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State Exchanges View All →

Four ways the ACA marketplace has changed coverage options

4 days ago

Insurers are refining plans amid modest increases in benchmark premiums.

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Half Of Obamacare Choices Are HMOs Or Narrow Network Plans

1 month ago

More than half of the insurance products offered on public exchanges under the Affordable Care Act are health maintenance organizations (HMOs) or plans that limit healthcare providers “within a predetermined network”.

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Some exchange plans offer free doctor visits to court consumers

1 month ago

A limited number of health plans offered on the insurance exchanges established under the Affordable Care Act are offering free doctor visits.

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Four Obamacare Worries For 2016 As More Seek Coverage

1 month ago

As health insurance companies begin the third year of providing subsidized private coverage under the Affordable Care Act, worries abound about whether the economics and politics will improve the unsteady individual commercial business.

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Obama Administration Details HealthCare.gov Renewals

1 month ago

Administration says 60% of HealthCare.gov users actively renewed coverage.

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Looking for Affordable Care Act activity for a particular state? Select here to find out what's going on:

Medicaid View All →

After Medicaid Expansion, a Sharp Drop in Uninsured Hospital Stays

4 days ago

Kentucky experienced the most dramatic change in uninsured hospitalizations: a drop of 13.5 percentage points. States that did not expand Medicaid saw very little change in inpatient payer mix.

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Dual eligible pilots proving pricey, time-consuming for states

2 weeks ago

Many states are finding the “nuts and bolts” of coordinating care for dual eligible beneficiaries to be more costly and time consuming than they anticipated, with states underestimating the “extensive financial investments” required to modify their IT systems for the pilots, lacking alignment across beneficiary materials, Medicare-Medicaid plan compliance processes and appeals processes, and spending […]

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Are dual-eligible demos succeeding? GAO says it will be hard to tell

3 weeks ago

The CMS needs to do a better job overseeing the 12 state-administered demonstration programs intended to improve care of people who are eligible for both Medicare and Medicaid, according to the U.S. Government Accountability Office.

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Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey

3 weeks ago

This 14th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies provides a point-in-time snapshot of policies as of January 2016 and identifies changes in policies that occurred during 2015.

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Expansion Waivers, Drug Pricing Among Top Medicaid Concerns

1 month ago

The Medicaid program turned 50 in 2015 and is coming off a year of significant enrollment growth, due in large part to the expansion of eligibility under the Affordable Care Act. 

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Emerging Healthcare Models View All →

3 Payer-Driven Strategies to Transform Care Models

4 days ago

Spectrum Health, a not-for-profit, integrated, managed care healthcare organization, is focused on redesigning care models to increase value. Its insurance arm has been key.

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ACA’s Basic Health Program gains traction in some states

4 days ago

But program may also reduce exchange participation, discouraging insurers.

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With Harken Health, United delves into primary care innovation

4 days ago

Insurer’s subsidiary focuses on individuals and small businesses seeking fully insured plans.

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A Payment Reform Conundrum: Reconciling Conflicting Policy Goals

2 weeks ago

So far, the gains from alternative payment models have not been large.

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Integrating Specialty Care Into Accountable Care Organizations: Perspectives From The Field

3 weeks ago

Integrating specialty care can be key for high performance and financial success for ACOs, as the most complicated and costly patient care usually is managed by specialists.

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Insurers View All →

Insurer Obamacare Losses Reach Billions Of Dollars After Two Years

4 days ago

After two years offering uninsured Americans subsidized products on public exchanges, health insurance companies have been hard-pressed to find financial success in this segment of the Affordable Care Act with losses reaching billions of dollars for the industry.

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Anthem Profits Tumble On Higher Obamacare Costs

2 weeks ago

Anthem surprised Wall Street this morning with news its fourth-quarter profits fell 64% as the company was hit with higher than-expected medical expenses in its individual health insurance business, which includes plans offered on public exchanges under the Affordable Care Act.

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CMS reins in special enrollment chances for ACA plans

3 weeks ago

Heeding the calls of upset health insurers, the CMS has purged several categories of circumstances that allow consumers to get plans through the Affordable Care Act marketplaces outside the open-enrollment period.

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Insurers Say Costs Are Climbing as More Enroll Past Health Act Deadline

1 month ago

Eager to maximize coverage under the Affordable Care Act, the Obama administration has allowed large numbers of people to sign up for insurance after the deadlines in the last two years, destabilizing insurance markets and driving up premiums, health insurance companies say.

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Humana to end grandfathered health plans in 2016

2 months ago

Humana Inc. is discontinuing the individual health plans that were in existence before the Affordable Care Act was enacted and that don’t comply with the law’s prohibitions against refusing coverage or charging more to people with health problems.

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