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Commercial Insurance Regulation

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Commentary

This commentary focuses on several provisions of the proposed 2022 “Notice of Benefit & Payment Parameters" that have implications for state oversight of insurance markets and the state-based marketplaces.  

Brief

This brief explores the shares of a typical nongroup insurance premium attributable to essential health benefits and estimates the financial implications should they be eliminated from the nongroup insurance benefit package.

Commentary

This commentary explores recent federal efforts to expand private insurance coverage of a COVID-19 vaccine, and provides a roadmap for states to close remaining coverage gaps that could inhibit vaccine uptake.

Commentary

This commentary summarizes recent guidance from the Centers for Medicare & Medicaid Services on permitting health insurance issuers to provide certain premium rebates for 2020 and the conditions rebates must meet.

Commentary

This commentary provides an overview of new federal guidance that attempts to answer questions about requirements for coverage of COVID-19 testing services.

Commentary

This commentary discusses the use of Telemedicine during the COVID-19 pandemic. It summarizes the federal legislation and guidance and discusses actions state departments of insurance can take to encourage greater access to telehealth services.

Report

In this report, researchers reviewed laws and interviewed state officials and insurers in six states—California, Georgia, Massachusetts, North Carolina, Pennsylvania, and Texas—to determine current policies and best practices to protect patients from disruptions in services and financial burdens as a result of disputes between providers and payers.

Report

In this report, insurance experts share findings from a case assessing New York’s experience with its Surprise Billing law, five years in.

Report

02.2019 / By Urban Institute

This study assesses short-term plan insurers’ marketing tactics in the wake of new federal rules and how regulators have prepared for this new market.

Report

01.2019 / By Urban Insitute

The Urban Institute conducted interviews with marketplace administrators and insurers selling marketplace coverage in ten states. They analyze marketplace insurer participation and pricing decisions, as well as several related topics.

Report

12.2018 / By Urban Institute

This analysis examine four policy scenarios meant to improve the ACA, which, taken together, could reduce the number of uninsured by 12.2 million people and to 7.3 percent uninsured.

Webinar & Presentations

This webinar discusses the implications of the proposed regulations easing the rules governing health reimbursement arrangements (HRA) and other account-based, tax-preferred health care benefits; and possible state responses.

Report

Alaska, Minnesota and Oregon were the first to gain approval and federal funding to implement their own reinsurance programs under a 1332 waiver. This issue brief assesses their progress and lessons learned to date.

Commentary

This national scan summarizes the health care reforms and innovations that newly-elected governors promoted in their campaigns and may become policy in 2019.

Report

08.2018 / By Urban Institute

The Trump administration finalized regulations for short-term limited duration policies in early August 2018, which increase the maximum length of short-term, limited-duration insurance policies to just less than one year. This report provides updated tables taking these state legislative changes into account.

Webinar & Presentations

The Trump Administration is expanding the availability of alternatives to Affordable Care Act-compliant health insurance. Rules to expand association health plans and short-term limited duration health plans are imminent. This webinar explores what options states have to respond to these developments, featuring experts from Georgetown University’s Center for Health Insurance Reform.

Webinar & Presentations

This webinar untangles HHS's annual Notice of Benefit and Payment Parameters and its many implications for states. The rule is a collection of policies governing the ACA’s marketplaces, insurance reforms, and premium stabilization programs. Speakers include Sabrina Corlette and Justin Giovannelli from Georgetown’s Center on Health Insurance Reforms, Joel Ario from Manatt Health, and Jason Levitis.

Report

03.2018 / By Urban Institute

On February 20, 2018, the Departments of Treasury, Labor, and Health and Human Services released a proposed regulation that would increase the maximum length of short-term, limited-duration insurance policies to one year. The brief analyzes the national and state-specific effects of ending the individual mandate and loosening limits on short-term, limited-duration policies.

Commentary

In response to President Trump’s October 12 executive order, the U.S. Departments of Health and Human Services, Labor and Treasury have published proposed rules to expand the availability of health coverage sold through short-term, limited duration insurance (STLDI).

Brief

In response to President Trump’s October 12 executive order (EO), the U.S. Department of Labor (DOL) published proposed rules to expand the availability of health coverage sold through associations to small businesses and self-employed individuals. The full brief provides state health officials with a detailed review of the content of the proposed rule and examines the implications for states.

Report

11.2017 / By Urban Institute

This report examines six states that faced the prospect of bare counties for 2018: Iowa, Nevada, Ohio, Oklahoma, Tennessee, and Washington.

Report

This report discusses the scope of state authority and tools available to ensure that consumers living within their borders benefit from the insurance protections promised under federal law. It also discusses specific statutory and administrative options for states in the event of selected possible federal administrative actions, including a: Rollback of the essential health benefits; relaxation of marketplace health plan oversight; re-definition of what constitutes minimum essential coverage; loosening of medical loss ratio standards; and an expansion of off-marketplace enrollment opportunities.

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