Individual Health Insurance Market

HHS extends special enrollment period for former Medicaid beneficiaries

April 2, 2024 - HHS has extended the temporary special enrollment period to facilitate marketplace enrollment for beneficiaries who lost Medicaid or Children’s Health Insurance Program (CHIP) coverage following eligibility renewals. The Medicaid continuous coverage policy ended on March 31, 2023, and states could resume eligibility determinations on April 1,...

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CMS chops short-term, limited duration plan length to 4 months

by Kelsey Waddill

The Biden administration has reduced the timeframe of short-term limited duration insurance plans, also known as “STLDI” or “junk” plans, in an effort to curb underinsurance,...

Few Physicians Participate in Both Medicaid and Marketplace Plans

by Victoria Bailey

Less than three in ten primary care physicians participating in Medicaid also participated in an average marketplace network, raising concerns about continuity of care for beneficiaries disenrolled...

Health Insurance Costs Are Growing Too Expensive for Small Businesses

by Kelsey Waddill

While small businesses know the advantages of providing health insurance, many employers are concerned about the rising costs of health benefits, with most businesses that do not offer health insurance...

What Health Plans Are Available For People With Disabilities?

by Victoria Bailey

Public and private payers alike offer a multitude of benefits for people living with disabilities. According to the CDC, up to 27 percent of adults in the United States have some type of disability, including mobility, cognition,...

How Do Payers Cover Prenatal, Postpartum Care for Pregnant People?

by Victoria Bailey

Prenatal, perinatal, and postpartum care help ensure healthier pregnancies and better birth outcomes for pregnant people. Access to this essential care comes easier with adequate health insurance. Pregnant people are almost guaranteed...

How Public, Private Payers Cover Care for the LGBTQ+ Population

by Victoria Bailey

In a country with rampant health disparities, health insurance coverage can be the difference between accessing necessary services and going without care. How health plans cover care for socially disadvantaged and vulnerable populations...

Price May Drive Affordable Care Act Marketplace Plan Selection

by Kelsey Waddill

The Affordable Care Act (ACA) marketplace was designed to incentivize enrollees to choose specific plans based on price and it seems to be fulfilling that goal, an analysis from the Urban Institute...

How the Top 4 Disruptive Insurtechs Have Evolved Since Their IPOs

by Kelsey Waddill

The insurtechs that saw the greatest success after the start of the coronavirus pandemic have faced a tumultuous path since their initial public offerings (IPOs). In 2021, four insurtechs achieved their IPO. Their goal was to disrupt the...

Exploring the History of the Blue Cross Blue Shield Association

by Victoria Bailey

Blue Cross Blue Shield is an easily recognizable name in the healthcare industry, but just how many health plans fall under this organization and what are the differences between them? In the following article, HealthPayerIntelligence...

HHS Proposed Rule Aims to Distinguish STLDI from Comprehensive Plans

by Kelsey Waddill

The Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury have released a notice of proposed rulemaking that applies to short-term, limited-duration...

Employer Sponsored Health Plan Enrollment Will Hit 159M in 2033

by Kelsey Waddill

Employer-sponsored health plan enrollment among nonelderly Americans will grow after 2025, accompanied by higher private payer premiums, a Health Affairs study found. The study used Congressional...

KFF: Over Half of Insured Adults Face Problems with Health Insurance

by Victoria Bailey

More than half of adults experienced problems with their health insurance, with issues ranging from payment discrepancies to limited mental healthcare coverage, a KFF survey found. The survey was...

Loss of ACA Preventive Care Mandate Could Impact 10M Enrollees

by Kelsey Waddill

With the Affordable Care Act’s preventive care coverage requirement under scrutiny, Peterson-KFF researchers investigated how many Americans rely on the law’s coverage and determined that...

KFF: Payers Will Issue $1.1B in Medical Loss Ratio Rebates in 2023

by Victoria Bailey

Payers will issue around $1.1 billion in medical loss ratio (MLR) rebates across commercial markets in 2023, KFF projected. In the individual and small group markets, payers must spend at least...

Potential Outcomes of Basic Health Programs for States, Consumers

by Kelsey Waddill

Basic Health Programs (BHPs) can streamline coverage and increase coverage continuity for certain populations, but the cost to states will vary, a report from the Urban Institute shared. “The...

The Role of Affordable Care Act Premium Tax Credits in the Payer Industry

by Kelsey Waddill

The Affordable Care Act marketplace premium tax credits were introduced in 2010 and continue to play an integral role in US health insurance. A Google search on premium tax credits will demonstrate...

PHE Expiration Will Lead to Medicaid Coverage Losses for 18M People

by Victoria Bailey

If the COVID-19 public health emergency (PHE) ends in April 2023, 18 million people may lose Medicaid coverage in the 14 months following its expiration, according to a brief from the Robert Wood...

Health Insurance Coverage Disruptions Tied to Higher Mortality Risks

by Victoria Bailey

Health insurance coverage disruptions were associated with higher mortality risks for people with private and public insurance, a JAMA Health Forum study found. Health insurance coverage is typically...

How Health Insurance Coverage Varies Across, Within Families

by Victoria Bailey

The Affordable Care Act (ACA) increased access to Medicaid and group health insurance, but the family glitch created a barrier to non-group coverage, leading to variations in health insurance coverage...

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