The American Rescue Plan: An Overview of Medicaid Provisions and State/Local Relief
OnTuesday, March 16, State Health and Value Strategies hosted the second of three webinars to address key provisions of the American Rescue Plan Act of 2021. The $1.9 trillion budget reconciliation package was signed into law by President Biden on March 11. The legislation is wide-ranging, seeking to support Americans as we continue to recover from the fallout of the COVID-19 pandemic and economic downturn. Health coverage programs will see the largest changes since the Affordable Care Act, with provisions that will strengthen Medicaid and CHIP, drastically increase affordability in the marketplace, create new coverage opportunities for those that lost jobs, and provide significant federal funding to support states and localities.
The second webinar, with experts from Manatt Health, reviewed key Medicaid provisions and state/local relief funding included in the COVID-19 relief package. Presenters will also discuss considerations for state policymakers as they look to implement the American Rescue Plan, and how some proposals that did not end up in the final legislation could foreshadow future policy priorities. The first webinar, The American Rescue Plan: An Overview of Private Insurance Provisions, is scheduled for Friday, March 12 and explored changes to private insurance, including Marketplaces. The third webinar, The American Rescue Plan: Communicating Affordability Provisions, is scheduled for Tuesday, March 23 and will discuss how to best to communicate with consumers and other stakeholders so residents can take full advantage of new financial help through the Marketplace, free COBRA plans, and more provided by the American Rescue Plan.
On October 7, the U.S. Departments of Health and Human Services (HHS), Treasury, and Labor (DOL) and the Office of Personnel Management (OPM) published a third 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 third rule, an interim final rule, provides details on the independent dispute resolution process (IDR), good faith estimates for enrollees on the cost of services, the dispute resolution process for uninsured patients, and external review. This expert perspective summarizes the provisions of the IFR and notes particular implications for state regulators.
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.