Last Friday, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that will implement new policies next year including eligibility restrictions and expanded access to non-traditional health plans.
The rules will allow plans that otherwise would not qualify for the Affordable Care Act's (ACA) insurance exchange,...
Health insurance premium rates for Affordable Care Act (ACA) plans are up substantially for 2026, across the country and for Arizonans.
Last Friday, the Arizona Department of Insurance and Financial Institutions finally announced the submitted preliminary rate increases for 2026 ACA plans, as reported in early August by The Hertel...National News
CVS Health's Aetna will stop offering plans on the Affordable Care Act (ACA) healthcare individual exchange in 2026 as the company projects major losses this year. Health plans preparing to submit Marketplace rate proposals are considering scenarios with and without cost savings reductions, but APTCs aren't included.
The announcement...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) have finalized a rule that imposes new standards for the Affordable Care Act (ACA) individual market for the federal and state exchanges in 2026.
The rule is meant as a consumer protection, preventing policy coverage from being swapped without authorization from the policy...National News
The election is just around the corner, and the Trump and Harris campaigns are clarifying their health policy positions to court voters in the home stretch.
A major concern for the Republican campaign is the perception that given a second term, former President Donald Trump would continue the pursuit of overturning the Affordable Care...CMS Rules
Last week, the Centers for Medicare and Medicaid Services (CMS) announced new proposed rules for the ACA Marketplace in 2026. The agency intends for the rules to control the quality of brokers and agents who enroll people in plans and updates the risk adjustment program.
Since June, CMS has suspended at least 200 brokers on suspicion...
First quarter of 2024 results are in across the insurance industry, with UnitedHealth Group (UHG) pulling out ahead for shareholders despite a costly cyberattack shaking up subsidiary activities.
The repeated attacks against Change Healthcare left UHG with an approximate $1.2 billion loss, with the cyberattack directly costing the...
Last week, the Assistant Secretary for Planning and Evaluation (ASPE) for the U.S. Department of Health and Human Services (HHS) published an issue brief on the changes over time in the demographics of Marketplace insurance coverage.
The brief, Marketplace Enrollee Demographics, Plan Generosity, and Plan Premiums in HealthCare.gov...Arizona News
A key driver of 2024 premium growth is predictable: medical trend, including growth in prices paid by insurers for medical services and medications, plus increased utilization, according to this Peterson-KFF Health System Tracker Report.
After analyzing RateReview.Healthcare.gov for 320 insurers across 50 states and Washington,...
During a year of record-breaking enrollment, national insurers have expanded their Marketplace policies but the number of insurtechs competing on HealthCare.gov has dropped 45% due to financial losses and tight capital.
Rule Highlights
Non-Standardized Plans
The new rule from the Centers for Medicare & Medicaid Services (CMS)...
On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that includes revisions to network adequacy standards for Marketplace plans and paths to transitioning Medicaid members to the Marketplace. The proposed rule adds behavioral healthcare, including substance use disorder facilities and providers, to the...
Insuretech companies have suffered some huge financial losses this year, as a result some of them are pulling away from certain Medicare markets and pivoting to other methods of improving business.
For the third quarter of 2022, Clover Health posted a $75.3 million net loss, but doubled its total revenue year-over-year from $427...News
The Biden administration is looking into making more payment models offered through the Center for Medicare and Medicaid Innovation (CMMI) mandatory in the future as it moves forward on value-based care coverage.
Over the past 10 years, CMMI has tested 54 models and only five have been shown to produce effective cost savings for the...Arizona News
Health care enrollment under the Affordable Care Act (ACA) is continuing to climb in Arizona and across the country during the special enrollment period (SEP) as benchmark premiums also continue to decline.
According to ABC15, the Centers for Medicare & Medicaid Services (CMS) logged 17,081 Arizonans have selected plans during the...Arizona News
The Department of Health and Human Services (HHS) announced a 25% drop in premiums for new enrollees on HealthCare.gov. During the 2021 special enrollment period, and as a result of Affordable Care Act (ACA) premium tax credits, nearly 940,000 enrollees have joined plans offered on the exchange, according to Healthpayer Intelligence....Arizona News
Insurance giant UnitedHealth revealed its policy recommendation package “The Path Forward To A Next-Generation Health System” last week, a reform proposal that states could use via the Affordable Care Act’s waiver authority to move low-income exchange enrollees into a Medicaid buy-in program.
In Arizona, UnitedHealthcare covers...National News
In week two of the 2020 Open Enrollment, 754,967 people selected plans using the HealthCare.gov platform.
CMS released the following numbers Nov. 13.
...Arizona News
Democrats took the House during midterm elections, leaving a divided Congress to take on legislation. Healthcare policies and ideas were big ticket items on the campaign trail and Democrats are eager to implement their plans.
According to a CNN's exit polling, 41 percent of respondents said healthcare was the most important issue...
