Communities of color, even once they have insurance, face barriers that can hinder access to those providers. Of those barriers, one of the most notable is the often limited availability of health care providers and facilities in communities of color. Today’s post outlines 10 tactics advocates can use to work with state and federal officials to help address these issues.
Federal Standardized Health Insurance Plans Could Help Improve Access to Care without Raising Premiums
Health insurance companies should offer marketplace plans that make the cost of basic outpatient care—like primary care, specialty care, and prescription drugs—affordable to consumers. This report shows that the new federal standardized silver plans will help consumers by covering this care before people meet their deductible.
Last month, HHS and the Department of the Treasury issued new guidance on state innovation waivers that includes stronger protections for low-income and vulnerable consumers. We believe many of its provisions should be added to federal rules.
In November, the National Association of Insurance Commissioners (NAIC), the organization composed of insurance regulators from every state in the nation, will finalize a model law to help states ensure that consumers can get access to the right health care, at the right time, without unreasonable delay. Dubbed the Network Adequacy Model Act, this draft bill is designed to be used by any state to enact provider access standards for private health insurance plans.
Accurate health plan provider directories are critical to ensuring that coverage works for consumers. Health plans and policymakers can take steps to reduce the prevalence of inaccuracies in provider directories.
This guide explains how to interpret health insurers’ annual statements. This knowledge can be helpful to advocates who are challenging rate increases during the rate review process.
This checklist is designed to help advocates and consumers understand who makes decisions about private insurance in their states. It suggests questions to ask the insurance department, state legislators, and others.
Both a call to action and a roadmap for progress, Families USA’s latest report, Health Reform 2.0 lays out a path for securing high-quality, affordable health care to all Americans—regardless of income, age, race, or ethnicity—and for achieving the “Triple Aim”: improving health, enhancing quality of care, and reducing health care costs.
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.
Much like a cell phone, an insurance plan is only as good as its network. Protections enacted at the federal and state levels are an important step toward strengthening private insurance provider networks. The Affordable Care Act created the first-ever provider network protections for private insurance consumers. These protections require health insurance marketplace plans to have adequate networks to meet their enrollees’ medical needs in a timely manner.