Kentucky Drops Adult Dental Care from State’s Essential Health Benefits Benchmark Plan Submission
The 2025 Notice of Benefit and Payment Parameters gave states the flexibility to require adult denta...
Posts tagged with: essential health benefits
Blog Posts:
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...
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...
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...
Proposed 2025 Payment Rule: Marketplace Standards And Insurance Reforms
Last month, the Biden administration proposed changes to Affordable Care Act (ACA) Marketplace polic...
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...
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...
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...
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...
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 ...
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: What Does My Marketplace Plan Cover?
Enrolling in coverage on the marketplace requires comparing different health plans and decide which ...
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 Does My Plan Cover?
With Open Enrollment now well underway, consumers are weighing their options for 2021 and trying to ...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
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...
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...
What Makes Covering Maternity Care Different?
The United States has a higher maternal mortality rate than any other developed country, but federal...
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...
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...
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...
Repealing The ACA Could Worsen The Opioid Epidemic
As our country grapples with an “unprecedented opioid epidemic,” Congress is taking steps to tak...
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...
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...
Comparing Nondiscrimination Protections under the ACA
HHS released the final Section 1557 rule, completing the suite of non-discrimination rules that cons...
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...
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...
Activity Afoot on Essential Health Benefits
Did you know states need to select their Essential Health Benefits (EHB) benchmark plan for 2017 in ...
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...
HHS Proposes EHB Rule Changes
The federal Department of Health and Human Services recently published a proposed regulation that si...
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 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...
Washington Eliminates Waiting Period for Transplant Coverage
Last week the state of Washington finalized rules banning insurers from imposing benefit-specific wa...
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...
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 ...
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...
Time for a Dental Check Up
One challenging question for families as they enroll in health insurance coverage on the new Marketp...
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...
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...
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...
Policy Cancellations – Another Tempest in a Teapot?
One of the latest ACA story lines involves people with individual health insurance policies receivin...
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...
Narrow Networks: Who’s Looking Out for Consumers?
Media outlets are reporting on a trend towards narrow network health plans offered through the Affor...
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...
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...
Rate Review 2.0: The Next Generation
Last week the Administration released its final rule implementing the ACA's insurance market re...
Essential Health Benefits Final Rule: No Major Departures
The Administration released its final regulation on the Affordable Care Act's requirement that ...
FAQs and RFCs, Oh My!
Last week HHS issued another round of Frequently Asked Questions, addressing the Basic Health Progra...
Breaking Down the NAIC’s Comments
In comments to federal regulators on recent proposed rules, the NAIC added its voice to the chorus o...
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...
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...
Emerging Policies on Dental Coverage for Kids
With the final rules on essential health benefits and market reforms now released, stakeholders have...
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 ...
Some States Consider Nondiscrimination Requirements
In implementing the Affordable Care Act, state regulators may increasingly look for ways to ensure t...
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...
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...
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...
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...
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 ...
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�...
Get Ready for the Rulemaking!
The election results mean full steam ahead with implementation of the Affordable Care Act. The ultim...
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...
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...