Insurance Market Reform

This Milliman brief discusses the organizations that are most likely to create CO-OPs, the challenges to developing CO-OPs, and areas where CO-OPs can help improve quality and reduce costs.

The Department of Health and Human Services (HHS) released draft rules on the implementation of Consumer Operated and Oriented Plan (CO-OP) program under the Affordable Care Act.  This program will fund the creation of CO-OPs to offer qualified health plans in insurance exchanges.

This brief provides a summary of the Robert Wood Johnson Foundation’s Changes in Health Care Financing and Organization (HCFO) Initiative's meeting discussion among expert researchers, policymakers, insurers, actuaries, and analysts focused on insurance pricing in the individual and small group markets once the health reform law is fully implemented.

This proposed rule would implement standards for states related to reinsurance and risk adjustment, and for health insurance issuers related to reinsurance, risk corridors, and risk adjustment consistent with title I of the Patient Protection and Affordable Care Act (ACA).

Senate Bill 89 would require health plans to cover preventive services without charging co-payments, co-insurance or deductibles.

According to the Urban Institute report, the ACA has the potential to reverse the significant decline in employer sponsored coverage that has occured over the last ten years

According to the State Health Access Data Assitance Center at the University of Minnesota, employer sponsored coverage has significantly declined over the last ten years.

A longitudinal study of heath care consumers that aims to  provide a comprehensive view of health care consumerism that goes beyond the conventional boundaries of what health and health care are commonly thought to encompass.

According to the Government Accountability Office (GAO) report, the Center for Consumer Information and Insurance Oversight (CCIIO) received a total of 1,415 applications for waivers on restrictions of annual limits on health benefits as of April 25, 2011.

This policy brief by AHIP examines trends in enrollment and Medicaid health plan participation in state Medicaid programs as well as trends in other types of Medicaid managed care, and describes how Medicaid health plans are working with states to address ongoing fiscal challenges.