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Issue Briefs , Regulatory Analysis

As health care costs rise, one of the chief determinants of the rate of increase has been the cost of prescription drugs. Over time, additional tiers have been included in pharmacy benefit designs and, as they were added, cost sharing in the new, higher tiers has increased.

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Date Created: Aug 15, 2014


Issue Briefs , State Materials

With the recent conclusion of the initial open enrollment period under the Affordable Care Act, opportunities now exist to examine the experiences and successes of several state-based marketplaces in order to evaluate how they reached consumers and enrolled them in Qualified Health Plans

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Date Created: Aug 15, 2014


Issue Briefs , Regulatory Analysis

As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and tax liability implications.

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Date Created: Aug 7, 2014


Issue Briefs

All-payer claims databases (APCDs) collect and compile medical, pharmacy, and sometimes dental claims, eligibility, and provider files from public and private payers. APCDs are currently being used for a variety of functions, including population health analysis, comparative analysis of provider and facility quality, cost management for Medicaid and other public programs, support for provider payment reform initiatives, and consumer transparency tools.

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Date Created: Jun 27, 2014


Issue Briefs

Under the Affordable Care Act (ACA), individuals seeking health insurance coverage through a Marketplace are assessed for eligibility for an advance payment of the premium tax credit (APTC) based on projected annual income. When eligible individuals file federal income taxes at the end of the year, the Internal Revenue Service (IRS) will reconcile the premium tax credit received based on estimated annual income with what should have been received based on actual income.

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Date Created: Jun 23, 2014


Issue Briefs

he Affordable Care Act (ACA) is already greatly expanding individual health insurance coverage, particularly among lower-income uninsured individuals. However, this is neither easy nor inexpensive to sustain, and it will require ongoing, effective public-private partnerships on multiple levels. One potential partnership opportunity is with “web brokers” who sell individual health insurance online, functioning as private distribution channels in a fashion similar to the new Marketplaces and offering a choice of health plans from multiple insurers, while relying primarily on websites and call centers for customer service.

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Date Created: Jun 19, 2014


Issue Briefs , State Materials

With full implementation of the health insurance coverage provisions of the Affordable Care Act (ACA) on January 1, 2014, there has been great interest in assessing the law’s early impact on health insurance coverage in Minnesota.

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Date Created: Jun 17, 2014


Issue Briefs , Webinars

This issue brief draws from the experiences of six states, Alabama, Colorado, Montana, New Mexico, North Carolina, and Vermont, to identify common policy considerations and action steps for coordinating care in rural environments.

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Date Created: Apr 2, 2014


Issue Briefs

Early evidence from across the nation suggests that consumer assisters are playing a vital role in helping people enroll in the new coverage options made possible by the Affordable Care Act (ACA). The State Health Reform Assistance Network has engaged with a number of states to develop easy to understand materials to educate consumer assisters about various issues that may confuse consumers and the assisters trying to help them during the eligibility determination and enrollment process.

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Date Created: Mar 25, 2014


Issue Briefs

The Affordable Care Act (ACA) has important implications for American Indians and Alaska Natives (AI/AN), including the expansion of Medicaid coverage to nearly 400,000 currently uninsured AI/AN individuals.

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Date Created: Feb 12, 2014