Health Affairs

The U.S. Supreme Court held oral arguments on Tuesday on the constitutionality of the minimum coverage provision of the Patient Protection and Affordable Care Act (ACA). Not since the New Deal has the Supreme Court considered such a fundamental challenge to the federal government’s power to regulate individuals. It is not surprising, therefore, that the... Read the rest of this entry »

In the design of health insurance exchanges, one key issue is whether exchanges will offer improved value to people buying insurance in the individual and small group markets.  A lot depends on whether the exchanges act as prudent purchasers – making design decisions that keep quality high and costs low.  It appears that many states,... Read the rest of this entry »

On March 16, 2012, the Department of Health and Human Services published a final rule regarding student health plans, an advanced notice of proposed rulemaking explaining how it intends to handle coverage of contraception services, and a notice regarding the early retiree reinsurance program.  This blog post addresses these issuances.  Separate blog posts will address... Read the rest of this entry »

On March 16, 2012, the Department of Health and Human Services published a final rule on the implementation of the reinsurance, risk adjustment, and risk corridor programs which are to be put in place under the Affordable Care Act (ACA), effective January 1, 2014. HHS also published final (and interim final) rules on Medicaid eligibility... Read the rest of this entry »

On March 12, 2012, the Department of Health and Human Services promulgated final regulations governing the establishment of the American Health Benefit Exchanges.  The exchanges are at the heart of the Affordable Care Act strategy for making health insurance available and affordable to millions of Americans in the individual (nongroup) and small group markets. The... Read the rest of this entry »

How much health spending is sustainable? Charles Roehrig’s post addressing this question heads the list of most-read Health Affairs Blog posts for February. Next on the list is a post contrasting Medicare and commercial insurance by Diane Archer and Theodore Marmor. Also in the top ten are posts by Larry Wolf and Ashish Jha examining... Read the rest of this entry »

The Health Insurance Exchanges required under the Patient Protection and Affordable Care Act (ACA) have the potential to create markets that will help millions of Americans get affordable health insurance coverage and access to high-quality care. The exchanges can enhance consumer and employer buying power to improve the overall quality and efficiency of the health... Read the rest of this entry »

On February 24, 2012, the Department of Health and Human Services (HHS) released guidance describing a proposed method for estimating the actuarial value of health plan benefit designs in 2014.  The actuarial value measures the percentage of expected medical costs that a health plan will cover. It can be considered a general summary measure of... Read the rest of this entry »

AHIP’s Summit on Payment Reform and Delivery Transformation, March 5 in Washington, D.C., spotlights efforts across the country to transform the payment system and care delivery. The Summit showcases initiatives where providers and health plans are partnering with success. The sessions will demonstrate the many lessons learned from these partnerships including gaining provider buy-in, governance... Read the rest of this entry »

If you haven’t already, take a look at the latest Health Wonk Review posted last week at the Healthcare Economist. Jason Shafrin presents a stellar line-up of health policy blogging. He includes Tim Jost’s Health Affairs Blog post on the Supreme Court briefs filed by the states challenging the Affordable Care Act; Tim examines the... Read the rest of this entry »

On December 16, 2011, the Department of Health and Human Services issued a bulletin describing the approach that it intended to take to defining the essential health benefits (EHB) that individual (nongroup) and small group plans must cover under the Affordable Care Act.  In that bulletin, HHS indicated that each state will select a benchmark... Read the rest of this entry »

As the debate over Medicare continues in connection to America’s fiscal problems, it is critical to understand how Medicare differs from commercial health insurance for working people.  There is a fundamental difference between these two types of health insurance plans, one social and one commercial. The basic difference between Medicare and commercial insurance is that... Read the rest of this entry »

The most-read Health Affairs Blog post for January was Tim Jost’s examination of the first set of briefs filed before the Supreme Court in the litigation over the Constitutionality of the Affordable Care Act. The full top-ten list for the month also includes Jerald Winakur’s post on disruptions experienced by many patients during care transitions... Read the rest of this entry »

Editor’s note: See another Health Affairs post on this topic by Tim Jost. How do you shop for health insurance today? For many of us, our employer makes the decision for us. And if there is a choice of health plans, the employer also provides helpful summaries of the benefits, premium differences, and cost-sharing so... Read the rest of this entry »

Editor’s note: Another Health Affairs Blog post, by Mila Kofman and Sabrina Corlette, also discusses the February 9 final rule implementing Affordable Care Act (ACA) requirements that health plans provide consumers with short, easy to understand summaries of benefits and coverage. Tim Jost’s post below discusses this new rule; additionally, it has also been updated... Read the rest of this entry »

The Affordable Care Act’s state health insurance exchanges for small businesses present a host of opportunities for states now creating them, but they also present design and regulatory challenges that could make or break the success of the program, according to a cluster of articles in the February issue of Health Affairs, released yesterday. The... Read the rest of this entry »

Briefs continue to be filed at a furious pace in the Affordable Care Act Supreme Court litigation.  On January 6, the federal government led off with its brief challenging the decision of the Eleventh Circuit federal court of appeals that the ACA’s minimum coverage requirement (individual mandate) is unconstitutional.  The states and the National Federation... Read the rest of this entry »

As every reader knows, the Supreme Court has agreed to consider challenges that have been brought to the constitutionality of two provisions of the Affordable Care Act (ACA) by twenty-six states, the National Federation of Independent Businesses, and individual plaintiffs.  The Court has scheduled the case for five and a half hours of oral arguments... Read the rest of this entry »

The most-read Health Affairs Blog post in 2011 was Tim Jost’s analysis of the arguments before the 11th Circuit Court of Appeals over the Affordable Care Act’s constitutionality.  Posts on accountable care organizations, the relative efficiency of Medicare and private insurance, and other topics also appear on HA Blog’s 2011 most-read list. Another post by... Read the rest of this entry »

With little fanfare and little attention from the media, the Obama Administration recently issued proposed rules to crackdown on health insurance scams that use ERISA to avoid state law enforcement and regulatory actions. Since the 1974 enactment of ERISA — the federal law governing employee pension and health benefit plans — crooks have used it... Read the rest of this entry »