Marketplace
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CMS Proposes A Medicaid Rule You (and States) Might Like
I’m not big on rules. When I ran New Hampshire’s Children’s Health Insurance Program and had to talk with a family who was unhappy about some bureaucratic rule, I often diffused the conversation by saying “I don’t make the rules, if I did there wouldn’t be any.” I know, that was a cop-out but it…
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Change Isn’t Easy
Some readers may remember the now deceased advice columnist Ann Landers – something of a national icon in her heyday. Sometimes she was off target — like when she told readers not to throw rice at weddings because birds would explode from eating it — but I was thinking today about (the only) one of…
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HHS Announces Early Innovator Grants for Development of State Exchange Information Systems
Successful implementation of the Affordable Care Act relies heavily on technology to provide consumer-friendly information, to ensure that eligibility is streamlined, and to coordinate enrollment between Medicaid, CHIP and the Exchange. To support the development of these critical systems, HHS has announced “Early Innovator” grants to encourage and reward states for leading the way and…
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Calling All Medicaid ‘Waiver Watchers’
I know you’re out there because our blog editor assures me that “section 1115 waiver” is one of the top 50 search terms leading readers to Say Ahhh! As I blogged about a few weeks ago, CMS recently released proposed regulations as required by ACA that establish a more robust public notice and comment process…
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Insurance Commissioners Respond to Consumer Concerns
By now many of you have probably heard about the big news coming out of the NAIC meeting this week in Orlando. After seven months of intense debate and negotiation, the NAIC voted in favor of a regulation defining the ACA’s required “medical loss ratio” (MLR). They rejected several amendments that were heavily pushed by…
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Pregnancy Viewed as Pre-Existing Condition by Many Individual Insurance Plans
By Amanda Jezek, March of Dimes If you are pregnant, it is highly unlikely that you would be able to get maternity coverage in the individual insurance market. An investigation conducted by the House Committee on Energy and Commerce confirmed that major insurers consider pregnancy to be a pre-existing condition that would result in an…
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HHS Announces Consumer Assistance Grants
By Joe Touschner Implementation of the Affordable Care Act continues: Today, HHS Secretary Kathleen Sebelius announced about $30 million in grants to states to fund consumer assistance activities. The grants will support efforts to aid consumers in navigating health insurance, whether it is finding affordable coverage, dealing with a disputed claim denial, or applying the…
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Medicaid and CHIP Buy-In Could Help Children Excluded from Private Market
Meg Comeau, Director of the Catalyst Centerat the Boston University School of Public Health A little over six months ago, I watched the signing of the Affordable Care Act (ACA) on television. I was filled with hope that as a nation we’d finally taken a giant step forward in ensuring access to high quality health…
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What’s Happening in the Employer Market?
By Martha Heberlein Despite its declining role in recent years, employer-sponsored insurance is a staple of coverage in the U.S. and still accounts for the largest share of health coverage. In fact, in 2009, 56% of people were covered by some form of ESI. However, as the recently released annual Kaiser Family Foundation/Health Research and…
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Behind Door #1….Coverage!
By Claudia Page, Social Interest Solutions The Affordable Care Act (ACA) is truly a game-changer in how consumers will connect to coverage. For many consumers, especially low-income individuals in need of public benefits, seeking coverage today is a complicated maze of paper forms and referrals, disconnected eligibility systems and silos, multiple trips to social services…
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Florida Ruling Swings Pendulum Toward Supreme Court
[The following blog was originally published on the Community Catalyst’s Health Policy Hub.] By Eva Marie Stahl, Community Catalyst Policy Consultant Yesterday, the federal judge in Florida, Roger Vinson, allowed the lawsuit against the new health law to go forward. In his ruling, the Judge maintained that there were constitutional issues in play and formal…
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Administration Goes to Bat for Children With Pre-Existing Conditions
Today the Obama Administration displayed its firm commitment to stand up for children with pre-existing conditions. HHS Secretary Sebelius sent a letter to the National Association of Insurance Commissioners condemning the insurance industry for failing to follow through on their commitment to allow families with sick or disabled children to buy child-only insurance coverage. (As…
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Consumer Rep Previews the National Association of Insurance Commissioners National Meeting
By Sabrina Corlette, Georgetown Health Policy Institute Hard to believe it’s come around again but that National Associatin of Insurance Commissioners (NAIC) is gearing up for a big national meeting – this time in Orlando, Florida from October 18-21. I and my fellow consumer representatives will be packing our Mickey Mouse ears and fanning out at the…
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No More Annual Limits? Not so Fast
By Sabrina Corlette, Georgetown Health Policy Institute One of the great new patient protections in the ACA is the ban on lifetime and annual limits. The law, as readers of this blog know, prohibits all plans from imposing lifetime dollar limits on essential benefits and, in 2014, prohibits annual limits on the dollar value of…
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A Medicaid Trend Nobody’s Talking About
By Martha Heberlein There are some pretty persistent rumors floating around out there regarding state budgets and the growth in Medicaid spending. The optimist in me wants to view these rumors as mere “misunderstandings,” an ill-informed look at the data, and not political posturing meant to frame a highly successful program in a negative light.…
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Eight Difficult Exchange Questions Addressed in New Report
Last week, the Commonwealth Fund released a new report by Timothy Jost on the state-based health insurance exchanges. The author analyzes eight of the most difficult issues that the states and federal government face in implementing the exchanges, and offers recommendations for addressing them. Read the blog or the report to get answers to these…
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Kansas Tackles Backlog with Commonsense Solutions to Improve Efficiency
By Suzanne Wikle of Kansas Action for Children At a time when I can pay my bills using an Iphone or Blackbery, it seems a no-brainer that states should be pursuing more technological fixes to simplify and streamline processes to ensuring that families are able to access health insurance through Healthwave, Kansas’ Medicaid and Children’s Health…
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MomsRising Receives Overwhelming Response to Invitation to Share Thoughts on ACA
In honor of the six-month anniversary of the Affordable Care Act, our friends at MomsRising invited moms, dads, grandparents, bloggers, community leaders, government officials, policy experts and others to share their thoughts and feelings about health reform. They received an overwhelming response to their invitation. Here are a few of the many interesting blog entries: Kerri Marrone…
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ACA September 23rd Reforms Will Make Insurance Work Better for Children and Families
Today marks the six-month anniversary of the passage of the Patient Protection and Affordable Care Act (ACA). It is also the date that some of the new law’s insurance reforms go into effect to help make insurance work better for families and children. Those improvements include: Prohibiting most insurers from limiting benefits or denying coverage…
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Choosing Your Own Doctor – New Protections for Children and Adults
By Joe Touschner Finding the right health care professional to provide primary care can be a challenge–we’re all looking for the right balance of expertise, compassion, communication skills, and availability. So no one likes it when an insurance company steps in to limit our choice when it comes to picking an available primary care provider. …