Marketplace
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The Medical Loss Ratio Rule – Report Highlights Savings for Consumers
By Sabrina Corlette, Center on Health Insurance Reform The Commonwealth Fund recently released a study evaluating insurers’ responses to the medical loss ratio (MLR) rules under the Affordable Care Act. The study’s authors found that the MLR has resulted in a total of $1.5 billion in savings from reducing insurers’ administrative costs and rebates for consumers. The MLR, often…
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Essential Health Benefit Regs Invite Comment, Provide New Info on Habilitative Services and Cost-Sharing
By Joe Touschner As we noted just before Thanksgiving, HHS recently proposed regulations on essential health benefits (as well as cost-sharing and actuarial value). A few new developments are noted below, but the most important aspect of the rule is its opportunity for comment. Included with the rule is a proposed set of essential health…
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New Development in the Stop-Loss Debate
By Christine Monahan, Center on Health Insurance Reforms There is a lot of talk around Washington, D.C. these days about whether or not more small employers will self-fund their employee’s health coverage with implementation of the Affordable Care Act – and, if they do, how this could impact the fully-insured small group market (including the…
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HHS Proposes Official Essential Health Benefit and Insurance Market Regulations
By Joe Touschner While HHS outlined its approach for setting Essential Health Benefits in a Bulletin nearly a year ago, we’ve been waiting for federal regulations to make things official. This week, those regulations were proposed. The Department has posted info on the regs at these links: EHB Fact Sheet EHB Proposed Rule We’re still…
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If You Build It Will They Come? Outreach Lessons from CHIP
Editor’s Note: This blog post originally appeared on the State Refor(um) By Carla Plaza, National Academy for State Health Policy (NASHP) If you build it will they come? If history repeats itself, they will, but not without intentional, focused efforts to reach, assist and enroll individuals and families into health care coverage. Prior to the…
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Affordable Care Act’s Ban on Lifetime Limits Has Ended Martin Addie’s Coverage Circus
By Joanne Volk, Center on Health Insurance Reforms What would you do if you had a health care condition that required regular, costly care your whole lifetime? You’d probably be sure you had uninterrupted health coverage so you could get the care you need without bankrupting your family. For tens of millions of Americans like…
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Eligibility and Enrollment Systems: An Advocate’s IT Toolkit
Efforts to improve public coverage programs have long been stymied by the prevalence of outdated IT systems that are the source of numerous consumer issues from confusing and conflicting notices to lost eligibility records to inadequate data to measure program performance. Meanwhile the state of technology and web-based services has advanced significantly, leaving many Medicaid…
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Eligibility and Enrollment Systems: An Advocate’s IT Toolkit
Efforts to improve public coverage programs have long been stymied by the prevalence of outdated IT systems that are the source of numerous consumer issues from confusing and conflicting notices to lost eligibility records to inadequate data to measure program performance. Meanwhile the state of technology and web-based services has advanced significantly, leaving many Medicaid…
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Countdown Clock Toward 2014 is Ticking (No More Timeouts)
The Affordable Care Act is the law of the land – even House Speaker John Boehner affirmed that point in an interview with Diane Sawyer on ABC Nightly News. The countdown clock on implementation is ticking and there are no more time outs left. States need to move full speed ahead to beat the clock…
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The Election Results Are In: Now What Happens with the Affordable Care Act?
(Editor’s Note: We welcome Senator Rockefeller’s Senior Health Policy Aide Sarah Dash to Georgetown University’s Health Policy team. She is joining our colleagues at the Center on Health Insurance Reforms where she will direct a 50-state evaluation of state health insurance exchange implementation and its impact on access to affordable, high-quality health care. She will also…
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What Do the Election Results Mean for the Affordable Care Act?
Last night was a good night for health care reform and the millions of Americans who will benefit from it. The Affordable Care Act has faced years of mudslinging, attempts to defund it, a Supreme Court challenge and played a high profile role in this year’s election. The election results underscore the fact that the…
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In-Person Assistors May Look a Lot Like Navigators
Quietly embedded in the June 29, 2012 update of the exchange establishment grant funding opportunity announcement (FOA) was a new category of consumer assistance – in person assistance (IPA). While federal officials haven’t been completely mum about this announcement, we have yet to see anything in writing (beyond what’s in the FOA and exchange blueprint)…
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Speaking of Medicaid …
By Joe Touschner Say Ahhh! readers talk about Medicaid and CHIP all the time and it’s long been a key topic during state budget hearings. But lately, Medicaid seems to be under discussion everywhere, including the last presidential debate. And talk of Medicaid is only going to intensify in the coming months as we enter…
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Final Rule Approves Pay Raise for Medicaid Primary Care Services
Starting in January 2013 and extending through December 2014, physicians and practitioners (such as physician assistants and nurse practitioners) will receive reimbursement for Medicaid primary care services comparable to those paid for Medicare. As I noted in this blog when the proposed rule was released, primary care is one of our best buys in health…
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Medicaid Expansion: Out of the Woodwork or Onto the Welcome Mat
By Lynn Blewett, SHADAC Director (Editor’s Note: This blog originally appeared on the SHADAC blog. ) The Woodwork Effect In health policy terms, the “woodwork effect” is a phenomenon that occurs when an expansion of public program eligibility takes place (whether through federal action or a state-level initiative), and individuals who were already eligible for…
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What Was Medicaid Doing in a Foreign Policy Debate?
My oldest son was required to watch this week’s presidential debate and report back to his teacher on flawed logical reasoning by the candidates. I thought my husband, who is somewhat of a foreign policy wonk, would be on homework helper duty and I could just sit back and enjoy the show—after all, it was…
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More Children Have Health Insurance Thanks to Medicaid, CHIP and ACA
Today we released a report with some encouraging news for America’s children and families. Our report found that despite the fact that childhood poverty remained high, the number of uninsured children declined last year. This builds on the good news on young adult coverage gains reported in September. The Affordable Care Act was behind the young…
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Where do States Stand on Affordable Care Act’s Essential Health Benefits?
By Joe Touschner As shocking as it may seem, the end of the year is less than 90 days away. That’s right, we’re in the fourth quarter, the one that includes Halloween, Thanksgiving, the holiday season, and New Year’s Eve. The third quarter wrapped up at the end of September, and with it the time…
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Blurriness Continues to Swirl Around Role of Navigators vs. Insurance Brokers
In July, HHS Secretary Sebelius responded to an inquiry from a group of Congressmen regarding distinctions between navigators and brokers. The Secretary’s letter clearly articulated that states cannot require navigators to be licensed insurance brokers or agents. The letter provides other helpful clarifications, as well. Unfortunately, some of the wording of the letter has spurred additional…
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New Issue Brief Focuses on State Action to Promote Child-Only Coverage
Editor’s Note: This blog originally appeared in the CHIRblog, a blog focused on health insurance coverage, insurance markets, and how people are affected by insurance reform. By Katie Keith, Georgetown University Center on Health Insurance Reforms Today, the Commonwealth Fund released a new issue brief on the availability of child-only policies. The issue brief is part of an ongoing series by CHIR on…