On January 27, 2023, the Centers for Medicare & Medicaid Services released a State Health Official (SHO) letter, “Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023.” The SHO letter is the second in a series of guidance related to section 5131 of the Consolidated Appropriations Act, 2023 (CAA), which established a fixed end date for the Medicaid continuous coverage requirement, a gradual phase-down for the enhanced federal match, and new guardrails for mitigating coverage loss for individuals who continue to be eligible. This expert perspective reviews the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter.
Impact of National Health Reform and State-Based Exchanges on the Level of Competition in the Nongroup Market
Wakely Consulting Group – Jon Kingsdale and Jason Aurori
This brief, prepared by Wakely Consulting Group, analyzes health plan participation in 10 state-based exchanges to provide an early indicator of the level of competition that market reforms and state-based exchanges are generating. In sum, carrier participation increased by 35 percent (52 to 70 issuers) when comparing the number of issuers applying to nongroup exchanges versus the number in the pre-reform base year. One of the objectives of the Affordable Care Act (ACA) is to enhance competition through reform of the nongroup insurance market, including new market and rating rules and reliance on public health insurance exchanges. More health plans increases consumer choice, and encourages carriers to compete on both quality and cost of care.
The Robert Wood Johnson Foundation issued a press release on June 17, 2013 regarding this brief.