Folder with close up on the word claims and a note where it is written under investigation. Concept of insurance fraud, 3d Illustration

Almost 180 million people obtain health coverage through private individual or group health plans. This market has experienced far-reaching reforms in the wake of the 2010 Affordable Care Act (ACA) and its implementing regulations.

While the ACA has helped expand insurance to millions of people, and given millions more peace of mind that they will be able to access comprehensive insurance when they need it, consumers consistently rank high and rising health care costs as one of their top concerns, and the primary reason many people do not have insurance coverage is due to lack of affordability.

Federal and state policies towards health insurers and health insurance markets continue to rapidly evolve, requiring thoughtful and timely policy research and analysis to aid federal and state policymakers, the media and consumer and patient advocates in implementation.

The Center on Health Insurance Reforms is engaged in insurance market research to support policymakers’ understanding of how federal and state policies affect insurance coverage access and affordability.

Research projects include:

With generous support from the Robert Wood Johnson Foundation, the Center on Health Insurance Reforms is engaged in a “Rapid Response” project, an ongoing series of timely issue briefs, blog posts and other analyses to address emerging issues relating to private health insurance and insurance markets.

With support from Arnold Ventures, CHIR experts conducted a first-ever 49-state survey of state employee health plan administrators and delved into their structure, organization, and cost containment efforts. For CHIR’s report on state employee health plan cost containment, click here. For CHIR’s interactive maps displaying the survey data, click here.

In partnership with the Urban Institute, CHIR also supports a comprehensive monitoring and tracking project to assess the impact of federal health insurance reforms in the states.

With support from the National Institute for Health Care Reform, CHIR experts have studied how private insurers and employer-purchasers respond to provider market consolidation and the resulting upward pressure on prices. CHIR experts are also assessing the effectiveness of policy initiatives to improve access to primary care for underserved populations. To access our case studies and reports for the consolidation project, please visit our page, Assessing Responses to Increased Provider Consolidation. The case studies and reports for our primary care project are published in partnership with the Milbank Memorial Fund and are available here.

Funding from the California Health Care Foundation supports CHIR experts studying California’s progress on enforcing the Mental Health Parity and Addiction Equity Act for California consumers, with a look towards ways to strengthen the state’s approach and provide lessons for other states.

West Health supports CHIR experts studying facility fees charges and coverage in the commercial insurance market, and current and potential legislative and regulatory action related to facility fees in this sector. For CHIR’s report and issue brief on state regulation of outpatient facility fee billing, click here.

With support from The Leona M. and Harry B. Helmsley Charitable Trust, CHIR experts are studying how private health insurance coverage and the regulation thereof impacts people living with insulin-requiring diabetes, with a focus on type 1 diabetes.

All reports and issue briefs under the project are available on the Publications section of our website.