On Thursday, April 25, State Health and Value Strategies, with Manatt Health, hosted a webinar for states on six key questions that state policymakers need to consider when choosing a buy-in model, designing its features, and introducing a Medicaid buy-in program. Lawmakers across the country are considering “Medicaid buy-in” or public option programs to stabilize the Affordable Care Act (ACA) insurance market and offer a coverage option that is more affordable and accessible than current options in the individual and employer markets. The concept of Medicaid buy-in/public option is evolving, encompassing the original Medicaid-based proposals and extending to other programs through which states can leverage government bargaining power to offer a more affordable coverage option, like state employee health plans or a Basic Health Plan. During the webinar, speakers from Manatt Health discussed considerations related to (1) goal setting, (2) sources of cost-savings, (3) potential impacts on existing insurance markets, (4) federal 1332 waiver considerations, (5) implementation capacity, and (6) key steps for implementation. Additionally, representatives from Colorado, Connecticut, and Washington shared the status of efforts in their respective states.
State Health and Value Strategies has published a companion brief, State Medicaid Buy-Ins: Key Questions to Consider, that dives deep into the key questions that states pursuing Medicaid buy-in or public option models will want to consider as they seek to design and implement their proposals. The State Health Policy Highlight, State Considerations for Medicaid Buy-In Proposals, provides a checklist summarizing the key questions, which are laid out in greater detail in the underlying issue brief.
In the absence of federal legislation, states are actively seeking tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.
On February 6, 2020, the U.S. Department of Health & Human Services (HHS) published its annual draft rule governing core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for individual and small-group market health plans, and premium stabilization programs. This expert perspective focuses on several policies that would have implications for state insurance regulation and the operation of the state-based marketplaces (SBMs). Comments on the rule are due March 2, 2020.
As we round out the seventh year of ACA open enrollment, State Health and Value Strategies (SHVS) is reflecting on the successful steps that states have taken to provide quality, affordable health coverage to more residents and draw on lessons learned as this work moves forward. SHVS is excited to launch a series of posts featuring policy and outreach strategies states are employing to meet the needs of their residents. This Expert Perspective highlights some of the key ways in which states are driving efforts to increase enrollment this past open enrollment period. Subsequent posts will include deep dives into certain specific state policies and outreach strategies, such as plan standardization and targeted outreach to address health disparities in coverage.
