With the Patient Protection and Affordable Care Act’s (ACA’s) ninth open enrollment period (OEP) set to launch in less than a month, the ACA Marketplaces are seeing record enrollment numbers with more generous subsidies, new carrier competition, and a relatively stable rating environment. At the same time, there is uncertainty with the trajectory of the COVID-19 pandemic and medical costs trending upward as the economy recovers, albeit at an uneven pace. These trends have made for a challenging rate review process in the 47 states plus the District of Columbia (D.C.) that conduct their own ACA rate reviews of carrier-proposed rates using federal review standards. State announcements of 2022 rates have trickled out at a slower pace than in prior years, and it is likely that many states will not publish their approved rates until the beginning of open enrollment. As always, state rate results vary widely and, even within states, there often are substantial variations among carriers and across different regions in geographically diverse states. With these caveats, this expert perspective highlights some observations about the factors that are impacting rate changes this year and the kind of variations that exist among states.
Repealing Medicaid Expansion: Implications for States
Medicaid expansion under the Affordable Care Act (ACA) has had a positive impact for states, both in terms of the number of people covered and the budget savings and revenue gains that they have realized as a result. A series of recent reports demonstrates the economic impact in states that have expanded Medicaid. A new webinar examined potential repeal of Medicaid expansion under the ACA, and what this would likely mean for states. This webinar, which was presented by the State Network team at Manatt Health, provides an overview of the proposals and process for repeal of Medicaid expansion, and outlines both the coverage and budget implications that repeal would have for states.