The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources.
Model Legislation for State Individual Mandate
[*Updated Feb. 21, 2018*] The tax bill passed in December 2017 repealed the penalty associated with the Affordable Care Act’s individual shared responsibility provision, also known as the individual mandate. The provision required those who could afford health coverage to either maintain coverage, qualify for an exemption, or make a payment with their federal income tax return. The Congressional Budget Office projects that repealing the mandate penalty will increase insurance premiums by 10 percent on average and result in 13 million more persons being uninsured. A number of states have expressed an interested in examining a state-level individual mandate, which Massachusetts has had in place since before the ACA.
Frequent State Health and Value Strategies partner Jason Levitis, health tax expert and former Counselor and ACA Implementation Lead at the U.S. Department of the Treasury, has developed model legislation for states interested in a state-level individual mandate. The model legislation that follows may be revised, so be sure to check this page to ensure you are working from the most current draft. For questions, contact Jason Levitis at email@example.com.