In 2019, the Washington legislature enacted a bill requiring insurers on the state’s health insurance exchange to offer plans with standardized benefit designs, beginning in 2021. Colorado and Maryland are considering similar requirements. As these and other states consider the option of standardized health plans, they can benefit from the experiences of California, the District of Columbia (D.C.), Connecticut, Massachusetts, New York, Oregon, and Vermont, all of which require insurers to offer standardized benefit designs. This Expert Perspective outlines benefits and risks of plan standardization, and raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.
Strategies for Building Seamless Health Systems for Low-Income Populations
The George Washington University – Sara Rosenbaum; Center for Health Care Strategies – Stephen Somers and Shannon McMahon
The Affordable Care Act offers numerous opportunities to stabilize coverage and care for beneficiaries as their incomes fluctuate, and states can reduce the impact of churn between coverage programs with design and purchasing strategies that promote seamlessness. This brief explores the challenges for states in creating seamless health coverage for low-income populations, while providing states with a roadmap as they consider building seamless health systems. Key issues for states to consider include managing subsidy fluctuations through carefully designed eligibility and enrollment strategies and ensuring stable coverage and care by creating seamlessness across benefits, providers, and health plans.