In light of recent postal delays and housing displacements caused by the COVID-19 pandemic and related economic crisis, and a wave of natural disasters across the country, state Medicaid and Children’s Health Insurance Program (CHIP) agencies face new challenges communicating with their enrollees about their health coverage. Acting now to mitigate these challenges is essential as states are preparing for the end of the public health emergency (PHE) and “catching up” on coverage renewals for a large portion of their enrollees. This expert perspective reviews strategies that state Medicaid and CHIP agencies may consider to help mitigate coverage losses.
Design Considerations in Structuring Employee Choice for SHOP Exchange
Wakely Consulting Group
The Affordable Care Act (ACA) created the Small Business Health Options Program (“SHOP”) to create new marketplaces for small employers (and employees) to shop for and purchase employer subsidized health insurance coverage. In addition to small business tax credits, the primary value proposition for the SHOP is to facilitate employee choice. Wakely Consulting Group has prepared a brief highlighting the design approaches to SHOP that allow employers to provide a defined contribution while giving employees the choice of one or more products offered on the SHOP. Under this defined contribution approach, the employer’s main responsibility is a financial contribution toward employees’ health insurance premiums, which the employee can put toward the purchase of the coverage that he/she chooses. The brief walks through the different employee choice models and two distinct risk selection impacts and how to address them. Finally, it touches on five design variable for an exchange to consider in order to minimize consumer confusion and adverse risk selection.