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.
Analyzing the Fiscal Impact of COVID-19, the Economic Downturn, and Recent Policy Changes: 50-State Databook
Jocelyn Guyer and Adam Striar, Manatt Health
On Thursday, June 4, State Health and Value Strategies (SHVS) hosted a webinar during which experts from Manatt Health discussed the fiscal implications for states and Medicaid programs of the COVID-19 pandemic, the emerging economic downturn, and recent legislation to address these twin crises, including the Families First Coronavirus Response Act (“Families First”) and the Health and Economic Recovery Omnibus Emergency Solutions (“HEROES”) Act. The Databook is a follow-on product to the webinar. As discussed in the Overview, each table in the Databook displays projected changes in federal and state Medicaid and CHIP expenditures during calendar years 2020 and 2021 across all fifty states and the District of Columbia for a given scenario and policy response. Taken together, the Databook provides estimates that span across a range of plausible scenarios reflecting increased enrollment and per enrollee spending growth and changes to the duration of the federal Public Health Emergency.