Before the Affordable Care Act, health insurance regulation in the individual market largely was managed by the states. The ACA saw a shift to a greater federal role. Now under the Trump administration, some responsibilities are going back to the states.
In a new tip sheet for AHCJ, Louise Norris, whom many AHCJ members know as a contributor to healthinsurance.org, explains the new responsibilities. One significant area is network adequacy – whether a plan has enough doctors, hospitals and other providers to meet the needs of beneficiaries. Continue reading
Kaiser Family Foundation
The New York Times Magazine’s recent feature, “Life in Obamacare’s dead zone,” looked at the Medicaid gap we’ve frequently written about since the Supreme Court in 2012 made the ACA expansion optional for states.
The article describes how people who fall into the bizarre coverage gap – in which they are too poor to get subsidized coverage that people just a few slim rungs up the income ladder can get – cobble together care, or just do without, often with pretty grim consequences. Continue reading
Source: Report Card on State Price Transparency Laws — July 2016Here’s how price transparency should work for a woman with a silver-level insurance plan in one state. Assume this consumer could go to any hospital and would choose based on the cost of care, meaning her out-of-pocket costs (deductible plus co-insurance). She could pay $5,079 at the highest-priced facility or $3,531 at the lowest-priced hospital. The difference between the two is $1,548.
Progress toward widespread price transparency comes slowly, according to the latest annual report from the Health Care Incentives Improvement Institute (HCI3) and the Catalyst for Payment Reform (CPR). In the “Report Card on State Price Transparency Laws – July 2016,” issued on Tuesday, the authors, Suzanne Delbanco, CPR’s executive director, and François de Brantes, HCI3’s executive director, explained what states are doing to give consumers the information they need to shop for care based on price.
As in past years, most states are doing poorly: 43 states earned an F grade for failing to meet even minimum standards. Last year, 45 states got an F. Continue reading
Massachusetts tops this year’s list of healthiest places for older adults, according to the 2016 America’s Health Rankings Senior Report. The Bay State jumped to the top perch from sixth place in 2015 thanks to it’s high overall health status, high percentage of diabetes management and low hip fracture rate.
Smoking decreased 20 percent since last year, which moves Massachusetts up 20 places in the ranking of that specific measure. Continue reading
For several years now, I’ve moderated an AHCJ conference panel on health reform in the states and will do it again this year at Health Journalism 2016 in Cleveland. We’ll get pretty granular this year, looking at two specific states – Massachusetts and Washington state – and provide a national overview of how states are looking ahead to next year to solve some of their persistent challenges.
Those challenges include a relatively low rate of young and healthy people signing up, persistent public misconception about what the law does and does not do, and of course, affordability, affordability, affordability. Continue reading