Private Coverage & Exchanges

Latest Update

On Feb. 17, CMS released a proposed rule intended to stabilize the private insurance market and ensure families continue to have private health insurance options while Congress and the administration consider health reforms.

On Dec. 16, 2016, CMS released the Final Notice on Benefits and Payment Parameters for 2018 and the 2018 Letter to Issuers in the Federally-facilitated Marketplaces. This guidance sets the parameters for all private health plans that will be sold through the Exchanges in 2018. CMS also released the final 2018 Essential Community Provider (ECP) List, which includes children’s hospital bed counts that were collected from CHA and AHA surveys.


Resources

Analysis or Summary
Final Market Stabilization Rule Summary
May 5, 2017

CMS released the final Market Stabilization rule, which changes certain standards for Exchange plans as well as some requirements for plans in the ...

Analysis or Summary
American Health Care Act: Overview of Provisions Impacting Children
April 28, 2017

The American Health Care Act would convert Medicaid to a per capita cap system in 2020, limiting future federal funding to the states and risking ...

Analysis or Summary
AHCA Amendment Would Allow States to Waive Some Commercial Insurance Protections for Children
April 28, 2017

The MacArthur amendment would give states waivers of certain private insurance protections, including the essential health benefit (EHB) requirements ...

Analysis or Summary
CHA Summary of Invisible High-Risk Pool Amendment to AHCA
April 13, 2017

CHA summary describes the pool structure to an approved amendment to the American Health Care Act (AHCA), which creates a federal invisible high-risk ...

Analysis or Summary
Children’s Principles and the AHCA Chart
March 31, 2017

The grid shows the impact of the American Health Care Act on important national protections currently in place for children.

Letter or Testimony
Comment Letters on Market Stabilization Proposed Rule
March 9, 2017

CHA submitted comments with allied organizations to CMS on the agency's proposed Market Stabilization rule.

Analysis or Summary
CHA Summary of ACA Market Stabilization Proposed Rule
February 24, 2017

On Feb. 17, CMS released a proposed rule intended to stabilize the private insurance market and ensure families continue to have private health ...

Analysis or Summary
2016 State Policy Trends Memo
February 20, 2017

During the summer and fall of 2016, CHA reached out to government relations professionals to inform our understanding of the state policy issues ...

Analysis or Summary
CHA Summary of Cassidy, Collins ACA Repeal/Replace Bill
February 2, 2017

CHA summary of the Patient Freedom Act of 2017, introduced on Jan. 23 by Sens. Bill Cassidy (R-LA) and Susan Collins (R-ME)

Talking Points
Key Provisions of the Affordable Care Act for Children
January 10, 2017

The ACA includes important provisions to make children's health care more age-appropriate, affordable, accessible and timely.It is important that ...

Analysis or Summary
Summary of Final 2018 Guidance for Health Plans
January 6, 2017

The CMS notice and letter set standards for qualified health plans and outline specific steps for plans to be certified for sale in the federally ...

Analysis or Summary
Children's Organizations Joint Comments on 2018 Draft Letter to Exchange Plans
December 8, 2016

The letter calls on CCIIO to define the pediatric Essential Health Benefit and adopt a network adequacy standard for appropriate access to care.

Letter or Testimony
CHA Comments on 2018 Draft Letter to Exchange Plans
December 8, 2016

CHA calls on CCIIO to define the pediatric Essential Health Benefit and adopt a network adequacy standard for appropriate access to care.

Analysis or Summary
CHA Summary of 2018 Draft Technical Guidance for Exchange Plan Certification
November 17, 2016

CHA Summary of 2018 Draft Technical Guidance for Exchange Plan Certification

Letter or Testimony
Habilitation Coalition Comments on Proposed Exchange Guidance
October 7, 2016

CHA joined with almost 50 disability and child advocacy organizations on a comment letter to CMS on the proposed 2018 Notice of Benefit and Payment ...

Issue Brief
Instructions for Hospitals to Complete or Update Revised Federal ECP Questionnaire By Oct. 15
October 7, 2016

CHA has developed instructions for hospitals to complete or update the revised 2018 federal ECP questionnaire by Oct. 15.

Letter or Testimony
CHA Comments on 2018 Exchange Guidance
October 6, 2016

The CHA comment letter addresses provisions in the proposed Notice that affect children’s access to care

Analysis or Summary
CHA Summary of Proposed Exchange Guidance
September 9, 2016

This CHA summary of the 2018 Proposed Notice of Benefits and Payment Parameters (NBPP) highlights those sections of the Notice that affect children’s ...

Analysis or Summary
Affordable Care Act Nondiscrimination Final Rule Summary
September 2, 2016

This summary outlines key provisions of the ACA Section 1557 final rule, which prohibits discrimination on the basis of race, gender, race, color, ...

Issue Brief
Strengthen Exchange Coverage for Children
June 10, 2016

CHA highlights key recommendations to improve the Exchanges for children.

Announcement or News
Participate in Patient Safety Initiatives to Qualify for Contracts with Exchange Plans
May 19, 2016

As of Jan. 1, 2017, hospitals with more than 50 beds must meet new federal requirements for participating in patient safety initiatives.

Letter or Testimony
Senate Democrat Dear Colleague Letter on Pediatric Essential Health Benefits
May 6, 2016

Eleven Senate Democrats sent a letter to HHS Secretary Burwell regarding the tenth category of pediatric essential health benefits.

Analysis or Summary
Summary of 2017 Notice of Benefits and Payment Parameters for Federally Facilitated Marketplaces
May 5, 2016

This summary addresses CMS's decision to delay new network adequacy standards for Exchanges, among other items.

Reference Material
Child Health Advocacy Guide: State Implementation of the NAIC Network Adequacy Standards
March 18, 2016

This advocacy resource provides information regarding the specific provisions of recently adopted standards by the NAIC that should be supported ...

Analysis or Summary
White House FY 2017 Budget Request Highlights
February 12, 2016

The White House budget includes a host of additional policy proposals related to Medicaid, Medicare and other health programs.

Contact

Policy Update Calls

Members receive the latest updates and suggest ways to best influence policy issues that impact children's health and children's hospitals in a weekly conference call.