Issue Briefs | Feb 12, 2012

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.


Expert Perspectives

September 23, 2021

Final Round of Rulemaking for 2022 Affordable Care Act Marketplaces: Implications for States

On September 17, 2021, the U.S. Departments of Health and Human Services and Treasury finalized the 2022 Notice of Benefit and Payment Parameters (NBPP) rule and announced a significant expansion of their oversight of health plans’ provider networks. This expert perspective reviews provisions of the rule of particular import to the state-based marketplaces (SBMs) and state insurance regulators.

The No Surprises Act Proposed Rule on Air Ambulances and Enforcement: Implications for States

On September 10, the U.S. Departments of Health and Human Services (HHS), Treasury, and Labor (DOL) and the Office of Personnel Management (OPM) released a second rule implementing the No Surprises Act (NSA), the comprehensive federal law banning balance bills in emergency and certain non-emergency settings beginning January 1, 2022. This Notice of Proposed Rulemaking (NPRM) details the data on air ambulance services that must be reported to HHS and the Department of Transportation (DOT) and discusses the departments’ proposed approach to enforcement of the NSA. Beyond the NSA provisions, the NPRM also provides guidance on new federal requirements that individual market and short-term plan insurers disclose broker compensation to current and potential enrollees as well as to HHS. Comments on the NPRM are due October 18, 2021. This expert perspective summarizes the provisions of the NPRM and notes particular implications for state regulators and marketplace officials.