Faced with a fluid federal regulatory environment, many states continue to encounter challenges in stabilizing their individual health insurance markets, including large premium increases and declining insurer participation. One solution to continued market instability is a state-based reinsurance program similar to the federal program that reduced premiums by more than 10 percent per year from 2014 to 2016. The brief provides a roadmap of policy, program design, and financing considerations for states that are contemplating development of a state-based reinsurance program under 1332 waiver authority.
The Centers for Medicare & Medicaid Services (CMS) recently released the proposed annual Notice of Benefit and Payment Parameters for plan year 2020. The Notice proposes regulatory and financial parameters for qualified health plans on the Exchanges, plans in the individual, small group, and large group markets, and self-funded group health plans. State Health and Value Strategies hosted a webinar for states Friday, January 25 at 1:00 p.m. E.T. During this webinar, experts walked through key components of the notice and discuss potential state considerations and options for commenting on the proposed rule.
On January 23, State Health and Value Strategies hosted a webinar examining the complexities of state Medicaid oversight of the pharmacy benefit in the managed care environment. State Medicaid programs commonly rely on contracted Managed Care Organizations (MCOs) and their subcontracted Pharmacy Benefit Managers (PBMs) to manage the prescription drug benefit offered to Medicaid enrollees. The webinar offered states real world tips on how to best monitor and evaluate operational and financial performance of their MCOs and their subcontracted PBMs.
On December 17, 2018 State Health and Value Strategies hosted a webinar on Medicaid buy-in proposals. Over the past year, state policy makers and advocates have expressed interest in proposals that would permit people above Medicaid eligibility levels to “buy in” to Medicaid (i.e., leverage the state’s bargaining power in some way) in order to offer more affordable and accessible coverage. During this webinar, Manatt Health discussed state considerations for developing a Medicaid buy-in proposal, evolving models of state proposals, and the administrative considerations and authorities needed for each model.
On Wednesday, November 28, State Health and Value Strategies hosted a webinar for state officials with technical experts to discuss the implications of the proposed health reimbursement arrangements (HRA) rule and possible state responses. The U.S. Departments of Health and Human Services, Labor, and Treasury recently released proposed regulations easing the rules governing HRA and other account-based, tax-preferred health care benefits. The webinar featured Jason Levitis, who led ACA implementation at the U.S. Treasury Department, as well as experts from Georgetown University’s Center on Health Insurance Reforms and from Manatt Health.
On November 16, State Health and Value Strategies hosted a webinar, with technical experts from Manatt Health, on H.R. 6, The Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (the “SUPPORT Act”) which was signed into law on October 25. Most stakeholders agree that the bill is a significant step forward in addressing the opioid epidemic, reflecting a range of important policy changes such as initiatives to increase access to medication-assisted treatment (MAT), new grant, pilot and demonstration projects, and a series of changes to Medicaid and Medicare. During the webinar, experts from Manatt Health reviewed major health provisions of the new law and implications for states.
Recent federal rules on Short-Term Limited-Duration Insurance and Association Health Plans mean that some insurers may now offer products that don’t adhere to previous Affordable Care Act (ACA) requirements.
As “skinny” plans are increasingly marketed and sold across the country, it’s important for Marketplaces and Departments of Insurance to provide consumers with the information they need to make good decisions when buying health insurance. This toolkit contains a variety of communications resources designed to support Marketplaces, state agencies and other partners in these public education efforts.
On October 23, State Health and Value Strategies hosted a webinar that explored state options for regulating provider risk-bearing organizations. The push to better manage costs and improve quality is resulting in payment models that transfer financial risk and accountability from payers to providers. An increasing number of provider organizations are entering into risk-based contracts with payers where they are accepting the financial risk of care. This financial liability is often shared with payers, and maximum risk exposure is typically capped. During the webinar, technical experts from Bailit Health reviewed approaches states could take to overseeing their risk-bearing organizations and highlighted examples from states that have elected to regulate to protect against provider insolvency. Click here to access webinar slides
On October 1, the Robert Wood Johnson Foundation’s State Health and Value Strategies program hosted a webinar, facilitated by experts at Manatt Health on the long-anticipated proposed rule released by the Department of Homeland Security (DHS) on September 22. The proposed rule seeks to change how DHS determines whether immigrants—when seeking admission to the United States, an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support). Consequentially, being determined a “public charge” may put immigration status at risk. The webinar reviewed the proposed rule and its potential impacts on consumers, states and providers. Specifically, we highlighted the key ways the proposed rule departs from current guidance, with a particular focus on the implications for Medicaid and other health-related public benefits, and how the proposed rule may impact consumers’ access to certain benefits. Click here for the webinar slides.
The Effects of Medicaid Expansion under the ACA: Select Articles Published Between January 1, 2018 and August 31, 2018
Thirty-three states and the District of Columbia have expanded Medicaid since 2014. As experience with Medicaid expansion grows, states and independent researchers are generating studies that evaluate its impacts at both the state and national levels. This resource highlights articles published since January 2018 that report on those impacts, organized by health access and outcomes, economic impacts, and coverage impacts.