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.
Each month, we weigh in on selected news stories and trending debates that are shaping the direction of health care policy.
The start of the second open enrollment period is less than 50 days away. Like many of you, I’ve been finding myself increasingly caught up in the whirlwind of activity around preparations for the new enrollment season—ensuring that America’s working families have the information and resources they need to get covered and stay covered.
The Affordable Care Act has made immense strides in expanding access to affordable health coverage. But some lower and moderate-income consumers may still struggle to afford coverage and care, even with the help of federal financial assistance. Nonprofits can alleviate some of the burden facing consumers.
Last week, we highlighted forward-thinking solutions some states have implemented to provide greater financial assistance to consumers, such as implementing the Basic Health Program.
The Obama administration announced on Monday that 115,000 consumers will lose their health coverage under the Affordable Care Act on October 1 because they did not submit the proper paperwork proving their legal immigration or citizenship status.
An additional 363,000 consumers may see their financial assistance affected because they did not accurately report their income. More than eight in 10 people who applied for health coverage in the federally facilitated marketplace qualified to receive this financial assistance (also known as premium tax credits or premium subsidies).
Proposed health insurance premium rates for 2015 varied greatly among states and insurers. To limit unreasonable rate increases, Families USA encourages state advocates to engage in the rate review process.
Earlier this year, we explained how advocates can participate in their state’s rate review process to influence the monthly premiums that health insurers are allowed to charge. We reached out to state advocates to “crowdsource” today’s blog about how advocates are challenging proposed rates.
The Affordable Care Act did a lot to help uninsured consumers get health coverage, but it did not entirely resolve the very real problems with insurance affordability for low- and moderate-income consumers. These consumers often struggle to meet other living costs and, even once they have health insurance, may not be able to get the health care they need because they have trouble paying for costs associated with their premiums, office visits, and other types of health care.
The Affordable Care Act (ACA) improved insurance affordability and access for all Americans, including those eligible for Medicare, Medicaid, and private coverage offered through the health insurance marketplace. It strengthened Medicare in many ways — by closing the Part D prescription drug doughnut hole, offering free preventive services, and extending the life of the Medicare trust fund. However, the ACA’s improvements to Medicaid and private market insurance highlight longstanding shortfalls in programs that assist low-income Medicare beneficiaries with their health care costs.
Last week, Paul Ryan—House Budget Chairman and the likely incoming chairman of the powerful Ways and Means Committee—released a plan proposing the broad reform and streamlining of the nation’s safety net programs for the poor. Tellingly, the plan (an outline that is reportedly intended to portray a softer side of conservatism) sidesteps the budget proposals put forth by Ryan over the past four years that have actually been voted on and passed by the Republican-led House.
Open enrollment for the health insurance marketplace begins this November. As a result, health insurers are filing their proposed health insurance premium rates for 2015. To examine how rates may change for consumers buying policies in 2015, we reviewed filings and news reports from 12 states where proposed rates have received media attention. For each state, we looked at overall proposed premium rate changes, which are an average for each insurer. A consumer’s actual premium increase or decrease may be higher or lower than the average depending on age, location, and plan choice.
The success of the Affordable Care Act’s first enrollment period is clear: More than 8 million people have signed up for health insurance coverage through the health insurance marketplaces since last October. Among different racial and ethnic groups, however, increases in health insurance coverage varied widely. African and Asian Americans enrolled at relatively high rates, while Hispanic enrollment was lower. The results from the first enrollment period tell us that minority enrollment is on the upswing, but there is more work to do.