States continue to develop strategies to strengthen coverage across the individual market and Medicaid. In recent months, we have seen several proposals at both the federal and state levels that would leverage state Medicaid programs as a key component of coverage stability and affordability strategies. The webinar highlights and defines potential policy options, including the “Medicaid Buy-in,” that states may consider to leverage Medicaid to achieve their goals with respect to coverage availability and affordability. We discuss the conditions that make each option more or less favorable for a state, and implementation issues or other considerations in play for states.
State Medicaid agencies are increasingly turning to managed care organizations (MCOs) to cover more Medicaid enrollees, including those with complex needs. The ongoing shift from a fee-for-service payment model to a value-based payment model at the health plan and provider level puts even more importance on Medicaid managed care procurement strategies and approaches.
At least seven states have submitted 1115 waivers requesting authority to introduce work requirements for some Medicaid beneficiaries. Many more states are considering them. We examine key design considerations for states, including the populations to which work requirements may apply; exemptions based on health status or community conditions (e.g. rates of unemployment; access to transportation); definition of work (how many hours per month? Per year? Will school, job training, and volunteer work satisfy a work requirement?); and, use of verification and attestation in determining whether work requirements apply and are being met. We also look at state operational issues including integrating work requirements with a streamlined online, electronic application and renewal process.
State Health and Value Strategies hosted a webinar for states on the Executive Order affecting state insurance markets and the implications for states of discontinuation of CSR payments. The webinar featured insurance market experts from Georgetown’s Center on Health Insurance Reforms and Manatt Health who discussed the elements of the Executive Order, what states can expect in the coming weeks, and the policy decisions states can consider.
Following the expiration of funding for the Children’s Health Insurance Program (CHIP), both the House and the Senate have turned their attention to the program’s renewal. As states know well, the program was provided with funding through fiscal year 2017, which ended on September 30th, creating pressure for Congress to act quickly before states begin to run out of CHIP dollars in the coming weeks and months. Both the Senate and the House recently have taken up legislation to provide funding for an additional five years and make a number of other modifications to the bill.
In a final effort to pass a bill to repeal and replace the Affordable Care Act before reconciliation instructions expire on September 30th, Senators Graham and Cassidy are advancing a proposal that would retain many key provisions of the Better Care Reconciliation Act (BCRA) – including per capita caps for Medicaid non-expansion populations – and replace federal funding for tax credits, cost sharing reductions, Medicaid expansion, and the Basic Health Program with a capped allotment that would be distributed to states in the form of a block grant.
Federal funding for the Children’s Health Insurance Program (CHIP) is set to expire on September 30th, raising multiple issues for states. State Health and Value Strategies, in partnership with technical experts from Manatt Health, hosted a webinar to discuss key considerations for states as Congress debates CHIP reauthorization. Topics included the funding level and duration of the extension, maintenance of the 23 point FMAP bump, maintenance of effort requirements, and operational implications of reauthorization timing.
Webinar — Understanding the Senate’s Better Care Reconciliation Act of 2017 (BCRA): Key Implications for Medicaid
Following our June 5th webinar, “Per Capita Caps Under Medicaid: Emerging Issues for States,” State Network, in partnership with technical experts from Manatt Health, is hosting a series of conversations that will provide opportunities for state leadership to dive deeper into emerging issues. Given the recent release of the Senate repeal and replace proposal, we will review and discuss the Senate’s BCRA. State Network, in partnership with technical experts from Manatt Health, will host a webinar during which we will review the major Medicaid provisions of the BCRA, providing an opportunity for state leadership to understand how the Senate bill compares to the AHCA and its potential implications for states. This session will start with a short presentation, followed by time for Q&A and a discussion, focusing on the Medicaid provisions of the BCRA.
State policy makers are increasingly focused on social determinants of health (SDOH) because of the important influence of these determinants on health care outcomes and Medicaid spending. This webinar includes an overview of the methods for gathering SDOH data, and the range of possible uses of the data by state policy makers. It also explores how states could factor SDOH into improved payment models and quality measurement activities. Lastly it describes a new payment model that Massachusetts Medicaid is using to adjust managed care payments for certain social risk factors among enrolled populations.
Following the House’s passage of the American Health Care Act (AHCA) and the Senate’s on-going repeal and replace negotiations, it is clear that significant changes to federal Medicaid financing remain in play. Building on past State Network webinars that have reviewed the AHCA Medicaid financing provisions and identified their implications for states, the State Network, in partnership with technical experts from Manatt Health, held a webinar that provided a deep-dive on critical issues that will influence the impact of capped funding on states, including choice of base year, trend rates, and treatment of supplemental payments. The discussion was informed by updated modeling based on the House-passed version of the AHCA.