On January 26, 2023, the Centers for Medicare & Medicaid Services approved California’s request to amend the California Advancing and Innovating Medi-Cal Section 1115 demonstration. This expert perspective describes the amendment, a centerpiece of which is approval for California Medicaid to provide a targeted set of Medicaid services to youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release. By providing re-entry services to Medicaid-enrolled individuals who are incarcerated, California aims to build a bridge to community-based care for justice-involved enrollees, offering them services to stabilize their physical and behavioral health conditions and establishing, prior to release, a re-entry plan for their community-based care.
Understanding the Potential Role Web Brokers Can Play in State-Based Marketplaces
Manatt Health Solutions – Joel Ario and Allison Garcimonde, and Wakely Consulting Group – Jon Kingsdale
The Affordable Care Act (ACA) is already greatly expanding individual health insurance coverage, particularly among lower-income uninsured individuals. However, this is neither easy nor inexpensive to sustain, and it will require ongoing, effective public-private partnerships on multiple levels. One potential partnership opportunity is with “web brokers” who sell individual health insurance online, functioning as private distribution channels in a fashion similar to the new Marketplaces and offering a choice of health plans from multiple insurers, while relying primarily on websites and call centers for customer service. This brief, prepared by Manatt Health Solutions and Wakely Consulting Group, seeks to understand the role that web brokers might occupy in this continuously developing landscape, and is intended as a tool for State-Based Marketplaces (SBMs) to investigate potential opportunities for partnerships with these entities. An executive summary of this issue brief provides an overview of this topic, including descriptions of five leading web brokers, a summary of the evolution of federal policy on web brokers, and potential SBM approaches for contracting with web brokers.