Open Enrollment Preview: Checking the Vitals of the Marketplaces

The Affordable Care Act’s health insurance marketplaces rely on robust competition to control costs and to provide consumer choice. But the decisions of several large insurers to scale back their 2017 marketplace participation, and the failure of many health insurance co-ops will leave marketplace shoppers in many states with fewer choices than they had in 2016. Furthermore, those insurers remaining in the exchanges have often found their marketplace customers to be less healthy than they projected, and they are raising premiums in response. Our briefing focuses on these trends, what they mean for the long-term viability of the marketplaces, and what public policy steps can be taken to bring more healthy people into the risk pool and to encourage insurer participation in the individual market.






Trends in Coverage and Affordability on the ACA Marketplaces

In advance of the fourth open enrollment period for health coverage under the Affordable Care Act (ACA), which begins Nov. 1, this briefing examined who has gained coverage, who remains uninsured, and why uninsured individuals have not obtained coverage. Speakers also discussed marketplace stability, factors driving premium trends, and the outlook for 2017 premiums. In addition to insights from our panelists, this briefing included a discussion of survey results from The Commonwealth Fund ACA Tracking Survey and what it tells us about consumers’ experiences with the marketplaces.






Workplace Wellness: Promises, Challenges, and Legal Questions

Employers have long been advancing a variety of efforts to engage their employees in their health care, reduce absenteeism, and decrease the cost of employee health benefits. Recently, however, some employer wellness programs offering significant incentives for participation–or penalties for nonparticipation–have raised legal issues regarding privacy and discrimination and are the subject of a recent proposed rule from the Equal Employment Opportunity Commission (EEOC).






Medicare Open Enrollment Preview

With Medicare Advantage (Part C) and prescription drug (Part D) open enrollment beginning October 15th, this briefing took a close look at what to expect, including trends in premiums and cost sharing, plan availability and benefit design.






Health Insurance Marketplaces in 2016: What to Expect

With the third open enrollment period for health insurance marketplaces launching November 1st, this briefing took a detailed look at what consumers can expect regarding premiums, health plan availability and affordability.






The ACA: Experiences in Health Care Coverage and Access

In advance of the third open enrollment period for health coverage under the Affordable Care Act, this briefing examined coverage trends, who has gained coverage and who remains uninsured, and why those uninsured individuals have not obtained coverage.






King v. Burwell Toolkit: To Subsidize or Not to Subsidize

A new Alliance for Health Reform toolkit will help you prepare for and understand the Supreme Court’s King v. Burwell decision, which could come as early as Friday. A major challenge to the Affordable Care Act (ACA) is before the Supreme Court, which is expected to make a decision in the King v. Burwell case by the end of its term in June 2015. The case concerns the legality of health insurance tax credits offered through a federally run health insurance marketplace, as opposed to a marketplace established by an individual state.

The Evolving Coverage Landscape for Small Businesses: Opportunities and Challenges

The Affordable Care Act (ACA) created new health insurance marketplaces for small businesses, known as Small Business Health Options Program (SHOP) marketplaces, and made substantial changes to the regulation of health insurance for small businesses. For purposes of health insurance regulation, small businesses have traditionally been defined by states as businesses with up to 50 employees. The ACA defined the small group market as employers with 1-100 employees, while allowing states to limit small group participation to employers with 50 or fewer workers from 2014 through 2016. Every state chose to do so, but, for plan years beginning in 2016, the definition of small business is set to expand to include those with 100 or fewer employees—with potentially significant consequences for the small group health insurance market and the SHOP marketplaces.






Reporter Briefing: Small Business Health Coverage Changes in 2016- Opportunities and Challenge

Join us for a special breakfast for reporters to address major changes set to take place for small businesses and health coverage in 2016, and proposals to delay or reconsider those changes. The Affordable Care Act (ACA) created new health insurance marketplaces for small businesses, known as Small Business Health Options Program (SHOP) marketplaces, and made substantial changes to the regulation of health insurance for small businesses. For plan years beginning in 2016, the definition of a small business is set to expand from up to 50 employees to up to 100 employees—with potentially significant consequences for the small group health insurance market and the SHOP marketplaces.






King v. Burwell: The Facts and Implications

This briefing told you what you need to know about a major Supreme Court challenge to the Affordable Care Act (ACA). The Court is expected to make a decision in June, and a ruling for the King petitioners could mean that individuals will no longer be able to receive subsidies to purchase health insurance through the federal marketplace. The federal government is operating insurance marketplaces in more than 30 states. Currently, subsidies to buy health insurance are available to individuals with incomes between 100 percent and 400 percent of the federal poverty level (i.e., those with annual incomes between $11,770 and $47,080).






ACA 101: What You Need to Know

This session was especially helpful to congressional staff members new to the issue, but is also a useful review for anyone dealing with the Affordable Care Act (ACA). The briefing took place just as the second marketplace enrollment period ended and the Supreme Court heard oral arguments in a case challenging the law’s subsidies.






ACA Enrollment Round II: Do Consumers Have the Help they Need?

The Affordable Care Act’s second open enrollment period runs through mid February, and millions of people are already looking for help to find the best insurance fit. While many who signed up last year are expected to shop around for different health plans, millions more may become first time buyers. This briefing will explore the availability and usefulness of in-person assistance programs (navigators, assisters and brokers) that are intended to help individuals search and apply for coverage. After last year’s enrollment difficulties, we will look at the challenges of this second round, with a particular focus on the help available to consumers.






Health Insurance Marketplaces, Round II: Results and Expectations

One day after this briefing, on November 15, the second open enrollment period begins for health plans sold in federal and state marketplaces. More than 7 million people who bought insurance for 2014 can shop around for new plans or stay where they are. Those who received federal subsidies will face a redetermination process to assess their current income and other eligibility factors. Experts estimate there may be millions of new enrollees.






Reporter Briefing: What’s Next for Obamacare?

The Association of Health Care Journalists’ Washington, DC Chapter and the Alliance for Health reform invite you to a discussion about how journalists can get ready for Round 2 of marketplace enrollment and uncover the next big issues related to the Affordable Care Act.






Navigating the Health Insurance Landscape: What’s Next For Navigators, In-Person Assisters and Brokers?

Approximately 10.6 million people were aided by more than 4,400 in-person assistance programs in searching and applying for coverage in the first six-month enrollment period. Brokers also played a role in helping consumers sign up for coverage. Some believe that in-person, enrollment assistance programs are key to future enrollment success, while others voice concerns about the training of those offering assistance, and the security of applicants’ personal information. Many questions arise about their effect on coverage moving forward and the funding required to support the programs.