The recent repeal of the federal health insurer fee may create an opportunity for states to secure funding to support health coverage, without increasing costs on consumers or the health care industry.
Enacting a fee to replace the federal one presents several design questions for states, including what lines of insurance to include, timing, rate, and targeted exemptions. Frequent SHVS partner and ACA tax expert Jason Levitis prepared slides to help states understand these issues. For states interested in learning more, SHVS is happy to make Jason available to provide technical assistance. If you have questions or are interested in assistance, contact Jason directly at firstname.lastname@example.org.
Eight states require or will require insurers to offer health plans with standardized benefit plans in the individual market, and several more are considering requiring such standardization in the future. On Wednesday, November 6, 2019 at 1:00 p.m. ET, SHVS hosted a webinar on the opportunities for states to implement standardized benefit designs, either through their health insurance marketplace or as part of a public option plan, issues to consider in developing standardized options, communicating with stakeholders, and leveraging standardized designs to improve affordability for enrollees and encourage maintenance of coverage. The webinar reviewed the development of standardized designs through state-based marketplaces, their role in Washington and other states’ public option proposals, operational requirements to improve the end-user experience, and data collection and analysis needs.
On August 12, the Department of Homeland Security (DHS) issued a final version of its public charge rule which was to go into effect on October 15, but has since been delayed as a result of litigation. On September 3, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted a webinar on the final rule, facilitated by experts at Manatt Health. The public charge rule will change how DHS determines whether immigrants—when seeking admission to the U.S., an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). The webinar reviewed the final rule, highlighted changes from the proposed rule, and explored the rule’s potential impacts on consumers, states and providers. Speakers highlighted the key ways the proposed rule departs from current guidance, with a particular focus on the implications for Medicaid and other health-related public benefits, as well as communications and messaging. In addition, New York provided one example of how a state has engaged its assistors to help communicate potential implications of the rule.
On Friday, June 21 at 1:00 p.m. ET State Health and Value Strategies hosted a webinar for state officials with technical experts to discuss the implications of the health reimbursement arrangements (HRA) rule and possible state responses. The webinar featured Jason Levitis, who led ACA implementation at the U.S. Treasury Department, as well as experts from Georgetown University’s Center on Health Insurance Reforms and from Manatt Health. The U.S. Departments of Health and Human Services, Labor, and Treasury released final regulations easing the rules governing HRA and other account-based, tax-preferred health care on June 13. The final rule represents the third of the three policy changes initiated by the October 12, 2017 Executive Order, which also called for easing the rules on short-term limited-duration coverage and association health plans. Like those changes, the HRA rule could have profound implications for health insurance markets, consumers, and Marketplaces. The rule is effective in 2020, which raises important considerations about Marketplace readiness and potential tax consequences for individuals.
On Thursday, April 25, State Health and Value Strategies, with Manatt Health, hosted a webinar for states on six key questions that state policymakers need to consider when choosing a buy-in model, designing its features, and introducing a Medicaid buy-in program. Lawmakers across the country are considering “Medicaid buy-in” or public option programs to stabilize the Affordable Care Act (ACA) insurance market and offer a coverage option that is more affordable and accessible than current options in the individual and employer markets. The concept of Medicaid buy-in/public option is evolving, encompassing the original Medicaid-based proposals and extending to other programs through which states can leverage government bargaining power to offer a more affordable coverage option, like state employee health plans or a Basic Health Plan. During the webinar, speakers from Manatt Health discussed considerations related to (1) goal setting, (2) sources of cost-savings, (3) potential impacts on existing insurance markets, (4) federal 1332 waiver considerations, (5) implementation capacity, and (6) key steps for implementation. Additionally, representatives from Colorado, Connecticut, and Washington shared the status of efforts in their respective states.
The Centers for Medicare & Medicaid Services (CMS) recently released the proposed annual Notice of Benefit and Payment Parameters for plan year 2020. The Notice proposes regulatory and financial parameters for qualified health plans on the Exchanges, plans in the individual, small group, and large group markets, and self-funded group health plans. State Health and Value Strategies hosted a webinar for states Friday, January 25 at 1:00 p.m. E.T. During this webinar, experts walked through key components of the notice and discuss potential state considerations and options for commenting on the proposed rule.
On Wednesday, November 28, State Health and Value Strategies hosted a webinar for state officials with technical experts to discuss the implications of the proposed health reimbursement arrangements (HRA) rule and possible state responses. The U.S. Departments of Health and Human Services, Labor, and Treasury recently released proposed regulations easing the rules governing HRA and other account-based, tax-preferred health care benefits. The webinar featured Jason Levitis, who led ACA implementation at the U.S. Treasury Department, as well as experts from Georgetown University’s Center on Health Insurance Reforms and from Manatt Health.
Recent federal rules on Short-Term Limited-Duration Insurance and Association Health Plans mean that some insurers may now offer products that don’t adhere to previous Affordable Care Act (ACA) requirements.
As “skinny” plans are increasingly marketed and sold across the country, it’s important for Marketplaces and Departments of Insurance to provide consumers with the information they need to make good decisions when buying health insurance. This toolkit contains a variety of communications resources designed to support Marketplaces, state agencies and other partners in these public education efforts.
States continue to identify and pursue strategies to further reduce the number of uninsured, to make coverage more affordable for consumers and to improve access to care. Several proposals have been introduced at both the federal and state levels that would permit people above Medicaid eligibility levels to “buy in” to Medicaid or would leverage the Medicaid program to strengthen coverage across the individual market and Medicaid. This issue brief presents two possible models for a Medicaid buy-in program for states, and details the design considerations and authorities needed to implement each model.
The U.S. Department of Health & Human Services released on April 9, 2018 its annual Notice of Benefit and Payment Parameters, a collection of policies governing the ACA’s marketplaces, insurance reforms, and premium stabilization programs. The first such annual notice issued under the Trump Administration, it contains a number of provisions that require state officials to make important decisions on short notice that will affect plan benefits, premiums, and marketplace operations. State Health and Value Strategies hosted a webinar, together with experts Sabrina Corlette and Justin Giovannelli from Georgetown’s Center on Health Insurance Reforms, Joel Ario from Manatt Health and Jason Levitis, to help participants untangle the rule and its many implications for states.