In 2019, the Washington legislature enacted a bill requiring insurers on the state’s health insurance exchange to offer plans with standardized benefit designs, beginning in 2021. Colorado and Maryland are considering similar requirements. As these and other states consider the option of standardized health plans, they can benefit from the experiences of California, the District of Columbia (D.C.), Connecticut, Massachusetts, New York, Oregon, and Vermont, all of which require insurers to offer standardized benefit designs. This Expert Perspective outlines benefits and risks of plan standardization, and raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.
Updated: Medicaid State Plan Amendment Requirements of the Affordable Care Act
Center for Health Care Strategies
A number of provisions in the Affordable Care Act (ACA), from changes to income eligibility (section 2002) to coverage for freestanding birth center services (section 2301), require states to alter Medicaid eligibility guidelines, service benefits, or payment criteria. To assist in determining which provisions require states to submit amendments to their Medicaid state plan, the Center for Health Care Strategies, with support from the State Network, has developed a resource which catalogs required and optional provisions that may require amendments, including links to the applicable ACA text, deadlines for approval, and available guidance. The hyperlinks within the document link directly to the specific sections of ACA referenced and to supporting documentation for those sections where available. States may use this document to plan sufficient time for development, stakeholder engagement, submission and approval of the applicable amendments to CMS.
This document has been updated as of July 2013 to reflect the latest guidance.