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.
Examining the Economics of Medicaid Expansion
As evidence of Medicaid expansion’s positive fiscal impact continues to mount across the country, the ability to identify and allocate state general fund dollars “saved” through expansion matters now more than ever. This presentation by Manatt Health reviews the most recent findings on the economic impacts of Medicaid expansion, discusses how state can refine estimates of enrollment, savings, and other expansion impacts, and addresses how states are using information on economic impacts to demonstrate the value of expansion. This slide deck was presented during a Small Group Convening hosted by the State Network in June 2016, bringing together state officials and technical experts to discuss issues currently being confronted by state Medicaid agencies.