When health plans design their provider networks, they need to ensure that these networks are adequate and provide meaningful access to care. The Affordable Care Act established the first-ever federal rights guaranteeing private insurance consumers access to adequate networks.
Lays out the key elements consumer-friendly wellness programs should have and the ways advocates can help protect enrollees if their state proposes a program that jeopardizes enrollees’ access to care.
Highlights state efforts to protect consumers from unreasonable increases in health insurance premiums, including examples from 12 states.
Discusses opportunities to protect consumers by requiring that insurance companies spend a minimum percentage of premium dollars on health care instead of administrative costs, marketing, and profits.
Examines four kinds of protections states have put in place that are designed to protect low-income, uninsured, or underinsured Americans from medical debt