On February 6, 2020, the U.S. Department of Health & Human Services (HHS) published its annual draft rule governing core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for individual and small-group market health plans, and premium stabilization programs. This expert perspective focuses on several policies that would have implications for state insurance regulation and the operation of the state-based marketplaces (SBMs). Comments on the rule are due March 2, 2020.
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.