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.
State Investments in Supportive Housing
Stephanie Anthony, Patricia Boozang, and Mandy Ferguson, Manatt Health
Supportive housing combines transitional or permanent housing with support services that help people experiencing or at risk of homelessness, people with disabilities, and older adults to secure and maintain housing. Research shows that access to affordable, safe, and stable housing can improve health outcomes and reduce health care costs. While Medicaid typically does not pay for housing (room and board), it does pay for some clinical and non-clinical services that can help people obtain and maintain their housing. More recently, new federal authorities to cover housing-related services have motivated states to think more broadly about the Medicaid populations who could benefit from access to housing-related services and the types of services that can promote housing stability.
This issue brief provides an overview of the federal authorities under which states are able to cover nonclinical housing-related services for high-need Medicaid enrollees and also details how states are using these authorities to invest in supportive housing for diverse high-need Medicaid populations. As a companion to the issue brief, Manatt Health has produced State Investments in Supportive Housing: An Inventory of State Efforts, which provides an in-depth look at states that are leveraging federal authorities to offer supportive housing benefits.