With the Patient Protection and Affordable Care Act’s (ACA’s) ninth open enrollment period (OEP) set to launch in less than a month, the ACA Marketplaces are seeing record enrollment numbers with more generous subsidies, new carrier competition, and a relatively stable rating environment. At the same time, there is uncertainty with the trajectory of the COVID-19 pandemic and medical costs trending upward as the economy recovers, albeit at an uneven pace. These trends have made for a challenging rate review process in the 47 states plus the District of Columbia (D.C.) that conduct their own ACA rate reviews of carrier-proposed rates using federal review standards. State announcements of 2022 rates have trickled out at a slower pace than in prior years, and it is likely that many states will not publish their approved rates until the beginning of open enrollment. As always, state rate results vary widely and, even within states, there often are substantial variations among carriers and across different regions in geographically diverse states. With these caveats, this expert perspective highlights some observations about the factors that are impacting rate changes this year and the kind of variations that exist among states.
2014 Medicaid Eligibility Transition Toolkit for States
National Academy for State Health Policy – Mary Henderson, Abigail Arons, and Alice Weiss
The 2014 Medicaid Eligibility Transition Toolkit is designed to assist states in systematically identifying issues and decisions they will face as they convert to 2014. The toolkit was originally provided to two states by the National Academy for State Health Policy (NASHP) as part of the State Health Reform Assistance Network that is funded by the Robert Wood Johnson Foundation. NASHP has updated the toolkit to be applicable to any state and to reflect the final Medicaid eligibility rules.
The toolkit includes:
Issue Brief: A brief, “Analysis of Eligibility Changes and Implications for Selected Medicaid and CHIP Eligibility Groups in 2014,” provides a detailed overview of the final federal Medicaid eligibility rules, transition issues and decision points that states will spot as they fill out the Eligibility Matrix. The brief is also written to be useful with or without the other components of the toolkit.
Instructions: Step-by-step instructions on how to fill out the Eligibility Matrix.
Blank Matrix: “Crosswalk” matrix for states to fill out (click on the link below)
Example Matrix: A completed matrix for “Sample State A” for reference.