Individual Health Insurance Market

CMS Seeks Comment on Purchasing Health Insurance Across State Lines

by Jennifer Bresnick

CMS is soliciting public comments on strategies that would allow enrollees to purchase health insurance across state lines in an effort to increase competition and improve affordability for...

Affordability Concerns Lead Consumers to Short-Term Health Plans

by Jennifer Bresnick

Consumers are turning to short-term health plans primarily because they cannot afford other options, according to a new survey from insurance portal eHealth.com. Instead of using short-term plans to...

House Joins Senate in Urging Delay of Health Insurance Tax

by Jennifer Bresnick

Democrats and Republicans from the House of Representatives have joined their Senate colleagues in introducing legislation to delay the ACA Health Insurance Tax for several years. Representatives...

State Legislatures Debate Value of Association Health Plans

by Kyle Murphy, PhD

State legislators in Vermont and North Carolina are considering legislation that would impact the viability of association health plans (AHPs) in their states. State bills in Vermont and North...

Payers, Trade Groups Defend Silver-Loading in Comments to CMS

by Jennifer Bresnick

Major health payers and representative trade groups are urging CMS not to eliminate the practice of silver-loading, which has been used to stabilize premiums in a volatile and unpredictable market. In...

Insurers Notch Legal Wins in Cost Sharing Reduction Fights

by Jennifer Bresnick

Multiple court cases have been decided in the favor of insurers looking to recoup millions of dollars in cost sharing reduction (CSR) payments withheld by the Trump Administration in 2017. Health...

Marketing for Short-Term Health Plans May Mislead Consumers

by Jessica Kent

Websites and brokers that sell short-term health plans as a replacement for ACA-compliant coverage often fail to give consumers the detailed plan information necessary to inform their purchase,...

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,...

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...

Coalition of State AGs Challenge Ruling of Unconstitutional ACA

by Kyle Murphy, PhD

Following a December 14 ruling stating the Affordable Care Act to be unconstitutional without its individual mandate, attorney generals from 16 states and the District of Columbia filed an expedited...

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...

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...

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...

Atrium Settlement Ends Steering Restrictions in Payer Contracts

by Kyle Murphy, PhD

The Department of Justice reached a settlement agreement with Atrium Health (formerly Carolinas HealthCare System) over alleged anti-competition in the form of steering restrictions in commercial payer...

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...

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...

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...

CMS Broadens ACA Waiver Scope for State Insurance Programs

by Thomas Beaton

CMS has issued federal guidance intended to expand the scope and availability of state-level waiver programs.   State governments can now apply for State Relief and Empowerment Waivers that may...

CMS: ACA Premiums to Decline in 2019 for Silver Plan Consumers

by Thomas Beaton

CMS has announced it expects the average ACA health plan premium to drop by 1.5 percent for healthy consumers that purchase low-cost silver tier plans. The agency stated that it is the first time...

AMA, Industry Orgs Object to Short-Term Health Plan Expansion

by Thomas Beaton

The American Medical Association and other industry trade groups have filed amici curiae in support of a lawsuit contesting the legality of short-term health plans. The Association for Community...