On January 15, 2022, health insurers will be subject to new federal requirements to cover and waive cost-sharing for over-the-counter diagnostic tests for COVID-19 for the duration of the federal public health emergency. Past federal guidance required insurers to fully cover COVID-19 tests, but allowed them to require enrollees to first obtain a health professional’s determination that a test is medically necessary. The new requirements, published January 10, enable consumers to obtain the tests directly from pharmacies or online retailers without being seen by a health professional. With case rates surging and the costs of over-the-counter COVID-19 tests ranging from $14 to $34, this new benefit should provide significant financial relief to privately insured individuals. This expert perspective focuses on key provisions of the new coverage requirements as well as health equity considerations and implications for state insurance regulators.
Medicaid Expansion and Criminal Justice Costs: Pre-Expansion Studies and Emerging Practices Point Toward Opportunities for States
Jocelyn Guyer, Deborah Bachrach, and Naomi Shine, Manatt Health Solutions
The expansion of Medicaid under the ACA in many states has generated substantial interest in the potential role that Medicaid may play in tackling pressing criminal justice issues. Recent research by Manatt Health Solutions has examined the fiscal implications of Medicaid expansion. The first and second reports explored state budget savings and revenue gains associated with expansion, while the third specifically examined the impact of expansion on uncompensated care spending and related state budget implications. This issue brief, the fourth in this series prepared by Manatt Health Solutions, examines state experiences prior to expansion, focusing on state savings associated with providing health care services and social support to justice-involved individuals through state-funded programs, and also highlights some of the new approaches being adopted by states with Medicaid expansion to connect justice-involved individuals to coverage and care.