Standards for Provider Network Adequacy in Medicaid and the Marketplaces

The Centers for Medicare & Medicaid Services (CMS) has issued final rules for provider network adequacy in Qualified Health Plans (QHPs) offering coverage in the Marketplaces that the federal government operates through HealthCare.gov. Under these rules, which come with the snappy title, “Notice of Benefit and Payment Parameters” and the even snappier initialism (NBPP), CMS […]

Updated Breast Pump Coverage Guidelines Provide Important Protections for Families But More Guidance May Be Needed to Increase Access

By Christine Monahan As a new mom to a seven-month old (hi Baxter!), I’ve been on a crash course in breastfeeding since he was born. I’ve quickly learned that breastfeeding isn’t easy and, despite the claims, it isn’t free. And I better understand why so few families meet the American Academy of Pediatrics (AAP) recommendation to feed infants only breastmilk for their […]

More Children Enrolled in ACA Marketplace Coverage in 2022, But Marketplaces Still Remain Modest Source of Health Coverage for Children

Medicaid and the Children’s Health Insurance Program (CHIP) currently cover more than 40 million children.  In comparison, relatively few children rely on the marketplaces for their health coverage.  But new data released by the Centers for Medicare & Medicaid Services (CMS) show 1.3 million children were enrolled in marketplace plans during the 2022 Marketplace Open […]

Build Back Better Act: Health Coverage Provisions Explained

On November 19, 2021, the House of Representatives passed the Build Back Better Act, the budget reconciliation bill, with the Senate expected to consider the legislation in coming weeks. The Build Back Better Act includes numerous provisions that would dramatically strengthen and expand both public and private health insurance coverage. Some of the new provisions […]

Three New State-Based Marketplaces Are Up and Running

By Rachel Swindle We’re a week into Affordable Care Act (ACA) marketplace open enrollment, and it looks like the three newest marketplaces, Kentucky, Maine, and New Mexico, are off to a solid start. These three states successfully transitioned this year from the federal marketplace platform, HealthCare.gov, to a full state-based marketplace (SBM). They join fourteen other states and the District […]