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Health Insurance Exchange

Gallup Reports 4-Year High in Number of Uninsured Americans

January 25, 2019 - Earlier this week, the Gallup National Health and Well-Being Index reported that the percentage of adults without health insurance reached 13.7 percent by the close of 2018. The polling group sampled more than 115,000 adults across the country. The latest increase continues an upward trend since the third-quarter of 2016 when the rate of uninsured Americans dipped to 10.9 percent, down...


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Bipartisan Bill Suggests Another Health Insurance Tax Delay

by Jennifer Bresnick

Senators from both sides of the aisle have sponsored a bill that would delay implementation of the ACA’s health insurance tax (HIT) once again, this time for two years. The $16 billion tax, designed to be levied on payers, would...

CMS Mulls End of Auto-Reenrollment, Silver Loading in ACA Market

by Jennifer Bresnick

CMS has issued its proposed Payment Notice for the 2020 plan year, which contains provisions that would significantly alter the operations and structure of the ACA individual marketplace. Continuing a pattern of using CMS regulatory...

TX Judge Rules ACA Unconstitutional in Highly Charged Court Case

by Jennifer Bresnick

In a highly politically court case brought by a number of Republican officials, US District Judge Reed O'Connor has issued a ruling stating that the Affordable Care Act as a whole is unconstitutional. The ruling stems from the notion...

Narrow Network Health Plans Continue to Dominate ACA Exchanges

by Kyle Murphy, PhD

New analysis of available health plans on ACA exchanges in 2019 shows that narrow networks remain a dominant force. Avalere researchers found that more restrictive networks own nearly three-quarters of all health plans on health insurance...

Health Payers Contend for Share of SMB Health Insurance Market

by Chuck Green

Changing government regulations and demands for benefits in the small to medium business market is likely to lead to consolidation and place a growing emphasis on creating innovative health plans, according to a recent Edifecs...

AHIP Eyes Solutions to Assist Consumers Shopping for Health Plans

by Chuck Green

American Health Insurance Plans (AHIP) recently issued a dozen solutions aimed at assisting families with an income over 400 percent of the federal poverty level afford comprehensive coverage covering their pre-existing conditions. Last...

Regulatory Uncertainty Continues to Disrupt ACA Marketplaces

by Chuck Green

New research published by the Kaiser Family Foundation provides insight into the forces driving health payers to participate in certain ACA marketplaces while wholly quitting others. Insurer participation in the Affordable Care Act health...

Robocalls Targeted Consumers During Health Plan Enrollment Period

by Chuck Green

Health insurance open enrollment’s kicked off, accompanied by a spike in automated calls with offers of Affordable Care Act or other health plans, much to the chagrin of consumers. “It’s at epidemic levels at this time...

HealthCare.gov Breach Exposes Data of 75K Individuals

by Chuck Green

Last month, a breach of HealthCare.gov took place that affected those applying for coverage under the Affordable Care Act, HHS reported last Friday. The intrusion led to inappropriate access to the personal information of about 75,000...

CMS to Audit Premium Subsidy Eligibility for Individual Health Plans

by Thomas Beaton

CMS has proposed a new rule that would audit premium subsidy eligibility for individual health plan beneficiaries and monitor premium assistance programs through the federal insurance exchanges. The Patient Protection and Affordable Care...

CMS Tells States to Curb Silver-Loading with Off-Exchange Plans

by Thomas Beaton

CMS is asking state insurance departments to offer more off-exchange health plans in order to reduce silver-loading of qualified health plans (QHP). Silver-loading is the practice of raising premiums so that payers can earn larger federal...

CMS Cuts ACA Navigator Funding Grants by $26M for 2019

by Thomas Beaton

CMS has announced a $26 million cut to funding grants for ACA navigators, from $36 million down to $10 million. CMS will provide a minimum of $100,000 in each of the states that operate a federally-facilitated exchange (FFE). The funding...

Medicaid Plans More Cost Effective, Stable than Exchange Plans

by Thomas Beaton

Medicaid health plans are more cost effective than federal exchange plans and could offer beneficiaries more affordable coverage options, according to a UnitedHealth Group analysis. UnitedHealth Group said that federal healthcare agencies...

11.8M Members Bought Health Plans Via Affordable Care Act Exchanges

by Thomas Beaton

Nearly 11.8 million beneficiaries have enrolled or re-enrolled in a health plan through the Affordable Care Act exchanges, reaching close to 2017 enrollment totals (12.2 million) despite federal changes in how the exchanges are funded and...

Affordable Care Act Changes May Bring a Rocky 2018 for Payers

by Thomas Beaton

2017 was a turbulent year for the Affordable Care Act.  Legislative battles in Congress, fluctuating support from healthcare stakeholders, and threats of repeal have left many payers facing an uncertain future. Even though Congress...

NB and IA Offer New Individual Market Plan For Open Enrollment

by Thomas Beaton

An new individual market plan created out of Medica and CHI Health will be available to consumers during the open enrollment period in Nebraska and Iowa, the health networks announced in a press release. The Medica with CHI Health plan...

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 returning insurance consumers. As premiums...

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 insurance exchanges. In a letter sent to...

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 period. Launched in 2013, the...

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