Federal Health Insurance Marketplace

Planning for Individual Insurance Exchange Stabilization in WA

by Thomas Beaton

State health insurance markets and their individual insurance exchanges have faced regular instability in the form of payer exits, imbalanced risk pools, and rising premiums that push out new and...

Narrow Provider Networks are 16% Cheaper for ACA Plans

by Thomas Beaton

Economists from Harvard Business School and Northeastern University found individual ACA silver plans with narrow provider networks were 16 percent cheaper for consumers and offer payers a promising...

Governors Propose Health Insurance Market Stabilization Plan

by Thomas Beaton

Eight state governors have outlined their proposals for a health insurance market stabilization plan that would control premium increases and improve competition in the federal and state health...

HHS to Spend $10M on Affordable Care Act Navigator Program

by Thomas Beaton

HHS and CMS announced that they will allocate $10 million to support the Affordable Care Act Navigator program, which helps health insurance consumers find coverage solutions during the Open Enrollment...

20.5 Million More Insured Since Start of Affordable Care Act

by Thomas Beaton

20.5 million more individuals have gained health insurance coverage since the implementation of the Affordable Care Act (ACA) in 2010, according to a new report from the CDC and the National Center for...

As ACA Debate Lingers, Non-Marketplace Members Present Risks

by Thomas Beaton

While much of the national debate over health insurance has focused on the options open to ACA marketplace enrollees, payers should be careful not to neglect coverage choices for their private plan...

Anthem to Withdraw from ACA Individual Market Exchanges in NV

by Thomas Beaton

Anthem BlueCross BlueShield (BCBS) will completely withdraw from Nevada’s ACA exchange for individual health plans in 2018, the health payer announced on Monday. The payer’s decision...

HHS Approves Alaska 1332 Waiver for State Reinsurance Program

by Thomas Beaton

Alaska will be able to move ahead with its plans to implement a state reinsurance program under a  1332 State Innovation Waiver, HHS confirmed this week.   The Alaska Reinsurance Program...

CMS: Reinsurance, Risk Adjustment Programs Worked Well in 2016

by Jesse Migneault

CMS has released the results from 2016 for reinsurance and risk adjustment transfers, two of the “three R’s” used to stabilize premiums in the Affordable Care Act (ACA) marketplaces....

New Insurers Enter Health Insurance Exchanges for 2018

by Jesse Migneault

Despite questions over the future of the Affordable Care Act (ACA) and its cost-sharing reductions (CSR), many insurers are opting to expand existing offerings or enter new markets in the 2018 ACA...

Senate Has Released Bill to Revise ACA Repeal Legislation

by Jesse Migneault

The Senate has released the working draft of the Better Care Reconciliation Act of 2017, revising the recently House-passed AHCA.   Both bills aim to repeal and replace the Affordable Care...

Medica Will Stay in NE and IA Health Insurance Exchanges

by Jesse Migneault

Medica has announced plans to stay in the Nebraska and Iowa health insurance exchanges for 2017.   Although committed to the Nebraska exchange, the payer had previously indicated it was going...

CMS Outlines Special Enrollment Period Rules for ACA Exchanges

by Jesse Migneault

Starting on June 23, 2017, CMS will be enacting its new rules regarding special enrollment periods (SEP) for the ACA marketplace.  The agency released the new special enrollment rules earlier...

Facing an Empty Exchange, Iowa Suggests Statewide Insurance Plan

by Jesse Migneault

If Iowa’s health insurance exchanges are completely abandoned, the state will request that the federal government allow the establishment of a state health care plan for 2018. If approved by...

Centene Will Enter Health Insurance Exchanges in 3 New States

by Jesse Migneault

Centene Corporation will expand its presence in a number of state health insurances exchanges in 2018, building on its successful 2017 marketplace results.  The payer is planning to enter...

Payers Leaving Affordable Care Act Insurance Exchanges in 2017

by Jesse Migneault

Questions over the future of the Affordable Care Act (ACA) and its cost-sharing reduction (CSR) payments have prompted many payers to abandon ACA state health insurance exchanges in part or entirely in...

PA Payer Market Stable, but OH Loses ACA Exchange Participants

by Jesse Migneault

Pennsylvania and Ohio are having very different experiences with their Affordable Care Act health insurance exchanges as they move into 2018. While Pennsylvania’s existing five payers will...

Nevada Legislature: All Residents Should Have Medicaid Access

by Jesse Migneault

The Nevada State Assembly has passed a bill which would open Medicaid enrollment to all of the state’s residents, regardless of income or health status.   The Nevada Care Plan would...

$18M Claimant Case Challenges Affordable Care Act Payers

by Jesse Migneault

In April of 2017, Wellmark Blue Cross Blue Shield, which operates in Iowa and South Dakota, announced it would exit the 2018 health insurance exchanges.  The payer cited higher than expected...

NC Payer Raises Health Insurance Rates Due to CSR Lawsuit

by Jesse Migneault

Blue Cross Blue Shield of North Carolina announced its 2018 individual premium rates will increase an average of 22.9 percent for coverage on and off the health insurance exchange in all 100 counties...