On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (the ARP), a wide-ranging package of health care and economic measures responding to the coronavirus pandemic. The ARP includes a broad expansion of the Affordable Care Act’s (ACA) main health insurance subsidy, the premium tax credit (PTC), the first major expansion of the health care reform law since its passage. This piece highlights the policymaking considerations that states must account for in light of the PTC expansion and uncertainty about future federal action. A key theme that emerges is that states will benefit from approaches that give them the flexibility to adjust policies year by year as the federal landscape develops.
Purchasing Coverage for Medicaid Beneficiaries in the Exchange: A Review of Premium Assistance Options
Manatt Health Solutions – Deborah Bachrach and Patricia Boozang
This brief prepared by Manatt Health Solutions examines some of the legal, policy and operational issues states should contemplate while considering the possibility of using “premium assistance” to purchase coverage for Medicaid-eligible adults in the Exchange. It overviews the benefits of premium assistance along with the logistical challenges of its implementation. States have authority under Section 1906 of the Social Security Act to use Medicaid premium assistance to wrap around employer coverage for an employed individual who is also eligible for Medicaid. In January 22, 2013 draft regulations, the Centers for Medicare and Medicaid Services (CMS) proposed to allow states to use Medicaid/CHIP funding to purchase coverage for Medicaid/CHIP eligible beneficiaries in the individual market, including coverage through Qualified Health Plans (QHPs) in Exchanges.