State health updates as of April 30, 2021.

On April 30, 2021, the U.S. Departments of Health & Human Services (HHS) and Treasury released the final 2022 Notice of Benefit & Payment Parameters (NBPP), the annual rule governing core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for insurers, and the risk adjustment program. This rule finalizes the majority of provisions included in a proposed rule published on November 25, 2020, although several proposals were finalized in a rule published on January 19, 2021. This expert perspective reviews provisions of the final rule of particular import to the state-based marketplaces (SBMs) and state insurance regulators.

The American Rescue Plan (ARP) Act enacted on March 11, 2021 establishes a state option to provide community mobile crisis intervention services for a five-year period beginning in April 2022. As an incentive to state adoption, the law provides for an 85 percent enhanced federal matching rate for qualifying services for the first three years of state coverage. To further encourage states, ARP also includes $15 million in state planning grants to support their efforts to develop a state plan amendment or waiver request to take up the option. The new mobile crisis provision arrives just as many states and localities are exploring strategies to address the worsening behavioral health as well as preparing for implementation of 998, the new, national hotline for behavioral health crises. For states and localities reviewing their policing procedures, the new option also could be used to support state efforts to refine the role of law enforcement in responding to behavioral health crisis, offering more resources to the police on such calls or, in some instances, even entirely avoiding the need for law enforcement. This expert perspective provides an overview and state considerations on the state option to provide community mobile crisis interventions services included in the American Rescue Plan.