Health Affairs

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

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 [...]

Editor’s note: See additional posts discussing Pioneer accountable care organizations by Debra Ness and William Kramer and Douglas Hastings. The December 19 announcement by the Centers for Medicare and Medicaid Services (CMS) of 32 Medicare Pioneer ACOs underscores the transition of “shared savings” and “accountable care” from policy concepts to implementation. Perhaps more than any [...]

The recent CMS bulletin on the essential benefits package (EBP) required for certain types of coverage under the Affordable Care Act has been described in greater detail in earlier Health Affairs Blog posts by Tim Jost and Kavita Patel.  The bulletin is a pragmatic document, seemingly driven by the overall exigency of implementing the ACA [...]

In the recently released bulletin from HHS on the essential health benefits (EHB), the administration answered a major question on the minds of many critical healthcare stakeholders: Will the administration be specific in their guidance and create a definition of what constitutes “essential?”  The answer, is no, they will leave the bulk of the decision-making [...]

On December 16, 2011, HHS released a “bulletin” describing the approach that it intends to take to establishing the “essential health benefits” under the Affordable Care Act.  A bulletin is a form of guidance that lacks the legal stature of a rule.  HHS believed, however, that the states, insurers, consumer advocates, and the public needed [...]

The week of December 5 was a particularly busy week in health care reform implementation.  After a lull over the Thanksgiving holiday, new regulations, proposed regulations, guidance, and grant announcements have poured out of the agencies.  This post will briefly summarize three of these issuances: the final rule on the Establishment of Consumer Operated and [...]

On December 2, 2011, the Department of Health and Human Services released both a final rule  and an interim final rule updating the medical loss ratio rule that it issued almost exactly a year ago.  The Department of Labor simultaneously issued a technical release giving direction to employer-sponsored health plans governed by the Employee Retirement [...]

As 2011 comes to a close, we draw ever closer to January 1, 2014, the day when the most significant changes wrought by the Affordable Care Act will come into effect.  Indeed, we are only weeks away from the halfway point between March, 2010, when the ACA was signed into law and October, 2013, the [...]

Attend AcademyHealth’s National Health Policy Conference (NHPC) to hear directly from state policymakers, analysts, and practitioners about how they are facing those challenges and seizing new opportunities in a post-ACA environment. The 2012 meeting agenda features a special focus on states: Challenges of ACA Implementation at the State Level Representatives from some of the agencies [...]

Editor’s note: A newly updated Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation provides more information on the CLASS Act and where we stand now regarding the need to provide affordable coverage for long-term services and supports. The announcement by U.S. Health and Human Services Secretary Kathleen Sebelius that the Community [...]

The McKinsey Global Institute reported in 2007 and 2008 that the United States spends twice as much for health care as for food. According to Census and Department of Agriculture data that pattern continues. Yet millions remain outside the protection of health insurance and many nominally within its bounds are seriously underinsured. Millions of individuals [...]

The latest edition of the Health Wonk Review is available at InsureBlog. There, Hank Stern highlights a smorgasbord of great health policy posts, including Mark Hall’s Health Affairs Blog post on the importance of the individual mandate to the workability of health reform.

Today, November 14, 2011, the Supreme Court decided to review a decision of the Eleventh Circuit Court of Appeals striking down the minimum coverage requirement of the Affordable Care Act (ACA) as unconstitutional.  The case will probably be argued before the Court in March and decided in the early summer. Procedurally, the Court “granted certiorari.”  [...]

Yesterday, November 8, the United States Court of Appeals for the District of Columbia became the second federal court of appeals to uphold the constitutionality of the minimum coverage requirement of the Affordable Care Act. To date, one federal appellate court has held the minimum coverage  requirement to be unconstitutional (although severable from the remainder [...]