resources on premiums and cost-sharing for worki...
Aliera Healthcare Prompts Increased State Activity on Health Care Sharing Ministries
Over the last few months, state officials have increasingly acted to warn consumers about the potent...
DOJ’s Proposed Remedy in Texas v. United States Is an Unrealistic Solution
In supplemental briefings to the Fifth Circuit Court of Appeals, the Department of Justice recently ...
Will it Fly? Wyoming Attempts End Run Around High Air Ambulance Prices
Air ambulance charges are a significant source of surprise out-of-network bills for many patients, w...
Preparations for the Affordable Care Act’s 7th Open Enrollment Season: Georgetown’s Updated Navigator Resource Guide
As August winds to a close, Georgetown CHIR's faculty are focused not on pumpkin lattes and back-to-...
New Addition to Advocate Toolkit Highlights Options for Protecting Consumers Amidst Expansion of Short-Term Plans
In July, a federal district court judge upheld the Trump administration’s rule expanding availabil...
July Research Round Up: What We’re Reading
This July, CHIR's Olivia Hoppe reviewed new studies on coverage gains for workers, the evolution of ...
A Perfect Storm: New Federal Rules on Health Reimbursement Arrangements Exacerbate Dangers of Unregulated Products
Next year, new Trump administration rules will allow employers to offer their employees an HRA to bu...
Federal Rule Creating New Health Coverage Option for Employers Could Destabilize the Individual Market
The Trump administration recently published final rules expanding employers' use of Health Reimburse...
New Resources Arm Advocates with Tools to Defend Essential Health Benefits, Pre-Existing Condition Protections
On July 9, the Fifth Circuit Court of Appeals heard oral arguments in Texas v. United States, the co...
States Are Taking New Steps to Protect Consumers from Balance Billing, But Federal Action Is Necessary to Fill Gaps
This year has seen a flurry of state-level action to protect patients from surprise balance billing....
Successfully Splitting the Baby: Design Considerations for Federal Balance Billing Legislation
The U.S. Congress is advancing legislation to protect patients from surprise medical bills. Yet cons...
States Looking to Run Their Own Health Insurance Marketplace See Opportunity for Funding, Flexibility
Last week, Pennsylvania Governor Tom Wolf signed legislation to establish a state-based health insur...
Is There Really A Question? Intervenor States Have Clear Interest in Defending the Affordable Care Act
The Fifth Circuit Court of Appeals has asked the parties in Texas v. United States to file supplemen...
June Research Round Up: What We’re Reading
This June, CHIR's Olivia Hoppe caught up on policy studies and proposals on surprise medical bills,...
New Trump Executive Order Could Expand Enrollment in Health Care Sharing Ministries, Direct Primary Care Arrangements
A recent Executive Order from President Trump calls on the U.S. Department of Treasury to allow taxp...
States Leaning In: Washington Doubles Down on Efforts to Shore up Market, Protect Consumers
In the wake of federal actions to roll back the Affordable Care Act's reforms, states have assumed a...
Are the Affordable Care Act Markets “Stabilizing”? Early 2020 Rate Filings Give Little Cause for Celebration
Changes in premiums are a key indicator of the overall health of an insurance market. CHIR's Sabrina...
May Research Round Up: What We’re Reading
This May, CHIR's Olivia Hoppe reviewed new studies on the effects of silver loading in the Affordabl...
2019 Insurer Participation: A “Quieter” Year As Companies Maintain, Expand Their Presence
Since implementation of the Affordable Care Act, insurer participation in the ACA marketplaces has f...
Coming up Short: The Problem with Counting Short-Term, Limited Duration Insurance as Coverage
In April, the nonpartisan Congressional Budget Office (CBO) released an analysis of federal legislat...
Can States Fill the Gap if the Courts Overturn Preexisting-Condition Protections?
The 5th Circuit Court of Appeals is expected to hear arguments in litigation over the future of the ...
Most Stakeholders Oppose Expanding the Sale of Coverage Across State Lines: Reactions to HHS’ Request for Comments
The Trump administration recently asked the public to submit input on policies that would encourage ...
States Step Up to Protect Insurance Markets and Consumers from Short-Term Health Plans
Short-term plans are now being sold to consumers as a replacement for Affordable Care Act (ACA) cove...
Protecting People with Preexisting Conditions Requires More Than a Piecemeal Approach: An Assessment of a Louisiana Bill to Codify Some, But Not All, ACA Protections
Several state legislatures are considering bills to re-instate the Affordable Care Act's preexisting...
April Research Round Up: What We’re Reading
April showers bring May flowers, and plenty of health policy research. This month, CHIR's Olivia Hop...
New York’s Law to Protect People from Surprise Balance Bills is Working as Intended, but Gaps Remain
New York's 2014 law to protect consumers from surprise out-of-network medical bills has been touted ...
New Reinsurance Toolkit for State Advocates
Last month, North Dakota enacted legislation to establish a state reinsurance program, and a number ...
ACA Marketplace Open Enrollment Numbers Reveal the Impact of State-Level Policy and Operational Choices on Performance
During the last open enrollment period, the Affordable Care Act’s marketplaces faced a number of h...
Federal Proposal Creating New HRAs for Employers Creates Risks for Employees, the Individual Market
The Trump administration is expected to soon publish a final rule to expand employers' use of Health...
Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 3: Consumer Advocates
On April 18, 2019, the Department of Health and Human Services finalized changes to the Affordable C...
Proposed Rule on Basic Health Program Impedes States’ Progress
Recently, CMS issued a proposed rule modifying the federal funding methodology for the Basic Health ...
Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 2: State Insurance Departments and Marketplaces
On April 18, 2019, the Department of Health and Human Services finalized changes to the Affordable C...
Court Strikes Down a Trump Administration Rule Designed to Circumvent the Affordable Care Act
On March 28, a federal district court struck down the core of the Trump administration’s new regul...
March Research Round Up: What We’re Reading
Spring has arrived, and the research is blooming! This March, CHIR's Olivia Hoppe was buzzing around...
New Study: Consumers Don’t Understand That Short-term Plans Lack Protections, Benefits
A study commissioned by consumer representatives to the National Association of Insurance Commission...
What Does the Latest Federal Court Decision Mean for Association Health Plans – and the States that Regulate Them?
On March 28, 2019, a federal district court invalidated the Trump administration's rule encouraging ...
Affordable Care Act Back in the Spotlight: Build on its Progress or Scrap it Entirely?
It is hard to find a starker example of the different approaches our two political parties take to h...
Trump Administration Pushes for Sale of Insurance Across State Lines
Recently, the Trump administration issued a request for information (RFI) seeking recommendations on...
Happy Birthday to the Affordable Care Act: Your Presence is our Present
On a chilly March Tuesday in Washington, DC, with the stroke of just 22 pens, health care as we know...
Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 1: Insurers
On January 18, the Department of Health and Human Services issued its Notice of Benefit and Payment ...
Stakeholders React to the Administration’s Proposed Rule on Health Reimbursement Arrangements. Part 4: Consumer, Patient, and Union Organizations
In October, the Departments of Treasury, Labor, and Health and Human Services issued a proposed rule...
What, if Anything, Do the Latest Cost Sharing Reduction (CSR) Court Rulings Mean for 2020 Premiums?
The federal government could be on the hook for billions of dollars in reimbursement to insurance co...
February Research Round Up: What We’re Reading
For February's Research Round Up, CHIR's Olivia Hoppe focuses on five studies on health care spendin...
Shopping for a Short-Term Plan? The Information You Get about it Will Depend on Your State
Stakeholders have expressed mixed views on the value of short-term limited duration insurance. Howev...
Saying Goodbye to a Hero
Over the weekend we said goodbye to a dear friend. Rob Restuccia lost his 6-month battle against pan...
Stakeholders React to the Administration’s Proposed Rule on Health Reimbursement Arrangements. Part 3: Employers, Brokers, and Employee Benefit Advisors
In October, the Departments of Treasury, Labor, and Health and Human Services issued a proposed rule...
The Administration Tried to Make It Easier for States to Waive ACA Rules: Will Any Take the Plunge?
Recent federal guidance made significant changes to the ACA’s section 1332 waiver program in order...
Stakeholders Respond to the Proposed Health Reimbursement Arrangement Rule. Part 2: Insurers
In October, the Departments of Treasury, Labor, and Health and Human Services issued a proposed rule...
House Hearings Shed Light on a Key Policy Priority: Protecting People with Pre-Existing Conditions
After becoming a rallying cry in the midterm elections, pre-existing condition protections have take...
Stakeholders Respond to the Proposed Health Reimbursement Arrangement Rule. Part I: State Insurance Departments and Marketplaces
In October 2018, the Trump administration proposed rules to expand the use of health reimbursement a...
January Research Round Up: What We’re Reading
For the January Research Round Up, CHIR's Olivia Hoppe goes over new research that examines the root...
Efforts to Protect Workers with Pre-existing Conditions
On February 6, 2019, the U.S. House of Representatives' Education & Labor Committee held a hearing o...
Short-Term Health Plans Sold Through Out-of-State Associations Threaten Consumer Protections
The expansion of short-term policies has raised concerns that they may be deceptively marketed, wit...
It’s All About the Rating: Touted “Benefits” of Association Health Plans Ignore Key Facts
A recent Washington Post article touted the emergence of association health plans under recent Trump...
The Marketing of Short-Term Health Plans: Industry Practices Create Consumer Confusion
A 2018 federal rule changing the definition of short-term limited-duration insurance (STLDI) has cre...
The Proposed 2020 Notice of Benefit and Payment Parameters: Summary and Implications for States
The U.S. Department of Health & Human Services has released a new set of rules and standards for the...
State Efforts to Protect Consumers from Balance Billing
While the U.S. Congress is considering multiple proposals to combat the problem of unexpected balanc...
Affordable Care Act Navigators: Lack of Funding Leads to Consumer Confusion, Decreased Enrollment
Last year, we talked with Navigators to learn about how they reached consumers despite major funding...
How Is the Partial Government Shutdown Affecting the Affordable Care Act Marketplaces?
We are now in the midst of the longest-ever shutdown of U.S. government agencies, resulting in close...
Translating Coverage into Care: Answers to Common Post-Enrollment Questions
Open Enrollment has ended in the majority of states, and almost 8.5 million people signed up for cov...
December Research Round Up: What We’re Reading
Many people make New Year’s resolutions, with popular ones being to get healthy and save money. In...
Complacency Slows Aggressive Approaches to Health Care Cost Containment: A View from Three Markets
Consolidation among hospitals and physician practices is driving a steady rise in health care costs....
Texas Court Ruling Throws Future of ACA’s Pre-existing Condition Protections, Coverage Gains into Doubt
A district court judge in Texas has issued a ruling that could throw close to one-fifth of the U.S. ...
State Insurance Department Consumer Alerts on Short-Term Plans Come Up Short
Open Enrollment for 2019 has ended in most states, but consumers are sure to be bombarded with sales...
November Research Round Up: What We’re Reading
This November, we at CHIR celebrated Thanksgiving with a Research Buffet. CHIR's Olivia Hoppe digs i...
Large Employer Strategies to Combat Increasing Healthcare Costs: Trends in Direct Contracting, On-Site Clinics and More
Employers currently insure 155 million people, but many are finding it increasingly challenging to m...
In the Wake of New Association Health Plan Standards, States are Exercising Authority to Protect Consumers, Providers, and Markets
States have begun to respond to the Trump administration's new rules for association health plans wi...
New Georgetown Report: Assessing the Effectiveness of State-Based Reinsurance
As state legislatures across the country prepare to convene in 2019, improving access to affordable ...
Proposed Marketplace Program Integrity Rule: Summary and Implications for States
The U.S. Department of Health & Human Services has proposed new standards for Affordable Care Act ma...
CHIR Holds Navigator Twitter Q&A: Top 5 Questions
The Center on Health Insurance Reforms held its first-ever Tweetchat in light of the release of our ...
Navigator Guide FAQ of the Week: Can Insurers Ask About Your Health History?
With just one month left in the open enrollment period for most of the Affordable Care Act’s marke...
Navigator Guide FAQ of the Week: Eligibility for Premium Tax Credits
The midterm elections are over, but open enrollment for the Affordable Care Act marketplaces is in f...
What Does the Change in House Leadership Mean for Private Health Insurance? CHIR Experts Make Some Predictions
The 2018 midterm election results mean the U.S. House of Representatives will be under new leadershi...
October Research Round Up: What We’re Reading
From price variation in hospital services paid by private insurers to how the Affordable Care Act (A...
Trump Administration Hands States Another Tool for Dismantling Preexisting Condition Protections
Last week, the Trump administration issued long-anticipated guidance regarding the ACA's Section 133...
Virginia’s Enrollment Season Perfect Storm
Across the country, states are yet again dealing with policy changes just before the fall open enrol...
States Lean In as the Federal Government Cuts Back: Navigator and Advertising Funding for the ACA’s Sixth Open Enrollment
With open enrollment into the Affordable Care Act marketplaces beginning November 1st, there will be...
Direct Primary Care Arrangements Raise Questions for State Insurance Regulators
Over the past year, new health coverage products that are not subject to the consumer protections ...
States Opt to Run their Own Exchanges to Save Money, Reclaim Autonomy
Last month, the Board of New Mexico’s health insurance exchange voted to transition from HealthCar...
What’s New for 2019 Marketplace Enrollment? Get Ready for Updated, Improved Navigator Resource Guide
On November 1, the sixth open enrollment period begins for marketplace coverage under the Affordable...
The Trump Administration’s Association Health Plans Emerge: What Early Announcements Tell Us About this New Market
This past summer, the Department of Labor (DOL) finalized a regulation calling for the expansion of ...
Proposed “Public Charge” Rule Risks Immigrants’ Access to Private Coverage, Too
A federal proposal would make it more difficult for immigrants to obtain a green card if they've rec...
September Research Round Up: What We’re Reading
This September, CHIR's Olivia Hoppe focuses in on health care spending and costs with new studies on...
New Report Shows Role of Medicaid Expansion in Rural Area, Small Town Health Coverage
Under the Affordable Care Act, 33 states and the District of Columbia expanded Medicaid, greatly inc...
Lawmakers had a Chance to Provide Relief from Surprise Medical Bills – and Whiffed It
Although health care costs and surprise medical bills top the list of voters' concerns this election...
House Farm Bill Supports AHPs with Federal Grants—Following in the Footsteps of the ACA’s CO-OP Program
The Farm Bill currently being debated in a House-Senate conference committee enables the Secretary o...
Federal Flexibility Grants Highlight State Priorities for Market Stability
Last month, the Department of Health & Human Services awarded $8.6 million in grants to 30 states an...
Massive Navigator Funding Cuts Pose Risks for Consumers, Marketplaces
On September 12, the Centers for Medicaid and Medicare Services released the in-person assistance aw...
When Policy and Politics Conflict: Challenges to State-level Market Stabilization Efforts
Within the last month, Delaware has adopted two policies with diametrically different effects on the...
Next Effort to Repeal ACA Would Likely Look Like Last One
Congressional Republicans plan to pursue another attempt at repealing the Affordable Care Act next y...
August Research Round Up: What We’re Reading
Summer is over, but health policy researchers have hardly taken a vacation. In August's research rou...
Lawsuit Threatens Affordable Care Act Preexisting Condition Protections But Impact Will Depend on Where You Live
On September 5, 2018, A federal district judge hears arguments in a lawsuit filed by 20 Republican g...
Major State Medical Association Warns Consumers about Health Care Sharing Ministries
The Texas Medical Association recently issued a warning to consumers about the risks of health care ...
Impact of Association Health Plans on Consumers and Markets Will Depend on State Approaches
In June, the U.S. Department of Labor issued a final regulation that implements President Trump’...
Cities File Suit Against the Administration for Deliberately Failing to Enforce the ACA
On August 2, a coalition of cities filed a federal lawsuit against President Trump and the Departmen...
New Report Examines State Options for Oversight of Risk-Bearing Provider Organizations
Value-based payment models are promoted as a way to transform our health care system from one that r...
Health Care Sharing Ministries: What Are the Risks to Consumers and Insurance Markets?
Health Care Sharing Ministries (HCSMs) are a form of health coverage in which members – who typica...
The District of Columbia’s Coverage Requirement Is Caught in Congressional Crosshairs, and Consumers Could Pay the Price
When Congress repealed the individual mandate’s financial penalty, some states acted quickly to pr...
July Research Round Up: What We’re Reading
Health policy researchers are keeping busy, assessing the impact of recent and potential state and f...
Understanding the Market for Short-Term Health Plans: States Prepare to Identify, Oversee Sellers and Products
Last week, the Trump administration issued a final rule reversing federal limits on short-term healt...
Short-term, Limited Duration Insurance Final Rule: Summary and State Options
The Trump administration has finalized a new federal definition of short-term, limited duration insu...
Coverage That (Doesn’t) Count: How the Short-Term, Limited Duration Rule Could Lead to Underinsurance
Any day now, the Trump administration is expected to publish new rules that will expand access to sh...
Bracing for an Affordable Care Act Enrollment Season Without Navigators: Risks for Consumers and the Market
The Centers for Medicare and Medicaid Services announced on July 10, 2018 that they would fund up to...
To Understand How Consumers Are Faring in the Individual Health Insurance Markets, Watch the States
Through both inaction and design, federal policymakers have put the onus on states to ensure access ...
House Committee to Consider Expanding Health Savings Account Tax Breaks for High Income
On July 11, the full House Ways and Means Committee approved multiple health-related tax bills, many...
Look Past the Jargon and the Trump Administration’s Risk Adjustment Decision Ultimately Hurts People with Pre-existing Conditions
The Trump administration recently decided to suspend payments under an obscure Affordable Care Act p...
The Road Not Traveled: How Policy, Business Decisions in Iowa Led to Higher Premiums
Iowa's legislature recently made the extraordinary decision to abdicate that state's authority over ...
A Main Reason New York and Massachusetts Will Sue the Administration Over the Final AHP Rule? Fraud and Abuse
New York Attorney General Barbara Underwood (D) and Massachusetts Attorney General Maura Healey (D) ...
June Research Round Up: What We’re Reading
State officials, insurers, and consumer advocates and assisters are gearing up for a hectic 2019 enr...
What’s in the Association Health Plan Final Rule? Implications for States
The Trump administration has released new rules to expand the availability of association health pla...
State Efforts to Pass Individual Mandate Requirements Aim to Stabilize Markets and Protect Consumers
A handful of states are moving forward with plans to implement state-level individual health insuran...
New Report Documents Barriers for People with Mental Illness, Substance Use Disorders Buying Coverage Before the ACA
In a report released this week by the National Alliance for Mental Illness (NAMI), Georgetown resear...
Stakeholder Views on the Proposed Short-Term Plan Insurance Rule: Key Takeaways from Our Review of Comment Letters
In February, the Trump administration published a proposed rule to expand the availability of short-...
When Being Uninsured Cuts Life Short: In Memory of My Dad
George K. Hoppe was the owner of a small architectural firm in Lavallette, New Jersey. He designed b...
Stakeholders Respond to the Proposed Short-term, Limited Duration Insurance Rule. Part IV: Short-Term Insurers and Brokers
The Departments of Labor, Health & Human Services, and Treasury received over 9,000 comments on thei...
Stakeholders Respond to the Proposed Short-term, Limited Duration Insurance Rule. Part III: State Insurance Departments and Marketplaces
The Departments of Labor, Health & Human Services, and Treasury received over 9,000 comments on thei...
May Research Round Up: What We’re Reading
In this month’s research round up, CHIR's Olivia Hoppe looks into analyses of the success of recen...
Stakeholders Respond to the Proposed Short-Term, Limited-Duration Insurance Rule. Part II: Major Medical Insurers
The Departments of Labor, Health and Human Services, and Treasury received over 9,000 comments on th...
Stakeholders Respond to the Proposed Short-Term, Limited Duration Insurance Rule. Part I: Consumer Advocates
Earlier this year, the Trump administration proposed rules to relax federal restrictions on short-te...
The FAA Reauthorization Bill – An Unexpected Vehicle for Relief from Surprise Medical Bills?
More often than not, air ambulance services are called in to serve people in severe physical distres...
The Effects of Federal Policy: What Early Premium Rate Filings Can Tell Us About the Future of the Affordable Care Act
Insurers have started to propose some pretty eye-popping premium increases for Affordable Care Act c...
The Urban Institute’s New Proposal to Get Us Closer to Universal Coverage
In preparation for the day when a progressive vision for health reform may have more supporters in t...
New Georgetown-Society of Actuaries’ Report: Estimating the Impact of Association Health Plans on the Individual Market
The Trump administration is expected to shortly finalize new rules expanding the availability of ass...
A Mother’s Day Gift Basket from Congress and the Trump Administration
This Mother’s Day, both Congress and the Trump administration have put together a special gift bas...
April Research Round Up: What We’re Reading
In CHIRblog’s April installment of What We’re Reading, CHIR's Olivia Hoppe digs into reports th...
Short-Term, Limited-Duration Insurance and Risks to California’s Insurance Market
In a new California Health Care Foundation issue brief, CHIR’s Dania Palanker, Kevin Lucia, JoAnn ...
States Leaning In: Washington
Since the Affordable Care Act was passed in 2010, states have embraced the law to varying degrees. W...
A Vacation in Germany: What’s Health Insurance Like Here?
Getting injured in the United States can be quite the financial headache, even with health insurance...
This Tax Filing Season, Many Will Spend their Refunds on Health Care
As tax filing season comes to a close, CHIR's Emily Curran discusses recent findings by the JPMorgan...
The 2019 Affordable Care Act Payment Rule: Summary & Implications for States
The Trump administration has released a new final rule to govern the Affordable Care Act's individua...
March Research Round Up: What We’re Reading
In CHIRblog’s March installment of What We’re Reading, CHIR's Olivia Hoppe dives into new resea...
The Future of the Affordable Care Act under President Trump: Stakeholders Respond to the Proposed Association Health Plan Rule. Part V: Departments of Insurance
In this final blog in our series reviewing stakeholder comments on the Department of Labor’s propo...
States’ Latest ACA Lawsuit Threatens to Reignite “Repeal-Without-Replace” – With Real Consequences for Stakeholders
Earlier today, California, along with 15 state attorneys general filed a motion to intervene in the ...
The Future of the Affordable Care Act under President Trump: Stakeholders Respond to the Proposed Association Health Plan Rule. Part IV: Business Groups
In a recent proposed rule from the Department of Labor, the Trump administration has proposed major ...
The Future of the Affordable Care Act under President Trump: Stakeholders Respond to the Proposed Association Health Plan Rule. Part III: Insurers
The U.S. Department of Labor received over 900 comments on its proposed rule, which aims to promote ...
How Did State-Run Health Insurance Marketplaces Fare in 2017?
In a new Commonwealth Fund issue brief, CHIR's Justin Giovannelli and Emily Curran interviewed leade...
New Georgetown – Urban Institute Report Finds Health Plans Bracing for More Federal Uncertainty Over Affordable Care Act
Researchers from Georgetown CHIR and the Urban Institute have released a new report documenting the ...
The Future of the Affordable Care Act under President Trump: Stakeholders Respond to the Proposed Association Health Plan Rule. Part II: Consumer Advocates
Over 900 comment letters were submitted to the U.S. Department of Labor in response to the proposed ...
The Future of the Affordable Care Act under President Trump: Stakeholders Respond to the Proposed Association Health Plan Rule. Part I: State Attorneys General
The Trump administration has proposed major changes to the regulation of Association Health Plans (A...
Making Short-Term Plans a Long Term Coverage Option: Risks to Consumers and to Markets
The White House and Secretary of Health & Human Services have recently called for making short-term ...
Translating Coverage into Care: Answers to Common Post-Enrollment Questions
Open enrollment has ended, and almost 12 million individuals signed up for coverage through the stat...
Coalition Demands Crucial Information About Association Health Plan Rulemaking
On March 1st, a coalition of stakeholders, including Georgetown University’s Center on Health Insu...
February 2018 Research Round Up: What We’re Reading
In CHIRblog’s February installment of What We’re Reading, CHIR's Olivia Hoppe digs into new rese...
Short-Term, Limited Duration Insurance Proposed Rule: Summary and Options for States
New proposed rules from the Trump administration would loosen current federal restrictions on short-...
State Regulators Keep a Watchful Eye on Healthcare Companies’ Federal Tax Cut “Windfalls”
In December, President Trump signed the Republican tax reform bill into law, which among other thing...
Proposed Federal Changes to Short-Term Health Coverage Leave Regulation to States
The Trump administration issued proposed rules on February 20, 2018 that rescind Obama-era restricti...
If It Talks Like Insurance and Walks Like Insurance: The Curious Case of Direct Primary Care Arrangements
For decades, elite “concierge” practices have been providing easy access to primary care in retu...
Stepping in When States Don’t Step Up: First “State-Based” Plans Filed in Idaho, Violating the Affordable Care Act
Last week Blue Cross of Idaho filed the first "state-based" health plans, products that don't comply...
New Funding Opportunity Allows States to Bolster Consumer Protections
On February 5th, the Center for Consumer Information and Insurance Oversight (CCIIO) put out a Notic...
January 2018 Research Round Up: What We’re Reading
In the past month, new research highlights the regressive effects of high health plan cost sharing. ...
Proposed Federal Changes to Short-Term Health Coverage Leave Regulation to States
The Trump administration is expected to reverse federal limitations on short-term insurance, which ...
Idaho Goes Rogue: State Authorizes Sale of Health Plans that Violate the Affordable Care Act
Idaho has just published rules for new, “state-based” health plans that are exempt from many of ...
Association Health Plans: Maintaining State Authority is Critical to Avoid Fraud, Insolvency, and Market Instability
Earlier this month, the Trump Administration issued a proposed regulation that would allow individua...
Association Health Plan Proposed Rule: Summary and Implications for States
In a recent brief for the Robert Wood Johnson Foundation's State Health & Value Strategies program, ...
The Future of the Affordable Care Act under President Trump: Stakeholders Respond to Proposed 2019 Marketplace Rule. Part III: States
The final 2019 Notice of Benefit and Payment Parameters has been submitted to the White House for re...
The Future of the Affordable Care Act under President Trump: Stakeholders Respond to Proposed 2019 Marketplace Rule. Part II: Consumer Advocates
The final 2019 Notice of Benefit and Payment Parameters has been submitted to the White House for re...
Affordable Care Act Navigators: Unexpected Success During 2018 Enrollment Season Shouldn’t Obscure Challenges Ahead
Heading into open enrollment for 2018 marketplace coverage, experts predicted far fewer people would...
Research Update: Health Care Expenses from Families’ Budgets to Federal Budgets
Recent research highlights how health insurance coverage eases financial pressure on families' budge...
Insurer Participation in ACA Marketplaces: Federal Uncertainty Triggers Diverging Business Strategies
A reliable indicator of health insurance markets’ stability is insurer participation, including th...
2018 Outlook: What Health Insurance Experts at CHIR Will be Watching
Last year brought a lot of surprises in health care policy, and 2018 is shaping up to be more of the...
Marketplace Plan Discontinued? Options after Open Enrollment
Blink and you may have missed it - open enrollment for HealthCare.gov was much shorter this year and...
Enrolling in Health Insurance is Complicated. That’s Where Navigators Can Help.
With the close of Open Enrollment for federally run marketplaces last week, preliminary reports sugg...
States Face Key Decisions if Alexander-Murray Proposal Is Included in Year-End Budget Bill
The Alexander-Murray bill to fund the Affordable Care Act's cost-sharing subsidies could be included...
The Future of the Affordable Care Act under President Trump: Stakeholders Respond to Proposed 2019 Marketplace Rule. Part I: Insurers
The Trump Administration has proposed a number of changes to the Affordable Care Act's essential hea...
New Rules Pending on Short-Term Health Plans: Impacts for Consumers, Markets and Potential State Responses
New rules are due any day now in response to President Trump's October 13, 2017 executive order to e...
The Open Enrollment Clock is Ticking: Drop (what you’re doing), Shop, and Enroll
Open enrollment for 2018 Affordable Care Act coverage ends on December 15th. While in the midst of t...
State Options Blog Series: Implications of Weakening the 80-20 Rule for States and Consumers
The Trump administration recently issued a proposed regulation that could significantly impact how m...
House GOP Tax Bill’s Elimination of the Medical Expense Deduction Takes Aim at the Middle Class
The U.S. House of Representatives' tax reform bill would eliminate the medical expense deduction to ...
When the Individual Market Dies, Where will People Go? A Eulogy
The individual market may not be dead yet, but it soon will be, thanks to recent actions by the Trum...
Shopping Tips for 2018 Open Enrollment
What's a marketplace consumer to think in this crazy-mixed up year for the Affordable Care Act? Fede...
Insurers, State Regulators Avoid Bare Counties in 2018, but Seek Long-Term Solutions
As we near the end of the second week of a so-far successful Open Enrollment, uncertainty over the f...
State Options Blog Series: Streamlined, Direct Marketplace Enrollment Has Risks, Benefits, but Much Depends on State Oversight
In the fourth of a multi-part blog series on state options in the wake of federal actions to roll ba...
State-Based Marketplaces Push Ahead, Despite Federal Resistance
Open enrollment for 2018 started last week on the Affordable Care Act’s health insurance marketpla...
Proposed 2019 Affordable Care Act Payment Rule: A Big Role for States
The U.S. Department of Health & Human Services published an annual set of proposed rules for the Aff...
States Step Up to Protect Consumers in Wake of Cuts to ACA Cost-Sharing Reduction Payments
In the wake of President Trump's decision to cut off payments for a key ACA subsidy for low-income e...
I’m A Certified Application Counselor. This Year’s Open Enrollment Will Be the Most Challenging Yet
Enrolling in marketplace health insurance is already a tall order for many consumers because of the ...
Got Questions on Private Health Insurance? Get the New and Improved Navigator Resource Guide
Marketplace enrollment is upon us. November 1 marks the start to the fifth open enrollment season. T...
It’s Not Time to Give Away Consumer Protections for Cost-Sharing Reduction Reimbursements
In the wake of a White House decision to end reimbursements to insurers for cost-sharing reduction (...
States Work to Preserve Affordable Care Act Progress amidst Federal Disorder
It's been a bumpy year for state insurance and marketplace officials, thanks to considerable uncerta...
A Blow to Working Class Coverage
On the heels of multiple failed attempts to repeal the Affordable Care Act, President Trump attempts...
New Executive Order: Expanding Access to Short-Term Health Plans Is Bad for Consumers and the Individual Market
President Trump signed a “very major” executive order related to health care that is “going ...
Trump’s Executive Order: Can Association Health Plans Accomplish What Congress Could Not?
In the wake of failed Congressional efforts to repeal and replace the Affordable Care Act, President...
Trump’s New Rule on Birth Control is Basically Discrimination Against Women
The Trump administration recently released regulations allowing employers, colleges, and universitie...
State Options Blog Series: Federal Regulators May Weaken ACA Essential Health Benefits Requirements, Creating Need for States to Protect Consumers
In the third of a multi-part blog series on state options in the wake of federal actions to roll bac...
In the Aftermath of a Natural Disaster and Have Questions about your Health Insurance Coverage? CHIR Experts Answer Some Frequently Asked Questions
In the wake of devastating natural disasters, consumers living in hurricane or wildfire affected ar...
ACA “Bare Counties”: Policy Options to Ensure Access Must Address Longer-Term Stability and Competition
September 27th marks the day most insurers have to formally decide whether they'll stay in the Affo...
Graham-Cassidy 2.0: Taking Insurance Protections Out of the Individual Market
Another day, another version of the Graham-Cassidy bill. This new version makes numerous technical c...
Graham-Cassidy’s Waiver Program Allows States to Erase Protections for People with Pre-existing Conditions
Once again, Congress is poised to repeal and replace the Affordable Care Act. Proponents of the bill...
The Next Round of Obamacare Regulations are Coming Soon: What Consumer Advocates Want to See
With the annual rule on marketplace operations and health plans expected this fall, we take a look a...
State Options Blog Series: Federal Regulators Relax ACA Health Plan Oversight, Creating Opportunities and Challenges for States
In the second of a multi-part blog series on state options in the wake of federal actions to roll ba...
States Take the Lead with Policies to Protect Residents with Chronic Conditions from High Out-of-Pocket Drug Costs
Lowering the cost of prescription medication has broad support over the political spectrum and there...
Recent and Potential Regulatory Actions to Roll Back the ACA: State Options Blog Series
While members of Congress debate possible bipartisan actions on the ACA, the future sustainability o...
Down to the Wire: Indecision on ACA Cost-Sharing Reduction Payments Creates Confusion for States
The Trump administration's indecision over whether to reimburse insurance companies for Affordable C...
EEOC Wellness Regulations Found Arbitrary and Capricious: Raises Importance of Public Comments
A federal judge found EEOC's wellness regulations arbitrary and capricious. Dania Palanker explains ...
Healthcare.gov Rolls out Two Operational Changes Related to Verifying Special Enrollment Periods and Immigration Status
While Congress shifts away from talking about how to replace the Affordable Care Act to stabilizing ...
Future of Health Reform: A prescription for individual market stability
As policy uncertainty in Washington, DC roils health insurance markets nationwide, states like Minne...
Lots of Questions but Few Answers: NAIC’s 2017 Summer Meeting
State insurance regulators met for the NAIC's annual summer meeting in Philadelphia last week amidst...
Relaxing the ACA’s Regulations: Stakeholders Respond to HHS’ Request for Information, Part 2 – State Departments of Insurance
In Part 2 of this three-part series, we look at how state departments of insurance responded to the ...
Short-Term Health Plans: Still Bad for Consumers and the Individual Market
Some state and federal policymakers are urging HHS to relax Obama-era rules for short-term limited d...
Relaxing the ACA’s Regulations: Stakeholders Respond to HHS’ Request for Information: Part 1—Insurers
The U.S. Department of Health & Human Services asked this spring for public comments on potential ch...
Affordable Care Act Reforms Not Fully Realized for Small Businesses: New Study Documents a Market in Transition
A new report published by the Urban Institute and Robert Wood Johnson Foundation uncovers trends in ...
No Rest for the Weary: Unexpected Defeat of ACA Repeal Effort Doesn’t Mean End of Threats to Law
In the wake of the surprise defeat of the effort to repeal the ACA, President Trump called for letti...
Important Gains under the ACA for Cancer Patients And Their Families
While there may be a respite from the push to repeal and replace the Affordable Care Act (ACA), a ne...
“Small Business Health Plans”: Undermining States’ Authority and a Recipe for Fewer Plan Choices and Higher Premiums
The U.S. Senate stands poised to debate a bill, the Better Care Reconciliation Act, that would not o...
Insurer Q2 Earnings Reports Begin—How Will Companies React to Federal Uncertainty?
We're in the midst of second quarter financial earnings calls for some of the biggest health insurer...
New Special Enrollment Roadblocks for Consumers: Hindering, not Helping Consumers Get Coverage
While Congressional leaders debate how to repeal and replace the Affordable Care Act, the Trump admi...
A Head Scratcher of a Bill: Revised Senate Health Care Legislation Likely to Undermine Pre-existing Condition Protections, Upend Insurance Markets
Policymakers promised to replace the Affordable Care Act with something that would cover "everybody,...
Have Employer Coverage? GOP Proposals Will Affect You Too (Part 2)
Much of the focus of the debate over repealing and replacing the ACA has been on the individual insu...
A Snake in the Grass? Choosing Between COBRA and Other Coverage Options After Leaving Employer Coverage
Leaving a job comes with many challenges, not the least of which is securing new health insurance. T...
What Makes Covering Maternity Care Different?
The United States has a higher maternal mortality rate than any other developed country, but federal...
Amid Market Uncertainty, Trump Administration Retreats from Health Plan Oversight
In mid-April, the Trump administration announced it would stop monitoring marketplace plans for comp...
Signs of Marketplace Stability May Be Undercut by Federal Policy Uncertainty
Recently, analysts have found evidence of marketplace stability after a number of insurers scaled ba...
Lots of Changes for 2018 Marketplace Enrollment Mean Confusion for Consumers
Open enrollment will be here sooner than we know it. But this year's open enrollment, will be quite ...
New Georgetown Issue Brief: 50-state Survey of State Action to Protect Consumers from Surprise Medical Bills
Balance billing occurs when a consumer who is treated by an out-of-network provider is subsequently ...
State Efforts to Lower Cost-Sharing Barriers to Health Care for the Privately Insured
Current federal proposals to replace the Affordable Care Act are likely to result in higher out-of-p...
Relaxing the Affordable Care Act’s Metal Level Definitions: Issues for Consumers and State Options
New ACA rules give insurers greater flexibility to meet metal level targets and increase cost-sharin...
“Bare” Counties Are a Real Concern. Short-Term Policies Are Not the Answer
Fourteen U.S. Senators have sent a letter to Secretary Price, urging him to roll back an Obama-era r...
The Ins and Outs of the New Approach to Special Enrollment Periods: Pre-enrollment Verification (SEPV)
Starting June 23, 2017, healthcare.gov will be rolling out a special enrollment period pre-enrollmen...
We Read Actuarial Memoranda so You Don’t Have to: Trends from Early Health Plan Rate Filings
A handful of states have received insurers' 2018 premium rate requests for the Affordable Care Act m...
Relaxing the Affordable Care Act’s Guaranteed Issue Protection: Issues for Consumers and State Options
As we've been blogging about, the Trump administration finalized a Market Stabilization rule that ma...
Running Down the Clock: Policy Uncertainty over Affordable Care Act Means Less Time for Oversight of Premium Hikes
Insurers are required to submit their health plans and premium rates for regulatory review in the fa...
Responding to the Opioid Crisis: Insurers Balance Stepped up Monitoring, Restrictions with Need for Appropriate Pain Treatment
The United States has an opioid epidemic, with an unprecedented number of opioid-related deaths in r...
Winding Down the Small Business Marketplaces: Feds Acknowledge the Failure to Launch
Last week, the Department of Health and Human Services announced that it would propose rulemaking to...
Proposed Premium Rates for 2018: What do Early Insurance Company Filings Tell Us?
Insurers are starting to submit their proposed plans and rates for 2018 coverage to state regulators...
Mother’s Day Menu from Congress and the American Health Care Act
This Mother’s Day, Congress is giving mothers a new health coverage menu with options for states a...
The MacArthur Amendment: The Final Death Blow for the Affordable Care Act CO-OP Plans
A provision tucked into an amendment to the House-passed "American Health Care Act" would effectivel...
2017 Federal and State Marketplace Trends Show Value of Outreach
The fourth open enrollment period ended in early 2017, with dwindling momentum behind enrollment eff...
Alexander-Corker Bill Would Likely Reduce, Not Expand, Consumers’ Health Insurance Options
Humana's decision to pull out of the individual market in 2018 has prompted more concern over areas ...
Court Dismisses Blue Cross and Blue Shield of North Carolina’s Risk Corridor Lawsuit—What About the Other Risk Cases?
On April 18, the United States Court of Federal Claims dismissed Blue Cross and Blue Shield of North...
New Report Emphasizes States’ Power to Protect Consumers and Ensure Stable Markets in the Midst of Federal Uncertainty
In the past few months, Congress and the Trump Administration have floated a number of proposals and...
At NAIC Spring National Meeting, the Future of the Affordable Care Act Was Front and Center
The National Association of Insurance Commissioners wrapped up its Spring National meeting, and the ...
Who Would Gain Under the Proposal to Expand Health Savings Accounts?
Health savings accounts play a key role in most Republican plans to repeal and replace the Affordabl...
What’s Going on in Tennessee? One Possible Reason for Its Affordable Care Act Challenges
Recently the Governor of Tennessee observed that his state was “ground zero” for insurers pullin...
Selling Health Insurance Across State Lines Doesn’t Lower Costs for Consumers
In the wake of the failure of the legislative effort to repeal and replace the Affordable Care Act, ...
New Network Adequacy Rules: Less Federal Oversight, More Deference to States
In a soon to be finalized "market stabilization" rule, the Trump Administration has proposed a new a...
Proposed Trump Administration Rule Shortens Open Enrollment: Policy Goals, Potential Impact, and State Options
In February, the Trump administration proposed a number of rules that they hope will stabilize the i...
Loss of Cost-Sharing Reductions in the ACA Marketplace: Impact on Consumers and Insurer Participation
In an updated article published on The Commonwealth Fund's To the Point site, CHIR experts JoAnn Vol...
Proposed Pre-Verification Process for Special Enrollment Periods: Policy Goals, Potential Impact, and the need for State Flexibility
In the wake of failed congressional attempts to repeal and replace the Affordable Care Act, we turn ...
Fix it, Don’t End it: Common Sense Prescriptions for Individual Market Stability
For the time being, the Affordable Care Act (ACA) is the "law of the land." But increasing uncertain...
House Proposal to Promote Association Health Plans Poses Risks for Insurance Markets, Consumers
The U.S. House of Representatives passed a bill to promote federally certified association health pl...
Stakeholders React to HHS’ Proposed Market Stabilization Regulations: Part 3 – State-Based Marketplaces
For the third and final blog post in our series examining reactions to the proposed market stabiliza...
Stakeholders React to HHS’ Proposed Market Stabilization Regulations: Part 2 – Consumer Advocates
Last month, the Department of Health & Human Services released proposed rules aimed at stabilizing t...
Eliminating Essential Health Benefits Will Shift Financial Risk Back to Consumers
In a new article published on The Commonwealth Fund’s To The Point site, CHIR experts Dania Pal...
With all Eyes on AHCA, House Advances 3 Bills that Could Reduce Benefits, Raise Costs for People in Employer-Based Coverage
While all eyes were on the House reconciliation bill to repeal and replace parts of the ACA, another...
Stakeholders React to HHS’ Proposed Market Stabilization Regulations: Part 1 – Insurers
In February, the Department of Health & Human Services released proposed rules affecting the ACA's h...
What’s the Difference Between Reinsurance and a High-Risk Pool? Two approaches to insuring those with pre-existing conditions
Congressional leaders and the President have said any plan to replace the Affordable Care Act (ACA) ...
Maryland CO-OP Health Plan Becomes a For-Profit Company
Just hours before President Trump took the oath of office, the Maryland health insurance CO-OP Everg...
Reading the Fine Print: Do ACA Replacement Proposals Give States More Flexibility and Authority?
State leaders have been heartened by statements from the new President and Congressional leaders tha...
CHIR Expert Testifies Before the House Committee on Small Business Regarding Enhancements to the ACA
On February 7, the House Committee on Small Business held a hearing titled, “Reimagining the Healt...
Policy Experts Talk Strategies, Obstacles for “Repeal and Replace”
The Affordable Care Act (ACA) has increased access to health care by expanding coverage and reducing...
Total Cost Estimators: Lessons from the ACA’s Marketplaces
CHIR researchers Justin Giovannelli and Emily Curran interviewed more than 40 marketplace officials,...
Progress on Mental Health Coverage Could Be Gutted by ACA Repeal
State regulators were making progress on mental health parity enforcement, due in part to new federa...
Risky Business: Health Actuaries Assess the Individual Market and Rates
As the health care debate continues, we face a number of unknowns. Congressional leadership and Pres...
Affordable Care Act Repeal Efforts Would Impact State Laws, Too
With much of the attention about ACA repeal efforts focused on Washington DC, it's easy to forget th...
Repealing The ACA Could Worsen The Opioid Epidemic
As our country grapples with an “unprecedented opioid epidemic,” Congress is taking steps to tak...
Congress Asked States for Health Reform Ideas. They May Be Surprised by What They Hear
Shortly after the election, Congress asked state officials to provide input on repealing and replaci...
Uncertain Future for the Affordable Care Act Leads Insurers to Rethink Participation, Prices
Amid an uncertain future for the Affordable Care Act, insurers face crucial decisions whether to rem...
State Experiences Show Why Repealing the ACA’s Premium Subsidies and Individual Mandate Would Cripple Individual Health Insurance Markets
What will happen if the Affordable Care Act is repealed without a replacement? In their latest artic...
Prior to the ACA, Where You Lived Determined How Accessible and Affordable Coverage Would Be
Before the Affordable Care Act, where you lived determined how accessible and affordable coverage wo...
Promising Steps to Strengthen Marketplace Risk Pools Could be in Vain, if Affordable Care Act is Repealed
While critics have been describing the demise of the marketplaces established by the Affordable Care...
States That Leaned In on the Affordable Care Act Have Much to Lose
In the wake of the Affordable Care Act's passage, 17 states embraced the chance to set up and manage...
Get Health Insurance Through Your Employer? ACA Repeal Will Affect You, Too
Job-based plans cover 150 million people in the U.S. If the ACA is repealed, they stand to lose crit...
President Obama’s Health Care Legacy
The end of the Obama Presidency is an opportunity to step back and assess his health care legacy and...
Busting the “Falling under its Own Weight” Myth: New Analysis Shows Better Outlook for the Affordable Care Act Marketplaces
It’s a new year, and with it comes new hope for the Affordable Care Act’s (ACA) exchanges. Wall ...
Tick Tock: An Unforgiving Calendar for Health Plans Makes Orderly “Transition” for Affordable Care Act Repeal Unlikely
The incoming Congress and Administration have pledged to repeal the Affordable Care Act but hope to ...
Loss of Cost-Sharing Reductions in the ACA Marketplace: Impact on Consumers and Insurer Participation
As Congress discusses ACA repeal, there is another, potentially more immediate threat to ACA marketp...
Twelve Days of Coverage
Despite the gloom and doom surrounding the Affordable Care Act (ACA), when we look back at what the ...
The NAIC Fall Meeting: ACA on the mind if not on the agenda
The NAIC wrapped up its Fall National Meeting last week, and although there was little of the upcomi...
The Final Countdown for 2017 Coverage Underway in the Shadows of Affordable Care Act Repeal
Extended to December 19, 2016, consumers have four more days to enroll in an Affordable Care Act mar...
New Analysis: Repeal of the Affordable Care Act through Reconciliation Throws Almost 30 Million off Coverage
A new Urban Institute analysis shows that close to 30 million people will lose coverage if the Affor...
From Acne to EcZema: The Return of Medical Underwriting Puts Millions at Risk for Losing Coverage or Higher Premiums
Medical underwriting, outlawed by the Affordable Care Act (ACA), is a practice used by insurance com...
A Lot to Lose: What’s on the Line for Women if the Affordable Care Act is Repealed
It’s the holiday season, but rather than visions of sugar plums dancing above our heads, we have v...
Though the ACA Faces Tough Critics, Millions are Having an Easier Time Paying Medical Bills
The Affordable Care Act (ACA) has extended insurance coverage to 22 million people, but the law’s ...
The Affordable Care Act prohibits discriminatory benefit design, but how is that enforced?
The Affordable Care Act put in place new protections to prevent health plan benefit designs that dis...
In the Midst of Federal ACA Woes, States Play an Important Consumer Protection Role
In Washington, our health policy minds are on system overload. Since the election last week, the tow...
Definition of Insanity? Trump Transition Team Proposals for “Replacing” the Affordable Care Act
President-elect Trump's transition team has posted their top replacement ideas for the Affordable Ca...
Soldiering On
This past week's stunning election results have put the future of the Affordable Care Act - and heal...
How Could a New Administration Tackle Affordable Care Act Challenges? Look to Medicare
The next President and Congress will likely need to consider policy options to help stabilize the Af...
Consumer Shopping on Healthcare.gov During Open Enrollment 4
Choosing a health plan is like putting a puzzle together, you need help putting all the pieces toget...
Simple Choice Plans Debut on Healthcare.Gov
Simple Choice plans, standardized benefit designs with fixed cost-sharing amounts and pre-deductible...
Health Plan Restrictions on Contraceptive Coverage: It’s like asking people to “renew their seat belt each month”
The Affordable Care Act (ACA) has lowered financial barriers to birth control by requiring health pl...
New Marketplace Research: Off-Marketplace Consumers and How Marketplace Enrollees Fare in Expansion and Nonexpansion States
Two new studies captured our attention recently. One, from the U.S. Department of Health & Human Ser...
New and Improved Navigator Resource Guide
There's a national election approaching but it isn't for President. In just one week, consumers can ...
Reaching the Uninsured: Outreach Strategy for Open Enrollment 4
Healthcare.gov will be taking lessons learned from the past three open enrollments, as well as its o...
The End of SHOP as We Know It?
There’s a provision tucked into a recently proposed federal rule that could effectively destroy th...
Enrollees Aren’t Abusing Marketplace Grace Period
Insurers and other critics have called on the Obama Administration to shorten the 3-month grace peri...
What to Expect When You’re Enrolling: A Preview of Open Enrollment Season 4
Since the beginning of open enrollment season three years ago, the administration has continually ma...
The Affordable Care Act: Efforts to Address Barriers to Health Equity
Disparities in health insurance coverage and accessing health care continue to be a challenge in the...
Low-Income Households and ACA Tax Policies: Benefit from Tax Credits but Paying the Penalty
We are well into the third tax year of ACA premium tax credits and the individual shared responsibil...
The Ever-Shrinking Pilot to Inform Consumers About Health Plans’ Network Size
The agency running the federal health insurance marketplace announced on September 30 they would pro...
Ch-ch-ch-ch-changes: Special Enrollment Periods Provide Essential Coverage During Common Life Transitions, but Many People Don’t Know They Exist
Change in life is unavoidable: people move, get married, change jobs and have babies. Special enroll...
CHIR Expert Sabrina Corlette Talks Marketplace Problems, Possible Solutions at Alliance for Health Reform Briefing
On Monday, September 26th, CHIR’s very own Sabrina Corlette spoke at a briefing on the future of A...
Hand-Wringing Over the Affordable Care Act Forgets How Very Far We Have Come
The latest round of news about insurance company exits and price increases in the Affordable Care Ac...
Increasing Deductibles in Employer Coverage: A Story Over a Decade in the Making
A graph has been making the rounds on the internet comparing cumulative increases in deductibles sin...
Quality Over Quantity? New Medicaid Network Adequacy Rules Illuminate Disparities Among Insurance Program Standards
Narrow network plans, or plans with a limited network of providers, present problems for consumers a...
Future of Children’s Health Coverage Series Brief #2: Rethinking Pediatric Dental Coverage
Inadequate coverage of children's dental health can lead to serious health problems and long-term co...
Want to Know Whether Your Health Plan’s Network is Narrow or Broad? You’ll Need to Wait Another Year
The Obama Administration has delayed a promised rollout of a new network size rating system on healt...
A “Volatile Marketplace”: Second Quarter Earnings Calls Offer Glimpse of How Insurers Are Faring on ACA Marketplaces—and What 2017 Might Bring
In a turbulent year for the Affordable Care Act, health insurers' second-quarter earnings calls and ...
New Report Recommends Policies to Promote Access to Affordable Prescription Drugs
Access to prescription drugs is critically important to millions of individuals and families nationw...
As Administration Reviews Comments on Short-Term Insurance Plans, Analysis Finds Gaps in Coverage
The Obama Administration is reviewing feedback on its proposed rule to clamp down on the sale of sho...
Stabilizing the Affordable Care Act Marketplaces: Lessons from Medicare
In the late 1990s, Medicare officials faced decisions by insurers to cancel nearly half of their Med...
The Proposed Update to the Premium Tax Credit Safe Harbor: A Solution in Search of a Problem?
In the waning days of the Obama Administration, Affordable Care Act regulations continue to trickle ...
New Commonwealth Fund Brief Examines Exclusions in Health Insurance Plans that Place Women’s Health at Risk
A new issue brief published by the Commonwealth Fund and authored by CHIR's newest faculty member, D...
Wisconsin’s Objection to Automatic Re-enrollment of Enrollees in Federally Facilitated Marketplaces
The administration recently issued a proposal to smooth renewals for consumers affected by insurance...
Announcing Our Newest Colleague: Dania Palanker Joins CHIR
We at CHIR are excited to announce the arrival of Dania Palanker, a nationally recognized expert on ...
As Health Market Consolidation Grows, So Do Prices
The Justice Department just stepped in to prevent two health insurance mergers. The health care mark...
State-Run SHOPs: An Update Three Years Post ACA Implementation
Small-business owners face unique challenges covering their employees; to lower barriers and increas...
New Health Affairs Policy Brief Examines the Regulation of Health Plan Provider Networks
Limited networks have become increasingly common on ACA marketplaces, comprising almost half of all ...
Factors Affecting Health Insurance Enrollment Through the State Marketplaces: Observations on the ACA’s Third Open Enrollment Period
Despite declining funding, enrollment through the state-based marketplaces increased nearly nine per...
The Sky is Not Falling: CHIR Expert Kevin Lucia Talks Trends in Coverage and Affordability on the ACA Marketplaces
On Friday, July 15, CHIR’s very own Kevin Lucia spoke at a briefing on ACA marketplaces put on by ...
State Legislators Conduct Post-Mortem on Affordable Care Act CO-OPs and Plot Next Steps
State insurance legislators held their national meeting in Portland, Oregon last week, and the demis...
Technology’s Impact on the Way We Access Health Care Continuing to Raise Questions
Technology is transforming how we access and receive health care through the use of telemedicine. As...
When Policy Isn’t Put Into Practice: State-Based Marketplaces Fail to Meet Goals of Standardizing Benefit Designs
As the federal insurance marketplace moves forward to standardize health plan benefit designs, what ...
Recent State Action: Are Formerly Vocal ACA Opponents Climbing on Board the Obamacare Bus?
As ACA opponents continue to vilify, challenge and undermine the law, four states that have been voc...
An Evolving Primary Care Model: Nurse Practioners, Physician Assistants are Gaining Autonomy, but Barriers Remain
Sixty million people in the U.S. lack access to primary care services, partly due to a shortage of p...
Obama Administration Announces New Strategies to Enroll Young Adults in Health Insurance, but Misses One Important Fix
The Obama Administration has announced several new strategies to boost enrollment among young adults...
Study: Medicaid Offers Stronger Cost Sharing Protections Compared with Marketplace Coverage
In the debate over Medicaid expansion, most of the attention has been on families in non-expansion s...
New Special Enrollment Confirmation Process Effective June 17, 2016: What it Means for Consumers
As of June 17, 2016, the federally facilitated market will require consumers who have enrolled into ...
California Moves Toward Offering Full Price Coverage to Ineligible Immigrants in its Marketplace
California will soon be requesting a waiver from federal officials that would enable the state healt...
You Don’t Know Who You Are Dealing With: Unscrupulous Broker Tries to Sell Us Short-Term Health Insurance
An insurance broker called a CHIR faculty member with a shady sales pitch for a short-term health pl...
Kaiser Family Foundation Survey on Assister Programs Reflects Signs of Progress – and Opportunities for Improvement
Assister programs and brokers play an integral role of navigating consumers through the marketplace ...
Comparing Nondiscrimination Protections under the ACA
HHS released the final Section 1557 rule, completing the suite of non-discrimination rules that cons...
Improving Marketplace Coverage for Children
What does coverage look like for children on the Affordable Care Act health insurance marketplaces? ...
Beyond UnitedHealthcare: How Are Other Publicly Traded Insurers Faring on the Marketplaces?
Two-and-one-half years in, how do we assess the success and stability of the Affordable Care Act's h...
Georgetown CCF Releases First in Series of Briefs on the Future of Children’s Health Coverage
Our Georgetown colleagues at the Center for Children and Families have released the first installmen...
Understanding Consumers’ Experience with Health Insurance: New California Report on Complaints Provides Insights
Earlier this month, the California Office of the Patient Advocate (OPA) released its first annual re...
The Next Stage in Health Reform
Health reform is entering a new stage. Going forward, federal and state policymakers must decide how...
Open Enrollment IV (OE4) is Just around the Corner: Things to Watch
While it seems like we just finished open enrollment, the next round for 2017 coverage is right arou...
Understanding ACA’s Coverage Gains: Welcome Mat Effect & State Marketplaces Keys to Success
How can we best understand the coverage gains under the Affordable Care Act? Researchers from Harvar...
New Rules on Special Enrollment Periods: What Do They Mean for Consumers and the Assisters Who Help Them?
What triggers a special enrollment period to allow someone to enroll on the individual market outsid...
CHIR Expert Testifies Before U.S. House Committee on Affordable Care Act “Alternatives”
Our very own Sabrina Corlette was invited back to the U.S. House of Representatives for the second t...
Taking a Look at ACA Non-Discrimination Rules: When Does Medical Management Cross the Line?
The ACA prohibits benefit limits and cost sharing that discriminate against individuals based on hea...
New Georgetown Report: Understanding the Consumer Enrollment Experience in the Affordable Care Act Marketplaces
A new report released by Georgetown CHIR researchers used call center data from the Assister Help Re...
The ACA is Helping Moms this Mother’s Day
A new Urban Institute study examines data from the National Health Interview Survey (NHIS) to analyz...
Obama Administration Delays Implementation of Star Ratings, Transparency Requirements for Marketplace Health Plans
On April 29, the Obama Administration signaled a phased-in approach to implementing the quality rati...
Major New Rule Seeks to Modernize & Improve Quality of Medicaid Managed Care
Last week the Centers for Medicare and Medicaid Services released a much-anticipated final rule on M...
NAIC Roundup: Catching Up on the Spring Meeting and Looking Ahead
The NAIC held its Spring Meeting earlier this month and looked at SEPs, balance billing, risk adjust...
One Way Insurers Could Improve Marketplace Risk Pools? Stop Cannibalizing Their Own Business
It’s starting to be as predictable as April showers. As soon as open enrollment for ACA health pla...
New Florida Law Protects Residents from Surprise Medical Bills
Florida is the latest state to enact legislation protecting its residents for unexpected medical bil...
HHS Study Shows Benefits of Shopping and Subsidies, but Costs Still a Concern
With health insurers' rate filings looming on the horizon, many are concerned we'll see proposed pre...
CHIR Expert Testifies Before U.S. House Education & Workforce Committee about Innovations in Health Care
On Thursday, April 14, CHIR's own Sabrina Corlette testified before the U.S. House of Representative...
Obama Administration Moves Forward with New Continuity of Care Protections—How Will They Affect Existing State Laws?
In the second of a two-blog series for the Commonwealth Fund, CHIR researchers Sabrina Corlette, Ash...
Post ACA, 3 Communities Respond to a Shifting Health Care Landscape for Newly Insured
There’s no question the ACA has been successful in reducing the number of uninsured. But what has ...
Telemedicine: Another Tool in the Toolkit to Meet Network Adequacy Standards?
Health plans have been increasingly narrowing their provider networks, raising concerns about gaps i...
Missouri’s Health Reform Assisters Triumph In Court
Health reform advocates experienced a win last month, when a federal court in Missouri struck down t...
15 States and DC Now Prohibit Transgender Insurance Exclusions
Three years ago, only 3 states and DC prohibited insurance companies from excluding care for transge...
Repeal of Small Business Provision of the ACA Creates Natural Experiment in States
Congress recently passed legislation allowing states to decide on the shape of the market for small ...
President Obama’s Budget Takes State-Level Debates over Surprise Out-of-Network Bills to National Policymakers
President Obama's 2017 budget includes a new proposal to help protect consumers from unexpected char...
Insurance Company Earnings Calls—A Useful Resource for Your Toolbox
The quarterly earnings calls of publicly traded health insurance companies can provide insights into...
Report Provides (Some) Insight on Network Adequacy as New Regulations Promise More
A new report from the Government Accountability Office (GAO) analyzes the relative adequacy of provi...
Tax Filing Preparation: FAQs in the Navigator Resource Guide
It’s tax time, so consumers are figuring out how to report their health insurance coverage as they...
As Self-Funding Increases in Popularity, Two States Step up to Address Potential Stop-Loss Policy Concerns
In the wake of the Affordable Care Act's insurance market reforms, policy experts have raised concer...
IRS Issues Guidance on Overlapping Medicaid and Marketplace Coverage
At last, the Internal Revenue Service has released guidance about what to do when a consumer has ove...
Not a Pretty Picture for Obamacare CO-OPs: 2015 Financial Losses Spike
The latest financial filings with the National Association of Insurance Commissioners show that 2015...
Final Rules Make Expanded Role Official for Some Navigators in 2018
When the administration finalized Marketplace regulations for 2017 and beyond earlier this week, it ...
Sharpen Your Pencils: One More Chance to Comment on SBC Changes
Last week, HHS, Treasury and Labor released a proposed revised template for the Summary of Benefits ...
A Roadmap For Getting Enrollment Right for Immigrant Families
The Affordable Care Act brought the promise of affordable coverage to many lawfully present immigran...
Healthcare.gov Changing Approach to Special Enrollment Periods, May be Bumpy Road for Consumers
The administration recently announced that it will require verifying documents from consumers with a...
States Innovation Waivers under the ACA: A Closer Look at the Updated Federal Guidance and State Proposals
Beginning in 2017, states can pursue "innovation waivers" under section 1332 of the Affordable Care ...
Commonwealth Fund Tool Demonstrates Effects of State Efforts to Expand Coverage and Improve Enrollment
The Commonwealth Fund has updated its interactive 50-state assessment of health system performance. ...
Obama Administration Creates a New Special Enrollment Period
This is the first year that the marketplace is denying financial assistance to individuals who faile...
Tax-related Information for Marketplace Consumers
While Old Man Winter barrels down on us with cold and snow, what better time to get your documents t...
2016 Federal Poverty Levels Are Out; What Does This Mean for the Marketplace and Medicaid?
Last week, updated federal poverty levels were published in the federal register. Our colleague Tric...
First Compliance Review Focused on Policies and Procedures, but a Better Approach Exists to Assess Health Plan Compliance
The administration recently published the results of its compliance review of health plans participa...
Little Known Provision Keeps Kids From Slipping Through Cracks Due to Differences in Eligibility Rules
For the most part, the ACA tries to align the ways that Medicaid and the health insurance marketplac...
Recent Guidance About Marketplace Residency Requirement and Special Enrollment Period When Moving
The administration recently issued guidance clarifying marketplace residency requirements and the sp...
2016 Insurer Participation Remains Stable in State-Based Marketplaces
In the wake of the high-profile closures and departures of some health plans from the individual mar...
A Look at Proposals for Improving Health Coverage Affordability
Welcome to 2016. With first votes being cast in the 2016 election cycle less than two weeks away and...
Enroll Before Jan. 15 for Feb. 1 Coverage and Other Open Enrollment Reminders
With open enrollment set to close in two week, enroll now before or on January 15 to get coverage by...
The Failure of the ACA’s Health CO-OPs: Lessons for Policymakers
The failure of 12 of the Affordable Care Act's CO-OP plans reveals much about the huge barriers faci...
Depressed Doctors and What Healthcare Payers and Providers Can Do
A recent study in the Journal of the American Medical Association found very high rates of depressio...
Proposed Mergers among Major Health Insurers: Context and Perspectives
Health plan consolidation has been in the news lately. The Department of Justice is reviewing propos...
Federal and State Policymakers Work to Ensure Continuity of Health Care for Consumers
Federal health insurance officials and the NAIC have recently put forward proposals to protect patie...
What About “Don’t Discriminate Against Sick People” Do You Not Understand?
Although it's a complicated law, there's one thing about the ACA that's not at all complicated: the ...
Deadline for January 1, 2016 Coverage Approaching: What to Do
The deadline for having health insurance starting on January 1, 2016 is quickly approaching. Consume...
NAIC Fall Meeting: As One Issue Winds Down, Another Rears Its Head
At the NAIC’s most recent meeting, two issues stood out: the long-coming Network Adequacy Model Ac...
Doctors at Your Service: An Appraisal of Direct Patient Contracting Practices
Out of frustration with insurance companies, physicians are increasingly turning to direct patient c...
Georgetown Experts Help States Weigh Solutions to Protect Consumers from Unexpected Medical Bills
As reports of patient encounters with unexpected provider bills continue to make headlines, state an...
No QHPs Comparable to CHIP, Says (Delayed) HHS Certification
The U.S. Department of Health and Human Services has finally released a long-awaited study comparing...
Filing Fee and External Appeals
One of the most significant consumer protections in the Affordable Care Act (ACA) is the right to ap...
Feds Propose Changes – and an Expanded Role – for Marketplace Navigators
A new proposed rule from the Obama Administration contains wide-ranging new requirements for insuran...
Paying for Miracles – The High Cost of Cures
It is every patient’s dream to hear the words, “You’re cured.” Yet the ability to cure can c...
State Efforts to Reduce Consumers’ Cost-Sharing for Prescription Drugs
High drug prices have been in the news lately, and consumers are bearing an ever-greater burden of t...
Shop to Renew During Open Enrollment
While many consumers with marketplace coverage will be eligible for automatic renewal, there are man...
Health Care Cost Considerations in Medical Education
Medical students are taught to care for the whole person. Shouldn't that include care for the patien...
Open Enrollment Begins, Kinks in the Cost Calculator Tool on Healthcare.gov and Other OE News
Open Enrollment 3 (OE3) is now underway and by all accounts, things are going smoothly. There are a ...
States Revisit Essential Health Benefit Requirements, but Have Little Data on Consumers’ Experiences
Federal Affordable Care Act rules require the states to revisit the standard scope of benefits for i...
Updated Navigator Resource Guide
CHIR is pleased to release an updated online Navigator Guide on Private Health Insurance and Health ...
Wondering What Marketplace Rate Increases Mean for Consumers?
The third open enrollment season for the Affordable Care Act's health insurance marketplaces begins ...
NAIC Wraps Up Recommended Changes to the Summary of Benefits and Coverage
The National Association of Insurance Commissioners wrapped up work on recommended changes to the Su...
Accessing Provider Directories and Formularies: CHIR Goes Sleuthing
We're counting down again to Open Enrollment 3 and this year, all health plans must make accessing p...
The Next Big Thing in Network Adequacy: The NAIC Model Act
In November, the National Association of Insurance Commissioners (NAIC) will finalize the Network Ad...
Who’s got the Best Crystal Ball? Estimates for 2016 ACA Enrollment
Experts and prognosticators have given widely different estimates for total enrollment through the A...
Half of the Uninsured are Eligible for ACA Coverage
A recent Kaiser Family Foundation reports finds that 49 percent of the remaining uninsured in our co...
Big Data and Baby Steps: Two Very Different Approaches to Data Collection
Most Americans see the need for more data about health insurance and how it’s working for consumer...
New Resource on Enrollment Now Available
As we draw nearer to the start of Open Enrollment 3, a new resource is available from the Centers fo...
Medicare Part D After Ten Years: Lessons for the Affordable Care Act
The year 2015 marks the 10-year anniversary of the Medicare prescription drug benefit program, known...
Post-Affordable Care Act Trends for Small Business Health Coverage: New Georgetown Report
The Affordable Care Act includes a number of market reforms affecting small business health insuranc...
The Experiences of State-Run Insurance Marketplaces That Use HealthCare.gov
Whether their exchange is state-based or federally facilitated, many state policymakers are seeking ...
Balance Billing for Air Ambulance Remains a Problem in Maryland
Although Maryland is among the handful of states that regulate balance billing for out-of-network si...
Why ACA Marketplaces Should Report Comprehensive Enrollment Data
The Affordable Care Act's new health insurance marketplaces could be critical sources of data about ...
The ACA Triggers Largest Decline in Uninsured since 1987: Now What?
U.S. Census data out last week shows that in 2014, the number of uninsured Americans declined by 8.8...
The Return of Proposals for Across State Lines Sale of Insurance: Still a Dumb Idea
It's like Groundhog Day. Every 2-4 years, politicians propose to allow the sale of insurance across ...
More than 400,000 Lose Marketplace Coverage: Let’s Fix This and Keep People Covered
This week federal officials released an updated marketplace enrollment report. While close to 10 mil...
Affordable Care Act Legislation Affecting Small Employers Sparks Rare Bipartisanship
Yesterday, the Health subcommittee of the House Energy and Commerce Committee had a hearing on H.R. ...
The NAIC’s Summer Meeting: Updating Network adequacy and ACA Transparency Requirements
The National Association of Insurance Commissioners (NAIC) has been hard at work updating a model st...
CMS Awards $67 Million to Assist Consumers with Accessing Coverage OE3 and Beyond
Last week the federal agency responsible for implementing the Affordable Care Act awarded $67 millio...
Consumer Assistance and Tools Needed to Ensure that All Eligible Marketplace Enrollees Get Cost-Sharing Reductions
A recent study has found that as many as 2.2 million people are missing out on Affordable Care Act c...
New Georgetown Report Calls for Harnessing of ‘Big Data’ for Better Health Plan Oversight and Consumer Protection
Last week the Obama Administration took a small step forward to implement Affordable Care Act transp...
Feds Take a Baby Step Forward on ACA’s Sunshine Rules
The Obama Administration has taken a step forward to implement long-delayed transparency provisions ...
How will Premium Rate Changes Affect Consumers’ Renewals into Marketplace Coverage? Lessons Learned from 2015’s Enrollment Season
As states finalize premium rates for marketplace plans by August 25, we'll know the extent of change...
A Look at the Latest Controversy Brewing over the ACA: The Annual Limit on Out-of Pocket Costs
The latest dust up in Washington is a fight between the Obama Administration and employer groups ove...
Getting Ready for OE3 – New Kaiser Family Foundation Survey Provides Helpful Lessons
We’re just 12 weeks away from the start of the third open enrollment period (OE3) for the Affordab...
CHIR Expert JoAnn Volk Joins Alliance for Health Reform Briefing on Empowering Health Care Consumers
Last week CHIR's JoAnn Volk served as a panelist on an Alliance for Health Reform briefing about emp...
New Report: The Experience of Six State-Based Marketplaces with First Year Renewals
A new report from CHIR researchers Sandy Ahn, Jack Hoadley and Sabrina Corlette revisits six state-b...
Proposed Premium Rate Increases for 2016: The Jury Is Still Out
There's been some hand-wringing over large proposed premium increases for health plans in 2016. But ...
Church Plans and Health Care Sharing Ministries: Different Entities, Different Consumer Protections
A provider association has recently heard from member physician offices about patients enrolled in "...
Supporting Health Plan Oversight: Consumer Organization Directory for State Regulators
In the wake of formal complaints that insurers are marketing health plans with discriminatory benefi...
Highlights on the FFM Approach for 2016 Open Enrollment
Hard to believe, but open enrollment for 2016 coverage is just four months away. As we get closer to...
CHIR Expert Sabrina Corlette Testifies before U.S. Senate Roundtable on Small Business Health Care
On July 7 the Senate Health Education Labor and Pensions Committee held a roundtable discussion abou...
Meeting Sustainability Challenges: A Useful Example for Insurance Regulators
State insurance regulators face the challenge of sustaining staffing levels achieved thanks to Affor...
CHIR Wishes Sally McCarty Well in Retirement
The faculty and staff of CHIR wish a fond farewell to their retiring colleague, Sally McCarty. Sally...
King v Burwell: An Exercise in Sound and Fury Signifying Nothing
In the wake of the Supreme Court's decision in King v. Burwell, our colleague at Georgetown Universi...
Changes to the Affordable Care Act’s Health Plan Summaries – and More to Come
The Affordable Care Act's Summary of Benefits and Coverage - standardized, easy-to-use summaries of ...
New Georgetown Report on State Approaches to Protecting Consumers from the Unexpected Charges of Balance Billing
A new report from Georgetown University researchers examines the phenomenon of surprise bills for ou...
Not One, Not Two but Three New Resources from CHIR: Small Business Health Plans in a Post-ACA World
There's been some renewed attention to the status and future of the small business health insurance ...
State Decisions on Allowing Mid-Sized Employers to Delay a Move to the Small-Group Insurance Market
Beginning in 2016, the Affordable Care Act requires states to change the definition of "small employ...
Telemedicine and its Effect on the Regulatory Landscape
Some states are making policies related to the emergence of telemedicine or the delivery of health c...
New Proposed Rules for Network Adequacy for Medicaid Managed Care Plans – Lessons Learned from Medicare & the Marketplaces
The Centers for Medicare and Medicaid Services (CMS) recently released draft regulations governing M...
New Guidance Clarifying Preventive Services under the Affordable Care Act
The Affordable Care Act requires most health plans to cover preventive services without cost sharing...
Celebrate or Condemn Enrollment Success? Affordable Care Act Critics Can’t Decide
Health care policy debates can often be confusing but the rapidly shifting positions in the latest t...
Rate Season Begins: Time to Find Out Who’s Up and Who’s Down for 2016
May 15th marks the official start of rate review season for health insurers' proposed 2016 premium r...
State-Based Marketplaces Look for Financing Stability in Shifting Landscape
State-based marketplaces created under the Affordable Care Act are contemplating their financial sus...
The Affordable Care Act’s State Innovation Waivers: A Need for Transparency and a Role for Stakeholders
Discussion of new "superwaiver" authority is a hot topic among many state and health policy circles....
Activity Afoot on Essential Health Benefits
Did you know states need to select their Essential Health Benefits (EHB) benchmark plan for 2017 in ...
Implementing the Affordable Care Act: State Regulation of Marketplace Plan Provider Networks
Narrow network plans were common on the health insurance marketplaces in 2014. In a new issue brief ...
New and Improved! The SEP for People Moving Out of the Medicaid Coverage Gap
Beginning this week, a new version of the change in income special enrollment period will take effec...
The Affordable Care Act: The Law Folks Love to Blame
The Affordable Care Act (ACA) can take credit for a historic reduction in the number of people unins...
Healthcare.gov Fixes System Glitch in Counting Social Security Income for Certain Tax Dependents
The Centers for Medicare and Medicaid Services (CMS) recently announced that they had fixed a techni...
New Web Video: CHIR Researchers Discuss Consumers’ ACA Coverage Experiences
In their latest web video, CHIR researchers JoAnn Volk and Sabrina Corlette discuss the findings fro...
3-Year Navigator Grants Will Provide Stability to Enrollment Assistance
The U.S. Department of Health & Human Services has published the first indications of where it inten...
CHIR Expert Testifies at Ways & Means Committee Hearing on the Affordable Care Act
The U.S. House of Representatives' Ways & Means Committee held a hearing on the individual and emplo...
New Georgetown Report: Assessing Consumers’ Experience with ACA Coverage through the Eyes of State Consumer Assistance Programs
While the ACA has successfully resulted in 16.4 million newly insured people, we don't yet know a lo...
The Affordable Care Act and Entrepreneurship
Recent media articles touted the news that Senator Ted Cruz was planning to sign up for health insur...
New Survey of Physicians Finds ACA Did Not Result in Influx of New Patients
A new report from the Robert Wood Johnson Foundation and Athenahealth finds that the newly insured u...
While All Eyes Are On Upcoming SCOTUS Decision, NAIC Work Continues
The NAIC Spring meeting tackled a number of ACA implementation issues important to consumers. JoAnn ...
Some Changes in Store for 2016 Health Plans that Affect Consumers
While open enrollment for 2015 has ended, insurers and marketplaces alike are gearing up for 2016 wi...
New Report Finds ACA Had Little Impact on Employer-Sponsored Health Plan Enrollment
A new report out from Mercer, a human resources consulting firm, finds that the Affordable Care Act'...
Health Plan Narrow Networks: Highlighting Transparency Deficiencies for Consumers
A recent conference hosted by the Robert Wood Johnson Foundation on health system transparency allow...
Final Rule on Wraparound Coverage as an Excepted Benefit
The Obama administration released a final rule providing the requirements for wraparound coverage to...
The Affordable Care Act CO-OP Program: Facing Both Barriers and Opportunities for More Competitive Health Insurance Markets
The recent financial troubles of some CO-OP plans created under the Affordable Care Act have sparked...
Confused about What Happens at Tax Time? FAQs on Penalties, Exemptions, Reconciliation, and SEPs
As part of a Robert Wood Johnson Foundation-funded project to help navigators and assisters in five ...
New to the Affordable Care Act, or Need a Refresher? ACA 101 Briefing Has What You Need to Know
A recent briefing hosted by the Alliance for Health Reform and the Kaiser Family Foundation offered ...
Latest in CHIR Video Series: Special Enrollment Opportunities for Affordable Care Act Coverage
More states are establishing new special enrollment opportunities to help people gain coverage throu...
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 relativel...
We Say Goodbye to a Visionary, Fighter and Friend
Faculty and staff at CHIR say goodbye to Andy Hyman, a champion for a health care system in which al...
The Latest on Special Enrollment Periods: An Assessment of State Approaches in 2014 and Update for 2015
Special enrollment is available to individuals who experience qualifying events allowing them to enr...
After a Slow Start, Federal Small Business Health Insurance Marketplace Offers New and Improved Functions
With intense focus on enrollment in the Affordable Care Act marketplaces, enrollment through the Sma...
Year One for the Shared Responsibility Payment: Taking a Closer Look at the Affordability Exemption
The current tax filing season, for the 2014 tax year, is the first in which consumers will need to i...
Critiquing the Performance as the Curtain Closes on OE2
The second open enrollment period (often called OE2) under the Affordable Care Act has come to its f...
Our Heartfelt Thanks to Affordable Care Act Navigators and Assisters – and a New Resource
We've wrapped up the Affordable Care Act's second open enrollment season and sign-ups exceeded expec...
Getting MAGI Right: Current Monthly Income Vs. Projected Annual Income
Under the Affordable Care Act, new rules for counting household size and income for purposes of Medi...
Some Insurers Cancel Noncompliant Health Plans, But Consumers Are More Informed of Coverage Options
The media furor over health plan cancellations in the wake of the Affordable Care Act has died down,...
Coverage that Falls Outside Affordable Care Act Protections: A Primer on “Excepted Benefits” and Short Term Health Insurance
As consumers shop for health insurance, many may be offered coverage, such as "excepted benefit" pla...
The Hidden Enrollment Weapon? What First-Year Experiences of Health Insurance Brokers Tell Us about Barriers and Opportunities for Their Engagement with the Marketplaces
Health insurance agents and brokers drove a significant portion of enrollment into the Affordable Ca...
New Premium Tax Credit Resource for Consumer Services Reps in State Regulatory Agencies
CHIR faculty who provide technical assistance to states through Robert Wood Johnson's State Health R...
What Difference do 10 Hours Make? What the Research Tells us About Shifting the Affordable Care Act Standard for Full Time Work from 30 to 40 Hours
Congress is debating controversial legislation to shift the Affordable Care Act's definition of full...
Understanding Federal Guidance on Reference Pricing: A New Primer from Georgetown’s Center on Health Insurance Reforms
Some employer health plans have begun to respond to dramatic differences in the cost of medical proc...
Workplace Wellness Programs in the News
Your employer may want to help you meet your New Year’s resolutions to lose weight or get fit by p...
Regulatory Activity in Two States Restricts How Plans Structure Specialty Drug Coverage
Two state insurance regulators, Florida and Montana, have taken recent regulatory action to address ...
Insurance Premium Surcharges for Smokers May Jeopardize Access to Coverage
While the ACA limits the power of insurance companies to charge higher prices to consumers based on ...
The First Tax Filing Season under the Affordable Care Act is Approaching: What Do Marketplace Consumers Need to Know?
The 2014 tax season will be the first time tax filers will have to report on their health insurance ...
Are People in Immigrant Families Gaining Coverage Under Health Reform?
Although we are in the midst of the second open enrollment period under health care reform, we still...
The Affordable Care Act’s Requirements for Quality Improvement in the Health Insurance Marketplaces: What Recent Federal Action Tells Us
The Affordable Care Act sets out several requirements for the health insurance marketplaces to encou...
Marketplace Coverage Renewals: Variation in State Approaches May Affect Consumers’ Finances
Auto-renewal through the health insurance marketplaces is an important mechanism for consumers to av...
Health Savings Accounts: Understanding the Basics
There are various routes to getting health insurance coverage for you and your family. One possible ...
MEC and MV: Keeping it All Straight When it Comes to Employer Plans
Open enrollment in the Health Insurance Marketplaces overlaps this year with many employer plan open...
Embedded Deductibles: Source of Consumer Confusion
Understanding how health insurance works can be confusing, particularly when it comes to deductibles...
Renewing Coverage under the ACA: Challenges and Opportunities for Federally Facilitated and State-based Marketplaces
December 15th marks the last day by which health insurance marketplace enrollees can actively renew ...
New Guidance on Re-enrollment in the Federally Facilitated Marketplace
On December 1, CMS published new guidance on the re-enrollment process for the federally facilitated...
State-Based Marketplaces Offer More Health Plan Choices for 2015 Coverage
One of the goals of the Affordable Care Act is to make health insurance more affordable and accessib...
HHS Proposes EHB Rule Changes
The federal Department of Health and Human Services recently published a proposed regulation that si...
New Content for the Navigator Resource Guide: Get Ready for Renewals
Last month CHIR released its Navigator Resource Guide, with background and close to 300 frequently a...
New Report on States’ Oversight of Health Plan Network Adequacy
The consumer representatives to the National Association of Insurance Commissioners (NAIC) released ...
A Busy November Weekend: Launch of OE2 and the NAIC Fall National Meeting
November 15th marks the start not only of open enrollment into the Affordable Care Act's health insu...
Consumers Should Resist the Urge to Do Nothing and Renew Coverage through the Federal Marketplace
Saturday, November 15th marks the start of open enrollment in the ACA's health insurance marketplace...
The Family Glitch Persists, Affordability Measure Increases to 9.56% in OE2
With open enrollment into the Affordable Care Act's health insurance marketplaces just around the co...
State Marketplace Approaches to Financing and Sustainability
While the Affordable Care Act provided significant start-up funds for the development of the new hea...
The ACA Hit List for the New Congress: A Prescription for Big Premium Hikes
The recent election brings us a new Congress and a new leadership dedicated to repeal of the Afforda...
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 "t...
New Online Resource Provides Answers to Common Health Insurance and Marketplace Questions
This week, CHIR is releasing an online version of the Navigator Resource Guide, with close to 300 se...
Raising the Curtain on Open Enrollment, Round Two
The second open enrollment period for the health insurance marketplaces, or OE2, is mere days away. ...
New “Halbig Provision” in Health Plan Agreements Poses Little Threat to Consumers
Insurers that sell coverage through the ACA’s federally facilitated marketplaces must sign a priva...
The Affordable Care Act and the End of Job Lock: Some Early Positive Signs
A little over a year ago, researchers at CHIR and the Urban Institute predicted a 1.5 million increa...
Strengthening the Summary of Benefits and Coverage as a Consumer Tool
The Affordable Care Act requires all insurers to provide a Summary of Benefits and Coverage (SBC) so...
Georgetown Navigator Technical Assistance Project: Lessons Learned and Recommendations for Future Enrollment
Georgetown University experts from the Center on Health Insurance Reforms and the Center for Childre...
Major Policy Changes Take a Backseat to IT During a Transitional Year for Health Insurance Marketplaces
As the health insurance marketplaces prepare for the second year of operation under the Affordable C...
Employer Coverage Remains Steady, But Long Term Trends Highlight Need To Strengthen All Forms Of Coverage
A recent study by the Kaiser Family Foundation finds that employer coverage is remaining steady, and...
Helping States Address Transparency of Health Plan Provider Networks
During the past few months, CHIR faculty have examined the proliferation of narrow provider networks...
Advocates File Civil Rights Complaint with HHS on Coverage Termination Day
Last week, on the day that 115,000 people who bought coverage in the federal marketplace lost that c...
Taking Stock and Taking Steps to Improve Consumer Assistance
A new report released by the Robert Wood Johnson Foundation and the Kaiser Family Foundation chronic...
Plan Cancellations Redux: Finally, an End to Pre-Existing Condition Discrimination?
Affordable Care Act watchers are bracing themselves for another round of health plan cancellations t...
Turf Battle or Promising Partnership? Understanding Marketplaces’ Responsibility to Offer Affordable Health Insurance
Local press in D.C. recently reported on a "turf battle" between the health insurance marketplace an...
New Issue Brief Reviews Employee Choice in Small Business Health Options Program (SHOP) Marketplaces
The Affordable Care Act (ACA) aims to improve access to health insurance coverage for small-business...
Major Minnesota Insurer Withdraws from State Marketplace: What Does it Mean for Consumers?
A major insurance company in Minnesota recently announced it would withdraw from the state's health ...
Question on Stand-alone Dental Plans and Upcoming Open Enrollment
With the change in weather, we're beginning to field questions related to the upcoming 2015 Open Enr...
We Can Fix This, People! More than Half of Uninsured Parents Are Hispanic
A recent Urban Institute study found that over half (57 percent) of uninsured parents are Hispanic. ...
Damaging House Bill Would Undo Health Reform Protections and Raise Small Business Premiums
The U.S. House of Representatives is debating legislation this week that would undermine consumer pr...
Do Nothing to Renew or Get an Updated Eligibility Determination? CMS Puts out Final Marketplace Renewal Rules
Last week the federal Centers for Medicare and Medicaid Services (CMS) published final rules for the...
Reforming State Regulation of Provider Networks: Efforts at the NAIC to Re-draft a Model State Law
Almost two decades ago, the National Association of Insurance Commissioners (NAIC) adopted a model s...
Consumer Assistance: Getting the Most Out of Limited Resources
While open enrollment is less than three months away, consumer assisters will have to do more with l...
The Next Frontier: Insurance Marketplaces That Promote Quality Improvement
While most state-based marketplaces in 2014 are rightly focused on the operational challenges of con...
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 c...
CHIR Launches First in Video Series: Coffee Conversations on Timely Health Insurance Topics
We at the Center on Health Insurance Reforms are excited to share the first of an upcoming video ser...
After Halbig: Considerations for States Revisiting the Option to Establish a State-Based Marketplace
A federal appeals court's ruling that premium subsidies aren't available for consumers who purchase ...
Summing Up Questions from Navigators: A Grab Bag of Consumer Queries
Though open enrollment into the new health insurance marketplaces is a distant memory and folks are ...
Decoding 2015 Health Insurance Rate Increase Requests
"The rates are coming, the rates are coming." The release of 2015 health insurance premium rates pro...
New Report Reviews State Action on Quality Improvement in State-Based Marketplaces
The Affordable Care Act envisions that the new health insurance marketplaces will encourage plans to...
All Enrollees Should Contact the Marketplace at Renewal
We're about 110 days away from open enrollment into coverage for 2015. In recent guidance, CMS has r...
Grace Periods for Failing to Pay Insurance Premiums: What Consumers Need to Know
On July 16 the Obama Administration published guidance for insurers in the federally facilitated mar...
ACA Days of Summer
It's getting to be a summer tradition: a new set of court decisions on the Affordable Care Act. This...
New Report on Key Lessons for LGBT Outreach and Enrollment under the Affordable Care Act
Today, Out2Enroll—a nationwide campaign dedicated to connecting LGBT people with their health insu...
Washington Eliminates Waiting Period for Transplant Coverage
Last week the state of Washington finalized rules banning insurers from imposing benefit-specific wa...
Enrolled in a Plan that Doesn’t Cover Your Prescription Drug: What Consumers Need to Know
One of the key consumer protections in the Affordable Care Act is the requirement that plans must ha...
New Report Finds that, Under the ACA, Consumers Nationwide Are Experiencing Improved Protections in the Individual Insurance Market
The ACA includes numerous consumer protections designed to remedy shortcomings in the availability, ...
Six Month Check-Up on Affordable Care Act
Washington DC's NBC affiliate wanted a status report on the Affordable Care Act, 6 months after full...
State Restrictions on Health Reform Assisters May Violate Federal Law
Regulations issued last month by the Department of Health and Human Services show that laws in more ...
Georgetown University Law Center Summer Program Promises Deep Dive Training on the Affordable Care Act
This July the Georgetown University Law Center's O'Neill Institute for National and Global Health La...
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...
SHOP Marketplaces for Small Businesses: State Design Decisions and Implications for Employers
The Commonwealth Fund recently hosted a one-hour webinar on the small business health insurance mark...
Changing Provider Networks In Marketplace Health Plans: Balancing Affordability And Access To Quality Care
While narrow provider networks are by no means new to health insurance, the practice has received re...
The Extended “Fix” for Canceled Health Insurance Policies: Latest State Action
In March, the Obama administration extended for two additional years a policy allowing states to per...
New Healthcare.Gov Screener Tool Needs Fixes to Avoid Confusing Consumers
Now that open enrollment into the new health insurance marketplaces is over, the only way people can...
Florida Complaint Should be Welcomed by Regulators and Advocates
A recent complaint filed with the U.S. Department of Health and Human Services’ Office of Civil Ri...
New Survey by Enroll America Provides Insights into ACA Implementation
A new survey commissioned by Enroll America helps us understand why some of the uninsured enrolled i...
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 ...
Final Rule on ACA’s Market Reforms Plugs a Loophole, but Questions Remain
The Obama Administration has finalized rules to protect consumers by regulating the marketing and sa...
New Rules Protect Navigators and Certified Application Counselors from Over-Reaching State Laws but Also Impose New Requirements
The Obama Administration has released final rules curtailing state laws that overly restrict the abi...
The Expatriate Health Coverage Act: Like “Using a Bat to Swat a Fly?”
Recent legislation passed by the U.S. House of Representatives attempts to fix a problem in the Affo...
Will Health Premiums Go Up or Down? Two New Resources Help Explain 2015 Rate Projections
We're starting to learn more about health insurance premium rates for 2015. Whether they go up, down...
Enrolled in Coverage That Just Got Harder to Use: Consumer Options When the Network Changes Mid-Year
Now that open enrollment is over, consumers are starting to raise questions about their coverage. On...
Back in the Day – Lessons from Pre-reform Days: Death to the Death Spirals
While we’re struggling with Affordable Care Act (ACA) issues, there’s value in taking the time t...
It’s Raining SEPs: New Administration Guidance on Special Enrollment Periods and What they Mean for Consumers
Just when you thought you had figured out all the possible special enrollment periods for coverage i...
New State-Based Marketplaces Unlikely in 2015, but Technology Challenges Create More Shades of Gray
It's decision time for states considering whether to transition to a state-based, partnership, feder...
It’s enough to make you loopy: inside the Kafka-esque world of Medicaid “loopers”
Remember the Medicaid loopers? These are people who applied for coverage through the health insuranc...
Changes in Census Survey Data Generate Misguided Criticism – Larger Census Survey will Remain Unchanged
The U.S. Census Bureau is implementing changes to the questions they ask on their Current Population...
Understanding Special Enrollment Periods, Part 2: Where does COBRA fit in?
How does COBRA fit into coverage options now that people who lose employer-sponsored coverage have o...
5M Fewer Americans Report Problems Paying Medical Bills, but Probably Not Because of the ACA (Yet)
Last week the CDC’s National Center for Health Statistics published a report documenting a decline...
Sebelius Will Be a Tough Act to Follow
Secretary Sebelius will soon be stepping down as head of the U.S. Department of Health and Human Ser...
Recommendations to Strengthen Navigator and Assister Programs
With the close of open enrollment in the new health insurance Marketplaces, it is a good time not on...
More New Resources Available to State Regulators
A set of new tools for state insurance regulators, as well as updated versions of some older resourc...
Who Gets Extra Time “In Line” and Beyond to Enroll in Health Coverage?
The Obama Administration is allowing extra time to enroll in the health insurance Marketplaces for p...
Two States on the Path to the Basic Health Program
Both Minnesota and New York are on the path to setting up a Basic Health Program (BHP) that will pro...
Florida’s ObamaCare Alternative: After 6 Years, is this the Best They Can Do?
Six years in the making, an insurance exchange finally opened last month in Florida, and it’s call...
Understanding Special Enrollment Periods, Part 1: A Look at Some Who Will be Out of Luck
Navigators have been fielding a range of questions. One that comes up repeatedly is whether an indiv...
A Limited Extension for Insurance Enrollment: Precedents from Part D
Recently, the Obama administration extended the enrollment period for people who've faced roadblocks...
New Tools to Help Consumers Compare Health Plans
One of the most difficult elements of enrolling in the new health insurance Marketplaces is plan sel...
People Who Have Tried to Enroll through HealthCare.Gov Get Extension Beyond March 31st
The Obama Administration has announced that consumers who've faced difficulties enrolling in the new...
New Issue Brief Examines Design of SHOP Marketplaces
SHOP marketplaces promise small employers features they say they want but typically have not been ab...
Consumer Services ACA Toolkit
CHIR faculty Sally McCarty, David Cusano, and Max Farris serve as technical assistance professionals...
Update on Fixed Indemnity Insurance: No Longer an ACA Loophole?
In recent rulemaking, the Obama administration attempts to close a potential loophole in the Afforda...
HHS Proposes to Preempt Some State Navigator Laws; Lays Out Federal Enforcement Framework
In a proposed regulation released Friday, March 14, the U.S. Department of Health and Human Services...
Shifting into Post-Enrollment Issues: Fielding New Questions from Consumers
As we approach the end of open enrollment into new coverage options under the Affordable Care Act, m...
Time for a Dental Check Up
One challenging question for families as they enroll in health insurance coverage on the new Marketp...
New Medical Loss Ratio Policy Means Consumers Will Receive Less in Rebates – But That’s OK
The Obama administration is proposing to provide insurers with temporary relief from an Affordable C...
Back in the Day — Lessons Learned from Pre-reform Days: Going “Old School” with Narrow Networks
While we’re struggling with Affordable Care Act (ACA) issues, there's value in taking the time to ...
READ THE FINE PRINT: A New Provision in BCBS of Mississippi Plan Could Mean Huge Unexpected Costs for Plan Enrollees
Blue Cross Blue Shield of Mississippi has included a new provision in its plan description that coul...
Help for Consumers Who Faced Marketplace Glitches
The Obama administration recently announced that the health insurance Marketplaces can offer consume...
Getting the most from your benefits: the ACA gives consumers new right to appeal a health plan denial
The ACA established new appeal rights for consumers facing a denial of a benefit or service from the...
Last Call for State-Based Health Insurance Marketplaces
There are reports that at least some formerly reluctant states are thinking of moving from a federal...
Federal Court Ruling Casts Doubt on State Power to Restrict Health Reform Navigators
In January, a federal court in Missouri became the first to rule on whether states have the legal au...
Narrow Networks Under the ACA: Financial Drivers and Implementation Strategies
The ACA's essential health benefits and metal tier coverage standards, guaranteed issue, and communi...
“For the first time in forever” women are now on more equal footing when it comes to health insurance
A recent news article chronicled worries that the disproportionate number of women signing up for th...
Halbig v. Sebelius and State Motivations to Opt for Federally Run Exchanges
A number of states recently filed amicus briefs in a court battle over whether federally facilitated...
How Do Updated 2014 Federal Poverty Level Thresholds Impact Medicaid, CHIP & Premium Tax Credit Eligibility?
The Administration recently released updated federal poverty level thresholds for 2014. With eligibi...
Want to Change Your New Marketplace Plan? Some New healthcare.gov Improvements Might Help
New improvements to healthcare.gov are making it easier for consumers to report life changes, correc...
New CBO Numbers: Cause for Controversy or Celebration?
The Congressional Budget Office's release of new numbers on the ACA's impact on employment sparked a...
Here’s the Latest on Mandate Exemptions
Now that 2014 is here, the ACA's individual mandate is in effect. In the last few months the Adminis...
New Report Finds that Most States Have Taken Some Action To Prepare For Major Components of the ACA
States have taken substantially varying actions to implement and enforce the Affordable Care Act’s...
Republican Health Proposal Likely Means Less Coverage, Higher Costs, Fewer Consumer Protections
A trio of Republican Senators have introduced legislation repealing the Affordable Care Act and deta...
How the “3 Rs” Contributed to the Success of Medicare Part D
Opponents of the Affordable Care Act are latching onto the law's "3Rs" (risk corridors, risk adjustm...
I Bought a Health Insurance Policy But Now I Want to Change It, Can I?
We're now a little more than halfway into open enrollment on the new health insurance marketplaces. ...
Federal Court Ruling: Navigator Laws Cannot Impose Additional Requirements on Navigators and Other Assisters in Federal Marketplace States
A federal court has decisively struck down a Missouri law requiring navigators and other consumer as...
The ACA: No Coverage for Biting Off Your Nose to Spite Your Face
Millions of people are enrolling in health insurance coverage, thanks to the ACA. But one congressio...
Relief – and New Options – for High Risk Pool Enrollees
High risk pool enrollees face particular challenges transitioning to new coverage when their coverag...
Helping People Select Insurance Coverage: A Tale of Two Programs
Shopping for and selecting a new health coverage plan can be challenging for many consumers. One gov...
The Affordable Care Act’s Disclosure Rules: Can They Improve Coverage, Raise Care Quality, and Cut Costs?
The Affordable Care Act is designed to expand access to affordable and adequate health insurance, im...
The ACA in 2014: Helping Consumers Transition to New Coverage
The start of 2014 marks the transition to new health plans that must meet ACA standards for adequacy...
Update: State Decisions on the Policy Cancellation Fix
Implementation of the President’s proposed fix for health insurance policy cancellations rests wit...
New Report Looks At Factors Leading to Medical Debt Among People With Insurance
The Kaiser Family Foundation—in collaboration with CHIR experts Kevin Lucia and Katie Keith—has...
2014 Brings New Protections for Consumers – and New Oversight Responsibilities for States
2014 brings sweeping new health insurance protections for consumers, but for those reforms to be rea...
Another Shift in Health Insurance Rules: Helping Consumers Keep Up
On the eve of the December 23 deadline to sign up for health insurance coverage, the Administration ...
How States are Simplifying Plan Choice in State-Based Marketplaces
Choosing the health plan that best meets your needs is no easy task, with much at stake in terms of ...
High Risk Pool Enrollees Get a Reprieve – and We Have Answers to What’s Next.
Last week the Administration announced plans to extend the Pre-existing Condition Insurance Plans (P...
Patience and Flexibility Needed as Those with New Insurance Start Using Health Care Services January 1
Now that healthcare.gov is finally working, attention is turning to challenges people might face as ...
Changing Health Plans, Changing Provider Networks: What They Mean for Consumers and How States Can Help
Did the President tell the truth when he told the American people: "If you like your doctor, you can...
Handling Premiums with Care in Medicaid, CHIP and the Marketplace
Connecting people with health coverage is a complicated process, and the last few weeks have demonst...
Studying for Final Exams and Signing up for Health Care: Answering Questions for Young Adults
Millions of college students traveled home last week for Thanksgiving and it's likely the Affordable...
Enrollment is Going Up and Costs are Going Down: Some Recent Good News for the Health Insurance Exchanges
The Thanksgiving weekend brought news for health care consumers to be thankful for. Healthcare.gov s...
One Step Closer to the Basic Health Program
The Basic Health Program was included in the Affordable Care Act to provide states with an alternati...
State Decisions on the Health Insurance Policy Cancellations Fix
Implementation of the President's proposed fix for health insurance policy cancellations rests with ...
New Resource for Assisters Covers Private Insurance and Marketplace Plans
Almost two months into open enrollment, Navigators and other consumer assisters must field a multitu...
As High Risk Pool Coverage Ends, Coverage Gaps Could Arise for Some Enrollees
As ACA implementation unfolds, one group that will be transitioning to new coverage is individuals e...
New Report Evaluates States’ Strategies to Stabilize Health Insurance Premiums and Build Sustainable Exchanges
The Affordable Care Act includes a range of health insurance reforms that will lead to health care c...
Health Affairs Podcast Delivers Lively Debate over ACA Implementation and the Prognosis for Reform
The latest Health Affairs podcast features CHIR's Sabrina Corlette and Bob Laszewski of Health Polic...
Energy and Commerce Subcommittee on Health Hearing Deals with ACA Policy Cancellation Issue
The House Energy and Commerce Subcommittee on Health held an oversight hearing yesterday, November 1...
Cancellation of Policies in the Individual Market: Apology Accepted, Mr. President – No Further Action Required
Last Thursday, the President apologized to those individuals currently covered under an individual p...
Beware a Rush to Judgment Based on Early Enrollment Numbers
The Obama Administration will soon release the first month enrollment figures for the new health ins...
Small Business and the ACA: Survey Debunks Opponents’ Claims
Many ACA opponents claim that the ACA will be a "job killer" and cause employers to drop coverage or...
Helping Consumers Understand their Coverage Options, from Coast to Coast
A massive consumer outreach and education effort is underway to help consumers understand their new ...
Under Pressure: An Update on Restrictive State Insurance Marketplace Consumer Assistance Laws
Seventeen states have enacted rules for health insurance marketplace navigators that could hinder th...
What CHIP Implementation Can Teach Us
The early problems with the ACA's health insurance marketplaces are frustrating. But if history is a...
House Ways and Means Congressional Hearing on ACA’s Website Woes Tackles Broader Policy Questions
The U.S. House of Representatives Committee on Ways and Means held an oversight hearing during which...
Policy Cancellations – Another Tempest in a Teapot?
One of the latest ACA story lines involves people with individual health insurance policies receivin...
It Wasn’t Me – HHS IT Contractors Shift Blame at Energy and Commerce Committee Hearing
The U.S. House of Representatives began the first in what is likely to be a series of oversight hear...
Back to Basics: A Reminder of What the ACA is all About
With the website for the ACA's health insurance marketplace off to a rocky launch, it can be hard to...
Update on Health Care Sharing Ministries: Exempted from the ACA’s Individual Mandate – and State Consumer Protections
The Obama Administration has asked health care sharing ministries to step forward to determine wheth...
Kaiser Report Finds More Than 5 Million Will Fall Into Coverage Gap Created by States Failing to Expand Medicaid
There's been a lot of talk lately about the technical problems with the new websites for the health ...
Health Affairs Podcast Discusses Early Enrollment Experience in the Health Insurance Marketplaces
The latest Health Affairs podcast discusses the significance of the early enrollment experience, fea...
Don’t Be Fooled – ACA Coverage is a Better Deal for Just About Everyone
Some are questioning the adequacy of health insurance on the new marketplaces. But such concerns neg...
Measuring ACA Enrollment: Lessons from Medicare Part D
The criticisms of the launch of the ACA's marketplaces continue to roll in, with some charging that ...
Clear the Path to the Federal Marketplace
Indiana, a state with a federally facilitated health insurance marketplace, is also home to health c...
How Does ACA’s First Week Compare to Medicare Part D’s?
The new health insurance marketplaces created under the Affordable Care Act had a bumpy launch this ...
PBS Program Looks at Early Experience in the Health Insurance Marketplaces
PBS' News Hour took a look at the early experience of the health insurance marketplaces, featuring C...
Health Insurance Exchanges Fulfill Both Liberal and Conservative Goals
Amid the controversial launch of the Affordable Care Act's health insurance marketplaces, it is not ...
Marketplace IT Glitches: The Sky Is Not Falling
The new health insurance marketplaces open for business today. In a blog originally posted on The Co...
Need Health Policy Basics? Help is Here
For those new to health policy, or even old hands that need a little brushing up, the Alliance for H...
The Multi-State Plans Unveiled
The U.S Office of Personnel Management has revealed the insurer behind the Multi-State Plan options ...
Answering Your Questions on Certified Application Counselors
Navigators, in-person assisters, and certified application counselors (CACs) have been getting a lot...
Delay the Individual Mandate? Why That’s a Bad Idea.
The Urban Institute has published a helpful analysis of proposals to delay the Affordable Care Act's...
Narrow Networks: Who’s Looking Out for Consumers?
Media outlets are reporting on a trend towards narrow network health plans offered through the Affor...
Attacks on Navigators Continue at House Energy and Commerce Committee Hearing
The U.S. House of Representatives' Energy and Commerce Committee held an oversight hearing to assess...
Message to Anti-ACA Bullies: Go Pick on Someone Your Own Size
Affordable Care Act opponents are using intimidation tactics to inhibit navigators from helping cons...
Only the Beginning — What’s Next at the Health Insurance Exchanges?
It's only 19 days to the launch of the new health insurance exchanges under the Affordable Care Act....
Navigators Should Not Let Politics Thwart Their Important Work
In yet another attempt in a very long line of efforts to delay or derail the health care law, member...
Waiting for Medicare: The ACA Will Help Fill the Gap
Until the Affordable Care Act is fully implemented, there are gaps in our system of health coverage ...
Health Plans Get Creative Skirting the ACA. And that Means Buyer Beware
You have to give them credit – health insurers are showing just how creative they can be at shirki...
The Affordable Care Act’s Early Renewal Loophole: What’s at Stake and What States Are Doing to Close It
The Affordable Care Act includes sweeping insurance reforms to improve the affordability and adequac...
Updates on Consumer Assistance: Navigator Grants and Training
Last week was a busy week for those focused on robust consumer assistance in the new health insuranc...
New Report on ACA Implications for State Network Adequacy Standards
The Affordable Care Act promises consumers a more comprehensive set of health insurance benefits, bu...
It’s Not Too Late – Options for Employers and Insurers to Limit Out-of-Pocket Costs For Consumers Beginning in 2014
A recent Administration decision allows employers and group health plans to delay an Affordable Care...
Delay of Certain Cost Sharing Limitations under the Affordable Care Act: What does it Mean?
This week the New York Times reported on an Administration decision to allow employers and group hea...
New Report on State Implementation of Essential Health Benefit Standard
As part of a Robert Wood Johnson Foundation-funded project to monitor implementation of the Affordab...
When One Young Person’s Life Took a Detour, the ACA Provided Help along the Way
An energetic college senior found himself on a life detour when he was diagnosed with stage 3 Hodgki...
A Story of Promise and Peril: OIG’s Review of the new CO-OPs
The Department of Health and Human Services' Office of Inspector General recently examined the progr...
New Report on State Approaches to Nondiscrimination under the Affordable Care Act
Today, CHIR released a new report exploring how private insurers and state regulators are incorporat...
Why Should Health Insurance Exchanges Drive Higher-Quality Health Care?
The Affordable Care Act requires the Qualified Health Plans (QHPs) participating in health insurance...
Shining a Light on Health Insurance: Senate Commerce Committee Examines Progress, Challenges
Health insurance is a complicated product that consumers have difficulty understanding, a common the...
What Do You Know About Health Care Sharing Ministries?
A number of states have acted in recent years to exempt health care sharing ministries from traditio...
Rate Review 2.0: The Next Generation
Last week the Administration released its final rule implementing the ACA's insurance market re...
Diane Rehm Show Takes a Look at Workplace Wellness Programs
The Diane Rehm show took a look this week at workplace wellness programs – what they are, how they...
Don’t Be Misled: Indiana’s Consumers Won’t Have to Pay $500 a Month for Health Insurance
Indiana officials are suggesting that people will have to pay an average of $500 per month for indiv...
Federal Agencies Answer Another Round of Questions on ACA Implementation
Yesterday three federal agencies released a set of Frequently Asked Questions about ACA implementati...
Welcoming New Arrivals to CHIR
We at CHIR are excited to announce the arrival of two new colleagues who will be helping us navigate...
How Will Families Fare with the Workplace Wellness Rule?
An often overlooked part of the workplace wellness rule is the application of "carrots and sticks" t...
NAIC Appoints Former Senator Ben Nelson as New CEO
The National Association of Insurance Commissioners (NAIC) has appointed former Senator Ben Nelson a...
Essential Health Benefits Final Rule: No Major Departures
The Administration released its final regulation on the Affordable Care Act's requirement that ...
RIP, PCIPs
On Friday, the Obama Administration announced that they were closing the Pre-existing Condition Insu...
Are the Wheels Coming off the ACA Wagon? History Suggests Not
There's been a lot of angst lately about strategic decisions by the Obama Administration to delay el...
Health Reform at Work: Lower Rates in New York State
Next year's premiums for individual market plans will be way down in New York thanks to the Affordab...
New Report Examines Early Indications of Insurer Participation and Competition in Health Insurance Exchanges
One of the key goals of the Affordable Care Act is to make health insurance coverage more affordable...
Final Regulations on Navigators, In-Person Assisters and Certified Application Counselors
It was another hot summer Friday for regulations with the release of the final rule on navigator and...
HHS Launches Outreach to Educate Public about Exchange Coverage; Unveils Name and Website for the Federal Exchange
With just under nine months to go until the open enrollment season begins on October 1, 2013, polls ...
Deeds Not Words: Senate Finance Committee Explores Health Insurance Exchange Progress
On Thursday the U.S. Senate Finance Committee held a hearing to examine implementation of the Afford...
The ACA’s Valentine to Veronica and Her Family: Peace of Mind
In this latest story in our ongoing series, funded by the Robert Wood Johnson Foundation, we look at...
FAQs and RFCs, Oh My!
Last week HHS issued another round of Frequently Asked Questions, addressing the Basic Health Progra...
ACA Reforms Free Up Entrepreneurs to Focus on Their Business
Entrepreneurs with dreams of venturing out to start their own business must now navigate a "wild we...
New Report: States Going Above and Beyond to Create Sustainable Exchanges and Deliver Choice and Value to Consumers
In a new report for The Commonwealth Fund, Sarah Dash, Kevin Lucia, Katie Keith, and Christine Monah...
Breaking Down the NAIC’s Comments
In comments to federal regulators on recent proposed rules, the NAIC added its voice to the chorus o...
Market Reforms Roundup: New Report on State Action on 2014 Market Reforms
In our most recent issue brief for the Commonwealth Fund, CHIR researchers studied the progress stat...
Multi-State Plan Program Final Rule: OPM's Balancing Act
The Office of Personnel Management recently issued a final rule on the multi-state plan program in w...
The “How To” Guide to the Federally Facilitated Exchange
Last week CMS released a set of instructions to insurance companies seeking to sell plans in the fed...
The Goldilocks Plan: Getting Benefit Design “Just Right” for Insurance Exchanges
Sabrina Corlette and Christine Monahan have co-authored an article in today's Health Affairs, "...
Health Insurance Reform under the Fiscal Cliff Agreement – Mostly Left Untouched
The health insurance provisions of the Affordable Care Act were largely off the table in the recent ...
Diving in on HHS' Recent FAQs on Preventive Services
HHS recently issued a new set of frequently asked questions designed to address some issues that hav...
Will New Laws in States with Federally Run Health Insurance Marketplaces Hinder Outreach?
Although the federal government will play a primary role in administering the navigator program in t...
An Unfortunate Decision on Student Health Plan Coverage
The Administration says it wants young and healthy people to enroll in the new health insurance exch...
Arming Navigators for the Millions of Enrollees Headed Their Way
With the fast approach to open enrollment for the new health insurance marketplaces, there is growin...
100 Days to “Launch”: What a Formerly Controversial Health Program Can Teach Us
On Sunday, June 23, there will be 100 days before the launch of the new insurance exchanges under th...
Evolving Dynamics of Health Insurance Exchange Implementation
Since the enactment of the Affordable Care Act, the roles of states and the federal government in es...
Figuring Out Premium Tax Credits
Amid debate about the cost of health insurance under the Affordable Care Act, our colleague at Georg...
As Self-Funding Remains Hot Topic in Press, States Begin to Take Action
Whether or not small employers will begin self-funding in greater numbers as the Affordable Care Act...
Florida’s Changes to Rate Review: Heading Backward?
Of the many consumer protection tools available to health insurance regulators, one of the most powe...
Navigator and Assister Training is Not a One-Shot Deal
The state-based and federally facilitated marketplaces have been busy recruiting and selecting navig...
Oh Where, Oh Where Are The Multi-State Plans?
More than two months after the deadline for health insurance issuers to submit applications for the ...
Final Rule on Workplace Wellness Programs: A Look at the Implications for Consumers
Employers are increasingly turning to workplace wellness programs with an eye toward improving emplo...
The ACA: Improving Incentives for Entrepreneurship and Self-Employment
Before the ACA, many people were hesitant to launch their own business because they feared losing th...
Using Rate Review to Make Health Insurance More Affordable: Once Again, Rhode Island Leads the Way
Rhode Island's insurance regulators are using their rate review authority in innovative ways to make...
Checking in on the NAIC: Work in Progress to Update Model State Laws to Comply with the Affordable Care Act
The National Association of Insurance Commissioners (NAIC) continues its work to support states' imp...
Reflections on Repeal Redux
Last week marked the thirty-seventh time that the House has voted to repeal the Affordable Care Act....
Breast Cancer Patient Had to Become a Fundraiser to Make Up for Insurance Plan Shortcomings
When Stacy Cook learned she had breast cancer, her health coverage fell short. In this latest story ...
In the Midst of “Rate Shock” Fears, Insurers Request Lower Rates in Oregon
An interesting thing happened in Oregon last week after the Division of Insurance publicly posted in...
Race to October: Health Insurance Marketplace Readiness
On May 7th, the National Institute for Healthcare Management Foundation hosted a webinar on state ma...
Helping Consumers Understand their New Health Insurance Options: CCIIO Releases Model Renewal Notice
This week CCIIO released new guidance and model language for insurers to use in communicating with c...
A Busy Week in Health Policy
While we have certainly seen some busy weeks for Affordable Care Act implementation, we had not expe...
News from the Feds: Latest Round of FAQs on ACA Implementation
In the last few days the federal government has released new guidance for insurance companies relati...
Taking Rate Review to the Next Level: New Report Examines Possible New Mechanisms to Bend the Cost Curve
A new report from Oregon examines the effect of that state's rate review program - and proposes inno...
Potential Costs and Challenges in Boston
With much of the country still reeling from the Boston marathon bombings, many of the victims, as we...
Consumer Assistance and Health Reform: Bridging the Gap
With open enrollment for the new health insurance marketplaces just around the corner, attention is ...
A Surprising Source of an Intra-Party Fight: The PCIPs
The U.S. House of Representatives is scheduled to debate the first major proposal in three years to ...
Emerging Policies on Dental Coverage for Kids
With the final rules on essential health benefits and market reforms now released, stakeholders have...
Senate HELP Hearing Examines Upcoming Market Changes Under ACA
Today Sabrina Corlette was called to provide testimony before the U.S. Senate's Health, Education, L...
Spring NAIC Meeting: Insurance Commissioners Take Houston
This past week marked the first of three national conferences for the National Association of Insura...
Exchange Plan Management: Updates from the Latest SERFF Meeting
The SERFF team held their 7th exchange plan management meeting with state and federal officials and ...
Factors Affecting Self-Funding by Small Employers: Views from the Market
In our most recent report, Kevin Lucia, Christine Monahan, and Sabrina Corlette assess attitudes tow...
New Guidance: Federal Regulators Allow “Collaborative Arrangements” for Enforcement
On March 15, 2013, federal regulators released guidance on how the Affordable Care Act's new market ...
Vermont’s Rate Fillings: What Do They Mean for Consumers?
On Monday, Vermont became the first state to release preliminary rate filings for plans to be sold i...
Diving Deep on Two New Rate Studies
With the Affordable Care Act’s most significant reforms going into effect in 2014, attention has i...
Missing the Point: Department of Labor’s Annual Report on Self-Insurance
On April 1, the Department of Labor released its annual report to Congress on Self-Insured Group Hea...
Paying for Value, By the Numbers
Everyone likes to talk about paying for value, but how is it being implemented in the real world? Sa...
Some States Consider Nondiscrimination Requirements
In implementing the Affordable Care Act, state regulators may increasingly look for ways to ensure t...
Ready for Reform?
On the third anniversary of Affordable Care Act implementation, significant reforms have been set in...
Beware the Latest Loophole
As significant an impact as the Affordable Care Act will have on the U.S. health insurance market, ...
NAIC Tackles Consumers’ ACA Questions: Subgroup Prepares Educational Materials for State Departments of Insurance
The National Association of Insurance Commissioners is developing a set of materials to help educate...
Building the New Insurance Marketplaces: Future of One State-Based Exchange Threatened
Planners in the District of Columbia have unanimously approved a proposal to ensure the long-term vi...
Essential Health Benefits in the States: Selections Have Been Made but Questions Remain
In our most recent issue brief for the Commonwealth Fund, Sabrina Corlette and CHIR colleagues exami...
Consumer Representatives Issue Recommendations for Sweeping Insurance Reforms Under the Affordable Care Act
On August 11, 2012, the consumer representatives to the National Association of Insurance Commission...
Putting the “Quality” in “Quality, Affordable Health Care”
As exchange watchers count down to the December 14th deadline for states to officially choose a stat...
Health Reform on the Campaign Trail
With much attention focused on this week’s Republican National Convention, Katie Keith dives in to...
New Developments in the Stop-Loss Debate
The debate over the sale of stop-loss insurance to small employers is a hot topic among health polic...
We Attend SERFF Meetings…So You Don’t Have To!
As the National Association of Insurance Commissioners meeting kicks off in Washington DC this week,...
Action on Multi-State Plans, But Still No Specifics
Last week the U.S. Office of Personnel Management (OPM) released its draft application for Multi-Sta...
Skip the Seconds and Take a Look at the Workplace Wellness Rules
Last week the Obama Administration released new, proposed rules on workplace wellness programs that ...
Pass the Stuffing: There's a lot going on in the new essential health benefit rules
Last week the Obama Administration released new, proposed rules establishing minimum standards to im...
Health Reform on the Campaign Trail – Obama's Blueprint
With the release of President Obama's plans for a second term in office, JoAnn Volk takes a loo...
State of the States: Choosing an Essential Health Benefits Benchmark Plan
To help make coverage more comprehensive, the Affordable Care Act (ACA) requires insurers to cover a...
Summary of Benefits and Coverage: Helping Consumers Shop for Health Insurance
As of September 23, consumers will begin to receive a new summary of benefits and coverage form that...
Using Rate Review to Address Affordability of Coverage: Efforts in the States
A handful of states are taking innovative approaches to the regulation of health insurance premium r...
Waiting for 2014: One Family's Story
Thanks to the support of the Robert Wood Johnson Foundation, CHIRblog will feature profiles of every...
Taking a Closer Look at Implementation of the ACA’s Insurance Reforms
As stakeholders wrap up their comments on ACA proposed rules published last month, JoAnn Volk takes ...
New Study Finds that Improved Coverage for Young Adults Has Increased Access to Care
A new study in the journal Health Affairs finds that the ACA's dependent coverage provision has...
The Top Three Questions on Multi-State Plans
With the deadline looming for comments on the Office of Personnel Management's (OPM) recent pro...
New Report Finds Patients Pay for Confusion Over Colonoscopy Screening
Today, the Kaiser Family Foundation—in partnership with CHIR, the American Cancer Society, and the...
NAIC – Moving Forward on Consumer Protections in the ACA
The National Association of Insurance Commissioners (NAIC) is moving forward with model state laws t...
Everything You Need to Know from This Week’s National NAIC Meeting
The National Association of Insurance Commissioners (NAIC) held its annual summer meeting in Atlanta...
First Public Meeting of New NAIC Working Group on Regulatory Alternatives to the ACA
On November 16, state regulators and interested parties held the first public meeting of the NAIC�...
New Report Adds Insights to Debate on Whether Florida Should Exercise Medicaid Option
Our colleagues at the Center for Children and Families are out with a new report analyzing the impac...
CCIIO Releases New Exchange Blueprint
States have consistently asked for more guidance from the federal government on health insurance exc...
Martin Addie: ACA Ban on Lifetime Limits Has Ended His Coverage Circus
Continuing our “Real Stories, Real Reforms” series, CHIRblog presents our third profile of every...
CHIR Faculty Member Mila Kofman Takes Helm of D.C. Insurance Exchange
Our friend and CHIR colleague, Mila Kofman, has been named the Executive Director of the health insu...
The House Energy and Commerce Committee Debates ACA Implementation
The House of Representatives Energy and Commerce Committee held a hearing on December 13 to discuss ...
State of the States: Minnesota, New Mexico, and Virginia
On August 9, 2012, the Robert Wood Johnson Foundation released three new reports prepared by the Urb...
The ACA and the Supreme Court: What’s Next for States and the Federal Government?
While many will be focused on the drama of the November election, Katie Keith discusses the need for...
Welcome to CHIRblog!
Welcome to CHIR's new blog - we’re excited to introduce ourselves and launch a new forum to s...
State of the States: Trends from 10 Key States
Today, the Robert Wood Johnson Foundation released four new cross-cutting reports prepared by the Ur...
New Issue Brief on State Action to Promote Child-Only Coverage
Today, the Commonwealth Fund released a new issue brief from CHIR on the availability of child-only ...
Get Ready for the Rulemaking!
The election results mean full steam ahead with implementation of the Affordable Care Act. The ultim...
The Medical Loss Ratio Rule – Report Highlights Savings for Consumers
A recent study documents major savings for consumers, thanks to the ACA's medical loss ratio ru...
The Results are In: Now What?
With the fundamental direction of health policy in our country on the line, Americans across the cou...
Leadership and Staffing Changes at CCIIO
As HHS races against some incredibly tight deadlines between now and January 1, 2014, we've no...
CHIR Proud to Welcome New Faculty Member, Sarah Dash
CHIR - and CHIRblog - are excited to welcome a new member to our team! Allow Kevin Lucia to introduc...
State of the States: California and Colorado Identify EHB Benchmark Plans
Last week, California became the second state in the nation to pass legislation adopting its essenti...
Revisiting CHIR's Across State Lines Report Post-Debate
The Affordable Care Act played a prominent role in last night’s presidential debate and those that...
The Impact of Laws to Allow Cross-State Sales of Health Insurance: Few Benefits, Potential Risks for Consumers
Although proposals to allow the sale of health insurance across state lines are believed to help con...
More Detail on Multi-State Plans from Proposed Rules
The Office of Personnel Management has released new information about the Multi-State Plan Program, ...
Waiting for 2014: One Family's Story
Continuing our "Real Stories, Real Reforms" series, CHIRblog presents our second profile of everyday...