The Centers for Medicare & Medicaid Services (CMS) has introduced a new option for states to update their essential health benefits (EHB) benchmark plan to include routine adult dental coverage, aiming to address disparities in oral health outcomes, particularly for low-income and minority adults. In their latest Expert Perspective for the State Health & Value Strategies program, CHIR's JoAnn Volk and Manatt's Tara Straw discuss considerations for states weighing this addition ..read more

Enhanced premium tax credits (PTCs) have significantly reduced health insurance premiums and expanded coverage for millions of Americans, particularly low- and middle-income individuals, but these subsidies are set to expire in 2025. If Congress doesn't act to make them permanent, premiums will rise, leading to coverage losses and greater financial hardship for millions. CHIR's Karen Davenport discusses what the incoming Congress can do to address healthcare affordability issues ..read more

The leaves are falling but the latest health policy research is evergreen! Last month we read about health system competition in metropolitan areas, health care affordability prior to the American Rescue Plan (ARPA,) how high deductible health insurance can exacerbate racial and ethnic wealth disparities, and about unmet dental vision and hearing needs among low-income Medicare Advantage beneficiaries ..read more

Many Americans struggle with high healthcare costs, leading state policymakers to explore transparency measures to lower prices. While transparency alone has limited impact on cost reduction, states are innovating by increasing transparency in areas like provider ownership, billing practices, and price data, which can inform broader policy solutions and have bipartisan support, paving the way for more effective cost-containment strategies. In their latest article for CHIRblog, CHIR experts Stacey Pogue and Nadia Stovicek explore transparency options for state policymakers ..read more

In recent years, federal price transparency rules have required hospitals and health plans to publicly post health care prices in both consumer-friendly formats and machine-readable files. However, challenges persist with data accessibility and usability, limiting its effectiveness for consumers and policymakers. Two bipartisan bills in Congress, the LCMT Act and the PRICE Act 2.0, seek to strengthen and standardize these rules. CHIR experts Stacey Pogue and Nadia Stovicek discuss the federal price transparency landscape in their latest piece for CHIRblog ..read more

The 2024 election results will require concerted and aggressive efforts to preserve gains in insurance coverage, improvements in health equity, and greater health care affordability. CHIR's faculty share thoughts on the work ahead ..read more

The U.S. health care system's lack of regulation over provider pricing and insurer claims has led to a rise in profit-driven middlemen, such as revenue cycle management firms. While these intermediaries aim to maximize reimbursements for providers, they often increase costs for consumers and complicate access to care. This complex environment underscores the urgent need for regulatory oversight to address the inefficiencies and rising expenses in the system. In their latest piece for Health Affairs Forefront, Linda J. Blumberg and Kennah Watts break down the effect of middlemen on US health ca ..read more

CMS recently released their draft Notice of Benefit & Payment Parameters (NBPP) for plan year 2026. In their latest piece for Health Affairs Forefront, Sabrina Corlette and Jason Levitis discuss what this means for Marketplaces, insurance reforms and Advance Premium Tax Credits (APTCs ..read more

The 2021 expansion of federal premium tax credits (PTCs) drove uninsured rates to a record low in 2023, but this critical financial assistance will expire after 2025 unless Congress acts. CHIR faculty Rachel Swindle and Justin Giovannelli talk more about this in their latest issue brief for the Commonwealth Fund ..read more

Open enrollment for the Affordable Care Act Marketplaces begins on November 1. We we review several important policies and programmatic changes that could effect Marketplace consumers in 2025 ..read more