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Standards for Health Insurance Provider Networks: Examples from the States

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 feder...

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Accelerating the Affordable Care Act’s Enrollment Momentum: 10 Recommendations for Future Enrollment Periods

On March 31, 2014, the Affordable Care Act’s first open enrollment period ended. The next period begins on November 15. And as of March 27, six million consumers signed up for health insurance throu...

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How King v. Burwell Could Affect Health Insurance Under Obamacare

Learn what King v. Burwell, the Supreme Court case that threatens the provision of health care subsidies (premium tax credits), is all about. The Court will announce its decision in mid- to late-June...

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Rate Review: How to Challenge Unreasonable Health Insurance Premium Increases

PDATE (August 3, 2015): Obama Administration Urges States to Cut Health Insurers' Requests for Big Rate Increases, The New York Times. When health insurance companies want to raise premium rates, ...

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1115 Waiver Transparency Requirements and Developing a Waiver Advocacy Strategy

Section 1115 of the Social Security Act allows the Secretary of Health and Human services to waive certain Medicaid requirements to give states the flexibility to test new benefit designs and new app...

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An Advocate’s Guide to Analyzing Insurers’ Financial Health

When health insurance companies want to raise premium rates, states use a process called "rate review" to decide whether proposed increases are justified. By participating in rate review, consumer adv...

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Evaluating the Consumer Window-Shopping Experience in Health Insurance Marketplace Websites: A Comparative Analysis

Today’s consumers have four goals in mind when they visit marketplace websites to shop for health insurance: to easily understand and compare health plan options, find out if they are eligible for f...

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Improving the Accuracy of Health Insurance Plans’ Provider Directories

Provider directory inaccuracies have caused problems for consumers and other stakeholders for many years. Our issue brief (PDF) explains the steps policymakers and health plans can take to improve d...

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What Advocates Should Know about 1332 State Innovation Waivers

Beginning in 2017, the Affordable Care Act permits states to apply for waivers to begin experimenting with strategies to provide residents with access to high-quality, affordable health insurance. Kno...

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Consumer Protections for Web Brokers that Participate in the Health Insurance Marketplace

The issue of “direct enrollment” for marketplaces has become a hot topic in many states. “Direct enrollment” is when an insurer or broker facilitates a consumer’s enrollment in a marketplace...

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