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.
This expert perspective reviews key considerations for states exploring Marketplace insurance subsidies and highlights the experiences in the five states that have established state-based subsidies that supplement the ACA’s premium tax credit and cost-sharing reductions.
The United States is in the midst of an unprecedented national effort to manufacture, distribute, and ultimately administer COVID-19 vaccines to all Americans. While the federal government is coordinating distribution of vaccines from manufacturers to states, individual states (and certain municipalities) are responsible for coordinating the various components of infrastructure and operational logistics needed to take the vaccine from federal distribution channels to the arms of Americans. This expert perspective outlines four recommendations for states to engage their managed care plans to assist in efforts to successfully and rapidly vaccinate the Medicaid population.