Regulatory Analysis | Mar 23, 2015

A Guide to Meaningful Difference

Sally McCarty, Georgetown Health Policy Institute, Center on Health Insurance Reforms

Federal regulations state that in order to be certified as a Qualified Health Plan in a Federally-facilitated marketplace, plans must be considered “meaningfully different” from all other plans in their subgroup.  This document, prepared by the Georgetown Health Policy Institute’s Center on Health Insurance Reforms, is intended to help insurance regulators to understand meaningful difference standards and the ways in which they are applied by CMS.  The document also includes information on the process for plans flagged for additional review and follow-up, as well as exceptions to these standards.


Expert Perspectives

January 17, 2025

Release of Updated CMS Guidance on Continuous Eligibility for Medicaid/CHIP Children and Youth

On January 15, 2025, the Centers for Medicare & Medicaid Services released updated State Health Official letter and Frequently Asked Questions guidance, replacing a previously issued SHO letter and FAQs on the requirement in the Consolidated Appropriations Act, 2023 that states provide 12 months of continuous eligibility for children and youth under the age of 19 in Medicaid and the Children’s Health Insurance Program, effective as of January 1, 2024.