Insurance Market Reform

The United States Department of Health and Human Services released a 2012 Annual Rate Review report highlighting that the ACA rate review and Medical Loss Ratio (MLR) provisions have saved an estimated $1 billion for consumers.

This report, prepared by a broad coalition of consumer representatives to the National Association of Insurance Commissioners (NAIC), provides consumer-focused recommendations to state and federal policymakers.

This toolkit is designed to help departments of insurance work with Exchanges to determine appropriate roles and operationalize many of the plan management functions necessary to successfully implement an exchange. 

The final rule outlines the data health plans must provide to determine whether they meet essential health benefit standards, and establishes a process for recognizing entities to certify qualified health plans.

This report by Wakely Consulting Group examines New York’s options and makes recommendations for its risk adjustment approach under health reform.

This report by the Urban Institute examines the health care reform law's ability to protect all individuals who purchase insurance through the small group and nongroup markets, especially those who have many health needs, and therefore high costs.

This summary from HealthReform GPS outlines issues around multi-state plans (MSPs) that will be offered on health insurance exchanges.

The U.S. Department of Health and Human Services has issued a bulletin laying out how it will run the risk adjustment program in states that do not choose to run it themselves.

This proposed rule addresses what data health insurers must provide to enable regulators to set essential health benefit standards and outlines a process for accrediting qualified health plans.

Presentations from New York's stakeholder meeting that reviewed recommendations from Wakely Consulting Group relating to risk adjustment and reinsurance mechanisms under the ACA and the state's key decisions in response.