The Advocate's Guide to: Health Insurance Reform

States across the country are looking for ways to address problems that have lingered in our health care system despite the progress made since the passage of the Affordable Care Act. This presents an opportunity for state advocates to engage in important conversations and advocate for policies that would strengthen consumer protections, address affordability concerns and continue to connect uninsured consumers with comprehensive coverage options. The goal of these guides is to arm state advocates with important background information and advocacy considerations on key topics surfacing across the country related to private insurance coverage and marketplace issues.

We will continue to post new issue briefs throughout the year, so be sure to check back often!

The resources in this toolkit were developed with the help of the Georgetown University Center on Health Insurance Reforms staff. For questions, please email Ashley Blackburn, Policy Manager, at ablackburn@communitycatalyst.org

• Advocate’s Guide To: The Health Care Repeal Lawsuit

  On December 18, 2019, the 5th U.S. Circuit Court of Appeals issued a ruling in the Health Care Repeal Lawsuit, threatening health coverage for millions of people across the U.S. This guide serves as a comprehensive explainer on the case, the decision and the next steps in the legal process.

• The Advocate's Guide to: Addressing Out-Of-Network Payment in Surprise Balance Billing Legislation

  Surprise medical bills are a top health concerns for many individuals and families. Legislation to protect consumers from surprise medical bills is under consideration at the state and federal levels with bipartisan support. Check out our new issue brief to learn more about different approaches to resolving the payment issue. 

• The Advocate's Guide to: Reinsurance

  Amid affordability concerns, policymakers are looking for ways to drive down premiums in their states’ marketplaces and improve market stability. Reinsurance has emerged as a popular option to lower premiums for those ineligible for federal subsidies, finding bipartisan footing in red and blue states alike, as well as support from the past and current presidential administrations.

• The Advocate's Guide to: Pre-Existing Condition Protections

  As we await the next ruling in Texas v. United States – a federal lawsuit challenging the constitutionality of the entire Affordable Care Act (ACA) – check out this issue brief to see how state policymakers and advocates can defend access to coverage for people with pre-existing conditions.

• The Advocate’s Guide to: Essential Health Benefits

  As state policymakers and advocates look for ways to address barriers keeping consumers from accessing adequate health insurance coverage, check out this issue brief to learn about state options to bolster Essential Health Benefits.

• The Advocate's Guide To: Short-Term Limited Duration Plans

  Given an expected increase in enrollment in short-term plans as a long-term coverage option, state policymakers and advocates are considering ways to protect individuals shopping for coverage and the individual health insurance market. About half the states restrict the sale of short-term plans so that they are not an option to provide long-term coverage. A number of states apply some or all ACA consumer protections to short-term plans in an effort to improve the products.

• Case Study: A State Campaign to Limit Short-Term Plans

  Short-Term Limited Duration Insurance (STLDI) plans have a very limited utility and actually threaten the stability of the ACA’s comprehensive coverage market. As such, the Obama administration issued regulations in 2016 that, among other protections, limited the duration of STLDI plans to three months. However, in 2018 the Trump administration issued final regulations rolling back these protections.