The start of the 2021 rate review process for the Affordable Care Act (ACA) Marketplaces coincided with the initial outbreak of COVID-19 cases, and early forecasts were ominous, with rate increases projected as high as 40 percent. There was also widespread concern about how to set rates when insurers’ COVID-related costs looked anything but predictable. In short, it looked like, after a period of relative stability in Marketplace rates, enrollees might be in for a rollercoaster ride. This expert perspective provides a brief overview of how the rate review process has developed since the first ACA OEP in 2013 and how those developments came together this year to enable regulators and insurers to manage uncertainty and achieve more stable rates for the 2021 plan year.
COVID-19 Resources for States
State Health and Value Strategies (SHVS), in partnership with Manatt Health, Georgetown’s Center on Health Insurance Reforms (CHIR), State Health Access Data Assistance Center (SHADAC), Bailit Health, and GMMB developed this resource page to serve as an accessible “one-stop” source of COVID-19 information for states. This resource is designed to support states seeking to make coverage and essential services available to all of their residents, especially high risk and vulnerable people, during the COVID-19 pandemic. SHVS will update this page frequently with new resources as they become available.
|If you have materials you are willing to share with other states through this page, or if there are topics of particular concern that you would like addressed, please contact SHVS.|
Please click on the links below to access topic-specific resources.
(e.g., tracking dashboards, equity task forces)
|Medicaid Coverage and Access
(e.g., eligibility and enrollment (including appeals), benefits and cost-sharing (prior authorization, refills))
|COVID-19 Testing and Care
(e.g., coverage and access, provider and plan reimbursement)
|Commercial Insurance Coverage and Access
(e.g. individual market coverage, regulatory options, surprise billing, Employee Retirement Income Security Act (ERISA) flexibilities)
|Funding and Coverage for the Uninsured||Telehealth/Telemedicine||Home and Community-Based Services (HCBS) and Long-Term Care (LTC)|
|Providers and Workforce
(e.g., licensure/certification, enrollment)
|Social Risk Factors and COVID-19
(e.g., housing, food insecurity, justice-involved individuals, interpersonal violence)
|Federal Authorities and Funding Opportunities
(i.e., Section 1135 Waivers, Section 1115 Waivers, 1915(c) Waiver Appendix K, Medicaid State Plan Amendments (SPAs))
|Substance Use Disorder (SUD) and Mental Health||Communications
(e.g. messaging and communications strategies for COVID-19 response, best practices across agencies, leveraging digital platforms)
|Reopening/Restarting from COVID-19 Shutdown|