In 2019, the Washington legislature enacted a bill requiring insurers on the state’s health insurance exchange to offer plans with standardized benefit designs, beginning in 2021. Colorado and Maryland are considering similar requirements. As these and other states consider the option of standardized health plans, they can benefit from the experiences of California, the District of Columbia (D.C.), Connecticut, Massachusetts, New York, Oregon, and Vermont, all of which require insurers to offer standardized benefit designs. This Expert Perspective outlines benefits and risks of plan standardization, and raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.
Medicaid Managed Care: How States’ Experience Can Inform Exchange Qualified Health Plan Standards
Manatt Health Solutions – Deborah Bachrach, Patricia Boozang and Allison Garcimonde
State Affordable Insurance Exchanges (exchanges) are at the core of the coverage reform in the Affordable Care Act (ACA). The exchanges establish a marketplace in which individuals and small employers can compare and select among affordable, quality health insurance options. In this policy brief, supported by the State Network and published by the Center for Health Care Strategies, authors from Manatt Health Solutions examine lessons from Medicaid managed care contracts in six states. The brief notes opportunities for exchanges to “borrow” from and align qualified health plan standards with Medicaid managed care requirements, as well as areas where managed care requirements may need to be modified for adoption in exchanges.