The individual health insurance market’s premiums mostly go towards highly utilized services, a Robert Wood Johnson study discovered.
“The requirement that these essential benefits be...
As the Supreme Court deliberates the fate of the Affordable Care Act after hearing the oral arguments, payers and the public alike are processing the court case and its implications for the healthcare...
Individual coverage health reimbursement arrangements (ICHRAs), which have been offered as the alternative to the Affordable Care Act, have negative impacts on low-income New Yorkers, according to a...
CMS has approved a Section 1332 demonstration for Georgia which, in part, moves the individual market to a private sector platform.
“I’m thrilled to support this comprehensive state-led...
Compared to 2019, the fully-insured group health insurance markets and Medicare Advantage markets have seen their margins increase and loss ratios decrease in the first half of 2020, with Medicare...
Update 11/5/2020: This article has been corrected to state that the Supreme Court will hear the oral arguments regarding the Affordable Care Act’s constitutionality on November 10, 2020. A...
Since the passing of late Supreme Court Justice Ruth Bader Ginsburg, many have questioned whether the Affordable Care Act is at risk of being overturned, a potentiality that would be extremely...
Major payers are beginning to send out individual and small group rebate checks for 2019, providing some financial relief for members, as the Tennessee Department of Commerce and Insurance...
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...
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...
While by and large patients were under the same waivers for coronavirus testing, payers have implemented a broad range of strategies to handle coronavirus treatment cost-sharing for the long term, a...
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...
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...
The blow to employer-sponsored plans in the final three quarters of 2020 could be lower than anticipated largely because coronavirus impacts have concentrated on lower income populations, Robert Wood...
With New Jersey’s small group health insurance market in decline, the New Jersey Health Care Quality Institute (Quality Institute), a nonpartisan group that advocates for collaboration among...
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...
Overall, nationwide healthcare coverage levels have remained steady because many furloughed workers are still receiving healthcare coverage through an employer-sponsored plan, Commonwealth Fund...
The federal and state health insurance marketplaces are dominated by Blue Cross Blue Shield-affiliated companies and there has also been a dramatic shift in enrollment from national and regional payers...
The coronavirus pandemic impacts on the individual health insurance market risk pool and healthcare costs for 2021 are infusing uncertainty into the 2021 rate setting process, America’s Health...
Fifteen healthcare payers have filed plans for the 2021 Affordable Care Act (ACA) individual health insurance marketplace, the Office of the Insurance Commissioner for Washington State announced.
For...
