Explainer: The Medicaid and Marketplace Provisions of the Budget Reconciliation Bill
With the recent signing of H.R. 1, many may be wondering what this means for their Medicaid and Mark...
Posts tagged with: health insurance marketplace
Blog Posts:
A Setback, Not a Defeat: Our Work to Ensure Access to Affordable, High Quality Health Care Continues
President Trump’s signature on H.R. 1, the budget reconciliation bill, will lead to upwards of 17 ...
Explore the Data: Interactive Map of Dental Coverage Through the Marketplaces
Dental coverage offered through the ACA Marketplaces is constantly changing. Building on CHIR’s 20...
Testimony of Sabrina Corlette, J.D. before the U.S. House of Representatives Ways & Means Health Subcommittee – June 25, 2025
The U.S. House of Representatives’ Ways & Means Health Subcommittee recently held a hearing about ...
Early 2026 Rate Filings Show Marketplace Policy Changes Contribute to Eye-Popping Rate Increases
This year, insurers are setting their rates for 2026 while Congress and the administration weigh sev...
Second Verse, Same as the First: Senate Reconciliation Language Failes to Fix Paperwork Burdens, Other Barriers to Marketplace Coverage
With the passage of H.R.1, the House of Representatives’ version of the budget reconciliation bill...
May Research Roundup: What We’re Reading
In May, we welcomed spring blooms and warm weather, while staying engaged with the latest health pol...
Federal Efforts Ostensibly Aimed at Marketplace “Fraud” Ignore Obvious Strategies to Counter Broker Misconduct
The proposed Marketplace Integrity rule and House-passed budget bill purportedly aim to curb ACA fra...
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...
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: State Insurance Departments and Marketplaces
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...
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
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
CMS recently finalized a change in the 2025 Notice of Benefit and Payment Parameters, granting state...
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...
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...
State Spotlight: The Use Of Provider-Based Reference Pricing In Oklahoma And South Carolina
Like other employer health plans across the commercial insurance market, state employee health plans...
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...
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...
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...
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...
August Research Roundup: What We’re Reading
More hot days mean more hot research! This month we read about the growing divergence between Medica...
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...
Enforcing Mental Health Parity: State Options to Improve Access to Care
The 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) is the primary federal law protectin...
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...
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...
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...
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...
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...
What’s New for 2024 Marketplace Enrollment?
The annual open enrollment period for Affordable Care Act (ACA) Marketplace coverage kicks off Novem...
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 ...
July Research Roundup: What We’re Reading
CHIR’s summer reading list includes the latest health policy literature. In July, we read about th...
May Research Roundup: What We’re Reading
April showers bring May flowers, and May was abloom with health policy research. Last month, we read...
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...
January Research Roundup: What We’re Reading
Welcome to another year of health policy research. In the first month of 2023, CHIR reviewed studies...
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: 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...
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...
August Research Roundup: What We’re Reading
For the August edition of our monthly research roundup, CHIR said farewell to summer by reviewing th...
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...
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...
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...
January Research Roundup: What We’re Reading
In our newest monthly roundup of health policy research, CHIR’s Emma Walsh-Alker reviews studies o...
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: 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 ...
November Research Roundup: What We’re Reading
For November’s monthly roundup of new health policy research, CHIR’s Emma Walsh-Alker reviewed s...
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 ...
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 ...
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 ...
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...
May Research Roundup: What We’re Reading
With another month comes a new crop of health policy research. This May, Nia Gooding reviewed studie...
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...
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...
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...
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...
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 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...
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...
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. ...
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...
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 ...
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...
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 ...
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 ...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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 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...
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 ...
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...
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 ...
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...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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 ...
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...
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...
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...
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...
Total Cost Estimators: Lessons from the ACA’s Marketplaces
CHIR researchers Justin Giovannelli and Emily Curran interviewed more than 40 marketplace officials,...
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...
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...
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 ...
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...
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 ...
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...
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...
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...
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 ...
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...
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...
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 ...
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 ...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
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...
Shop to Renew During Open Enrollment
While many consumers with marketplace coverage will be eligible for automatic renewal, there are man...
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...
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 ...
Why ACA Marketplaces Should Report Comprehensive Enrollment Data
The Affordable Care Act's new health insurance marketplaces could be critical sources of data about ...
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...
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...
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...
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 ...
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...
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...
State-Based Marketplaces Look for Financing Stability in Shifting Landscape
State-based marketplaces created under the Affordable Care Act are contemplating their financial sus...
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 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...
Health Plan Narrow Networks: Highlighting Transparency Deficiencies for Consumers
A recent conference hosted by the Robert Wood Johnson Foundation on health system transparency allow...
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...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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. ...
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...
Helping States Address Transparency of Health Plan Provider Networks
During the past few months, CHIR faculty have examined the proliferation of narrow provider networks...
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...
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 ...
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...
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...
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, ...
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 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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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. ...
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...
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 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...
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 ...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
Navigator and Assister Training is Not a One-Shot Deal
The state-based and federally facilitated marketplaces have been busy recruiting and selecting navig...
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 ...
Race to October: Health Insurance Marketplace Readiness
On May 7th, the National Institute for Healthcare Management Foundation hosted a webinar on state ma...
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...
Consumer Assistance and Health Reform: Bridging the Gap
With open enrollment for the new health insurance marketplaces just around the corner, attention is ...
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...
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...
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...