On January 23, 2023, the Federal Communications Commission issued an important ruling that provides states with new flexibility to support enrollee outreach and communication efforts as part of their processes to unwind the Medicaid continuous coverage requirement. The ruling permits state agencies and their partners to send text messages and make phone calls to individuals about enrollment-related issues not only for Medicaid but for other state-run health insurance programs, including marketplace coverage. This expert perspective reviews the ruling and implications for states.
A Strategic Approach for Insurance Exchanges to Select and Manage Qualified Health Plans
Wakely Consulting Group – Jon Kingsdale, Susan Tuite, Patrick Holland, and James Woolman
Wakely Consulting Group has prepared this policy brief to aid state Exchanges in their contracting strategies with qualified health plans (QHPs). Section I of this brief describes many of the types of decisions that Exchanges should consider in preparing to launch a clean, effective QHP solicitation process. Section II describes the standards that Exchanges will use to certify QHPs. It summarizes the major federal requirements that all QHPs must meet and sets forth examples of additional requirements that some states are considering. Section III sets forth options for “negotiating” key elements of the issuers’ proposals. Unlike many start-up tasks, certifying, re-certifying, de-certifying and managing the relationship over time with health plans is an ongoing and evolving set of tasks. Therefore, Exchanges should take a strategic approach to these functions, each state can craft plan selection and ongoing partnerships to support the achievement of its goals for health care reform.
Wakely also hosted a webinar covering the topics of this brief.