The start of the 2021 rate review process for the Affordable Care Act (ACA) Marketplaces coincided with the initial outbreak of COVID-19 cases, and early forecasts were ominous, with rate increases projected as high as 40 percent. There was also widespread concern about how to set rates when insurers’ COVID-related costs looked anything but predictable. In short, it looked like, after a period of relative stability in Marketplace rates, enrollees might be in for a rollercoaster ride. This expert perspective provides a brief overview of how the rate review process has developed since the first ACA OEP in 2013 and how those developments came together this year to enable regulators and insurers to manage uncertainty and achieve more stable rates for the 2021 plan year.
State Medicaid Financing Fact Sheets
As states seek to understand the impacts of proposed changes to Medicaid financing, comparative data on where states stand can be very valuable. The memos included here use state-specific data to analyze the impact of proposals to limit federal Medicaid funding on all 50 states and the District of Columbia. The state data are drawn from a tool kit prepared by Manatt Health for the Robert Wood Johnson’s State Health Reform Assistance Network. While the most recent attempt to cap federal Medicaid funding in the American Health Care Act did not advance to a vote in the Congress, it is likely that this issue will remain a priority for Congressional leadership. And, future capped funding proposals can be expected to rely on historic state-specific spending patterns and national trend rates as earlier proposals did. These memos are intended to assist states in evaluating how they might fare relative to other states under a capped funding model considering the unique features of each state’s health care landscape.