Health insurance brokers can play a unique role in helping all forms of marketplaces to reach out to uninsured households and assist residents with new enrollments, as well as coverage renewals. Recently, several marketplaces implemented pilot programs intended to leverage the resources of agencies that are particularly interested in building their direct enrollment business under the Affordable Care Act (ACA). The success of these initiatives is demonstrated by these marketplaces’ plans to expand their efforts for the upcoming open enrollment period.
In March of 2012, the U.S. Department of Health and Human Services issued a regulation defining student health plans as individual health insurance under federal law. As a result, they are now subject to the same consumer protections afforded to all those covered by individual health insurance set forth in the Public Health Service Act, as amended by the Affordable Care Act. This issue brief, prepared by the Center on Health Insurance Reforms at the Georgetown University Health Policy Institute, examines student health plans, which cover over 1 million students, and investigates the interplay between federal and state regulation with regard to these plans.
The State Network hosted its Annual Meeting in New Orleans, LA on April 29 – May 1, 2015, bringing together state officials and technical experts to provide technical assistance and discuss lessons learned on continuing implementation of the coverage provisions of the Affordable Care Act (ACA). The Annual Meeting included peer-to-peer sharing between stakeholders from exchanges, Medicaid agencies, departments of insurance, and governors’ offices throughout the topic specific breakouts on key ACA implementation issues.
Waivers available under Section 1332 of the Affordable Care Act offer potentially great flexibility to states in achieving the goals of the ACA through very different means than originally envisioned. They take effect as early as January 1, 2017, and require legislative authorization, substantial public engagement, and negotiation with the federal government. Moreover, without grant dollars to fund the development process, unlike for the establishment of state-based exchanges, 1332 waiver proposals will present additional time and resource challenges for states.
States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by authorizing states to rethink the law’s coverage designs. Under State Innovation Waivers, states can modify the rules regarding covered benefits, subsidies, insurance marketplaces, and individual and employer mandates.
A recent report from Manatt Health Solutions reveals that early data from states that expanded Medicaid demonstrate consistent economic benefits, including budget savings and revenue gains. Data from eight states show $1.8 billion in budget savings by the end of 2015 as a result of Medicaid expansion. This webinar reviewed the findings from this study.
As some states continue to debate whether to implement Medicaid expansion under the Affordable Care Act, early results from those that have done so show the impact this decision has had on their state budgets. States that expanded the number of people eligible for Medicaid are seeing big budgetary savings without reducing services. This report, prepared by Manatt Health Solutions, analyzes data from eight states, showing $1.8 billion in budget savings by the end of 2015 as a result of Medicaid expansion.
Final HHS Notice of Benefit and Payment Parameters for 2016: Brief Summary of Key Provisions for the 2016 Plan Year
On February 27, 2015, the federal Department of Health and Human Services published the Notice of Benefit and Payment Parameters for 2016 Final Rule, which included several provisions pertaining to form review. This analysis, prepared by the Georgetown University Health Policy Institute’s Center on Health Insurance Reforms, provides a brief summary of the key provisions specific to form review and other notable provisions specific to the 2016 plan year.
Federal regulations state that in order to be certified as a Qualified Health Plan in a Federally-facilitated marketplace, plans must be considered “meaningfully different” from all other plans in their subgroup. This document, prepared by the Georgetown Health Policy Institute’s Center on Health Insurance Reforms, is intended to help insurance regulators to understand meaningful difference standards and the ways in which they are applied by CMS.
Stemming from training at insurance departments in various State Network states, Georgetown University Health Policy Institute (Georgetown) has released updated form review checklists. These resources are designed to help insurance regulators effectively implement Affordable Care Act (ACA) provisions, regulations, and other guidance by ensuring that insurance forms submitted by carriers meet all the ACA requirements.