The COVID-19 Relief Package and the “No Surprises Act”: Implications for States
In the waning days of 2020, Congress enacted a $900 billion COVID-19 relief package and government funding bill. Included in the measure is the “No Surprises Act,” which contains new protections for consumers from surprise medical bills from out-of-network providers. State Health & Value Strategies hosted a webinar during which experts from Georgetown University’s Center on Health Insurance Reforms, Manatt Health, and tax expert Jason Levitis reviewed the provisions of this legislation and their implications for states. The webinar reviewed the No Surprises Act and provided an overview of the next steps for implementing the federal balance billing protections and what the law will mean for state-level protections. Additionally, presenters discussed a number of other key health care provisions, including state and locality funding for COVID-19 vaccine distribution and testing as well as policy changes to the Provider Relief Fund, and the impact of additional unemployment compensation and relief payments on eligibility for financial assistance for health coverage.
On December 6, the Centers for Medicare & Medicaid Services published and made effective an interim final rule (IFR) with comment period regarding states’ ongoing unwinding efforts to redetermine eligibility for all Medicaid enrollees nationwide. This expert perspective summarizes the IFR, which interprets and implements the state reporting requirements and CMS enforcement authorities that Congress enacted last winter in the Consolidated Appropriations Act of 2023.
The 11th annual open enrollment period (OEP) is underway, providing consumers with an opportunity to enroll in health coverage for plan year 2024 through the Affordable Care Act Marketplaces. To support consumers during this OEP, State-Based Marketplaces (SBMs) are innovating to make health coverage more affordable and easier for consumers to enroll. This expert perspective highlights new initiatives being implemented by SBMs during the plan year 2024 OEP, including establishing or improving state subsidy programs to reduce out-of-pocket costs, expanding coverage for undocumented populations, or implementing policies to improve the enrollment process.
As the unwinding of the Medicaid continuous coverage requirement continues, both states and the federal government are tracking and monitoring the impacts of the resumption of eligibility redeterminations and disenrollments. Given the time-lags and caveats of CMS data, many states are publishing their own state data dashboards. To date, 46 states (including the District of Columbia) have released unwinding data in either an interactive dashboard or static pdf format, or are making public their required CMS Monthly Unwinding Data reports. This expert perspective includes an interactive map with links to state reporting, as well as a table tracking the unwinding indicators and disaggregated data that states are reporting on. SHVS will continue to update this EP as more states publish their unwinding data.