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 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.
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.
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 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 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 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 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 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.
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 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.
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 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.