Affordable Care Act

Two Blues Partner with Providers to Launch New Health Plans

by Kyle Murphy, PhD

Horizon Blue Cross Blue Shield of New Jersey and Anthem Blue Cross and Blue Shield are joining forces with leading providers to offer new health plans. Horizon BCBSNJ announced a new Medicare...

Tobacco Surcharge Hinders Coverage Access for Low-Income Seniors

by Kelsey Waddill

Smoking can lead to higher premiums, a recent study on the tobacco surcharge and tobacco users’ Affordable Care Act marketplace premiums revealed. According to the Centers for Disease Control...

CA Legislature Expands Behavioral, Mental Healthcare Parity Law

by Kelsey Waddill

Under a newly revised bill from the California state legislature, California health plans will have to cover mental health conditions to the same extent they do medical services in an effort to achieve...

GA’s Affordable Care Act Exchange Model Moves to Public Comment

by Kelsey Waddill

CMS has confirmed that Georgia’s Section 1332 state innovation waiver, which changes the Affordable Care Act exchange model, is complete. The waiver will now move into a public comment...

ACA Special Enrollment Members Have Higher Healthcare Spending

by Kelsey Waddill

Affordable Care Act marketplace beneficiaries who enroll in plans during special enrollment periods tend to exhibit higher healthcare spending, a recent Health Affairs article revealed. The...

Many Working-Age Americans Face Unstable Coverage, Medical Debt

by Kelsey Waddill

Two out of every five working-age adults in the first half of 2020 had unstable healthcare coverage and a third faced medical debt, a Commonwealth Fund study recently uncovered. The survey is a part...

Court Affirms CSR Reimbursement, But Amount Still Questionable

by Kelsey Waddill

On August 14, the Federal Circuit court made two decisions affecting payers which centered around practices meant to lower costs for Affordable Care Act marketplace enrollees: government reimbursement...

NY Announces Record Low Individual, Small Group 2021 Premium Rates

by Kelsey Waddill

New York has announced 2021 premium rates and the state appears to be following CMS’s lead for 2020 rates by keeping 2021 rates low. The New York State Department of Financial Services announced...

Consumer Assistance Remains Key to Medicaid, ACA Enrollment Process

by Kelsey Waddill

Around one-fifth of Americans continue to rely on consumer assistance to navigate their healthcare coverage options, but not all of them can access the help that they need, a Kaiser Family Foundation...

CMS Temporarily Lowers Individual, Small Group Exchange Premiums

by Kelsey Waddill

The Centers for Medicare and Medicaid Services (CMS) announced that it will allow payers to use premium credits to temporarily lower the individual and small group exchange premiums for...

Appeals Court OKs 3-Year Short-Term Limited Duration Health Plans

by Kelsey Waddill

The US District Court of Appeals for the District of Columbia Circuit upheld the Trump Administration’s decision to extend the potential duration of short-term limited duration health plans. The...

Consumers Prioritize Broad Networks, Keeping Current Provider

by Kelsey Waddill

Consumers are willing to pay more for broader provider networks and many, including women, also place high priority on maintaining coverage for providers to whom they are already connected when...

How to Help Debt-Laden Grads Get Affordable Healthcare Coverage

by Kelsey Waddill

As graduates entered a job market stalled by the pandemic, the United Hospital Fund recommended that the state of New York begin offering tax credits toward health insurance premiums linked to student...

What is the Medical Loss Ratio of the Affordable Care Act?

by Kelsey Waddill

The medical loss ratio is a financial standard that plans on the Affordable Care Act exchanges must uphold. It sets the baseline for how much of payer revenue must go directly toward covering consumer...

Most Furloughed Workers Still Covered by Employer-Sponsored Plan

by Kelsey Waddill

Overall, nationwide healthcare coverage levels have remained steady because many furloughed workers are still receiving healthcare coverage through an employer-sponsored plan, Commonwealth Fund...

Congress Considers Expanding ACA As Feds Move to Dismantle It

by Kelsey Waddill

The House of Representatives voted to expand the Affordable Care Act only days after the White House reiterated its resolve to dismantle the Affordable Care Act altogether. The House of...

Private Payers Face More Medicaid Competition on ACA Marketplaces

by Kelsey Waddill

Private payers are facing steeper competition from Medicaid health plans on the Affordable Care Act marketplaces, a Robert Wood Johnson Foundation study found. Researchers surveyed six...

Major Payers Find HHS Finalized Nondiscrimination Rule Too Narrow

by Kelsey Waddill

Major payers and payer organizations objected to the finalized HHS nondiscrimination rule—Affordable Care Act Section 1557—saying that the rule eliminates much of the specific language in...

Medicaid Expansion Impacts Contraception Access, Women’s Health

by Kelsey Waddill

Medicaid expansion has an impact on women’s health by opening up access to longer-acting, effective contraceptives that can prevent unwanted pregnancies in adults and adolescents, a study...

Total Medicaid Expansion May Cut Uninsurance, Uncompensated Care

by Kelsey Waddill

If all of the nonexpansion states adopted Medicaid expansion, thus establishing total Medicaid expansion nationwide, there would be a 28 percent reduction in uninsurance, the Urban Institute found in...