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This blog examines the current slate of proposals to reform abusive billing practices in the commercial market.
This blog examines New York and Minnesota’s experiences with the BHP and lessons for its design and implementation in other states.
This blog compares Washington’s “selective procurement” approach with Colorado’s requirement that all carriers offer public option plans.
This report analyzes healthcare coverage and eligibility of nonelderly noncitizens compared with the entire nonelderly population of the US.
This blog focuses on market reforms and consumer assistance within the 2024 Notice of Benefit & Payment Parameters.
This blog focuses on provisions of the final rule most of interest to State-Based Marketplaces and state insurance regulators.
The blog discusses parameters for reentry 1115 demonstrations.
This blog discusses the impact of the Braidwood Ruling depending on source of insurance.
This blog highlights state strategies to maximize continuity of coverage for consumers coming off Medicaid and needing to transition to the marketplace.
Despite the changes brought about by the COVID-19 pandemic, California’s health insurance landscape remained relatively stable during 2021. This blog focuses exclusively on coverage trends for Californians under age 65.
This brief focuses on enforcement of parity requirements for “non-quantitative” treatment limits that insurers impose on enrollees, such as prior authorization requirements and medical necessity determinations.
This blog examines how states are working with the federal government to implement the No Surprises Act.
In this blog, CHIR’s Sabrina Corlette and Justin Giovannelli recap the legal issues in the case and outline options for states seeking to preserve consumers’ access to preventive services.
This blog discusses how federal regulators can put greater restrictions on short-term plans, including limiting their coverage duration and banning sales during open enrollment to prevent junk plan sales.
This blog analyzes the new rule's ability to close gaps and extend best practices identified by CMS and states in the course of preparing for the end of the Medicaid continuous coverage requirement under the federal public health emergency (PHE).
The ACA’s guarantee of free access to preventive services is at risk. If it is ultimately struck down as unconstitutional as the result of a court case that is winding its way through the federal judicial system, Congress will be the only entity that can act to codify and fully restore its benefits. However, there are some actions states can take. This brief explores what state-level health officials can do to mitigate the fallout of the preventive services provision being struck down.
In this blog, Jack Hoadley, Kevin Lucia, and JoAnn Volk review the final rule and discuss its implications for state balance billing protections and oversight.
Amid rising healthcare costs, this blog explores how a public coverage option in the individual and small group Marketplace could help reduce costs and expand access to coverage for people with job-based insurance.
This blog examines insurers use of utilization management tactics, including prior authorization and claims review.
This blog details the Colorado public option, the significance of the 1332 waiver approval, projected impact on premiums and enrollment, and what this means for future state action.
With the premium tax credit expansion’s (PTC) sunset approaching, Congress has been considering passing an extension—first in the Build Back Better Act and more recently for potential inclusion in narrower reconciliation legislation. This blog explores cost and enrollment rates without an extension of the ARPA’s expanded PTC.
This blog analyzes the Centers for Medicare & Medicaid Services' final rules for provider network adequacy standards in the federal healthcare marketplaces and Medicaid.
This blog post reviews policy approaches to providing greater access to services that treat and manage mental health and substance use disorders (MH/SUD).
This blog provides updates focused on health insurance coverage, insurance markets, and how people are affected by insurance reform.
This blog summarizes feedback from representatives of consumer advocates, insurers, and state agencies on CMS' proposed annual Notice of Benefits and Payment Parameters, which updates regulations governing the Affordable Care Act’s marketplaces.
This map and chart provide the status of state legislation to address prescription drug costs across the country.
This blog explores the obstacles consumers have faced obtaining free preventive services since the Affordable Care Act (ACA) was enacted in 2010.
This report builds on The Oregon Health Authority (OHA) ’ draft “Recommendation Memo,” to make a public health insurance option available in the individual market and, potentially, the small group market as well.
This interactive map highlights the status of individual state’s legislation to address health care costs in 2021.
This commentary explains how rising health care costs and increased consolidation of hospitals and provider groups into large health systems have led states into exploring ways to contain costs and provide oversight of the growing market power of large hospitals.
This article highlights NASHP’s Center for State Rx Drug Pricing five years of state action to lower drug costs.
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.
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.
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.
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.
This commentary provides an overview of new federal guidance that attempts to answer questions about requirements for coverage of COVID-19 testing services.
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.
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.
These were the ten most-visited resources on StateNetwork.org during 2019
In this report, insurance experts share findings from a case assessing New York’s experience with its Surprise Billing law, five years in.
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.
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.
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.
These were the five most-visited resources on StateNetwork.org during 2018.
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.
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.
This national scan summarizes the health care reforms and innovations that newly-elected governors promoted in their campaigns and may become policy in 2019.
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.
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.
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.
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.
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).
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.
This report examines six states that faced the prospect of bare counties for 2018: Iowa, Nevada, Ohio, Oklahoma, Tennessee, and Washington.
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.