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.
Understanding the Fiscal Impact of COVID-19, the Economic Downturn, and Recent Policy Changes
On Thursday, June 4, State Health and Value Strategies hosted a webinar during which experts from Manatt Health presented key results from a financial model examining the Medicaid fiscal implications of the interaction between the COVID-19 pandemic, the emerging economic downturn, and recent policy changes.
States and Medicaid programs are entering a time of substantial fiscal uncertainty as they continue to respond to the COVID-19 pandemic while also preparing for a potentially severe recession that is expected to lead to significant budget shortfalls and surges in Medicaid enrollment. At the same time, the federal government has authorized significant policy changes in response to these twin crises, including an increase in the federal Medicaid matching rate and the establishment of maintenance of effort and continuous coverage requirements, which require states to maintain coverage and benefits for any individual enrolled at the start of the federal disaster period. This confluence of factors is likely to have significant fiscal implications for state Medicaid programs. In the coming weeks and months, it will be critical for state budget officials, Medicaid policymakers, and other stakeholders to understand these implications in order to facilitate sound policymaking and resource allocation.
During the webinar, Manatt discussed key considerations for states as they develop their own internal forecasts and plan for the challenging times ahead. This webinar included a question and answer session during which webinar participants can pose their questions to the experts on the line.