State action to prevent discriminatory benefit designs has been prompted, in part, by vital input from consumer advocacy organizations. Recognizing the important role that they can occupy in this process, the Georgetown University Health Policy Institute’s Center on Health Insurance Reforms sought to gather a directory of these organizations. Georgetown gathered those organizations willing to be made available to states as resources to insurance regulators in need of assistance with identifying discriminatory benefit designs or for other regulatory tasks that require expertise related to a certain disease group or consumer concern.
In order to ensure that Consumer Services Divisions within state insurance regulatory agencies are equipped with the necessary resources to assist consumers experiencing insurance problems, the State Health Reform Assistance Network (State Network) team at the Georgetown University Health Policy Institute has developed a toolkit intended as a guide for consumer service representatives (CSRs).
The State Network 1332 Waivers Affinity Group continued with a webinar presentation by the team at Manatt Health Solutions. The initial webinar for this affinity group focused on the basics of the waiver process, as well as information on statutory guardrails and what can and cannot be waived. This most recent webinar investigates waiver possibilities more deeply, with more information on specific examples of what can be waived through this process.
The Robert Wood Johnson Foundation’s Plan Choice Challenge: Winning Tools and Considerations for States
The Robert Wood Johnson Foundation’s “Plan Choice Challenge” was a recent competition facilitated by Health 2.0 to spur the development of innovative technology applications that better support consumers as they shop for and purchase health insurance. The State Network and the National Academy for State Health Policy (NASHP) recently hosted a webinar featuring background on the challenge from Health 2.0, an overview of the winning apps, and insights on what states should consider as they explore plan selection tools.
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.
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.