The Affordable Care Act (ACA) sets up a structure with key roles for both federal and state policymakers. From establishing a state-based marketplace to a temporary Maryland supplemental reinsurance program, Maryland has taken steps to make health insurance more affordable. This case study describes the measures taken by the state to improve affordability and coverage, identifies unique program design features, and discusses their bipartisan appeal as experienced in Maryland. Maryland’s efforts can serve as a helpful framework for other similarly situated states seeking to address pressing health coverage affordability issues.
Eight states require or will require insurers to offer health plans with standardized benefit plans in the individual market, and several more are considering requiring such standardization in the future. On Wednesday, November 6, 2019 at 1:00 p.m. ET, SHVS hosted a webinar on the opportunities for states to implement standardized benefit designs, either through their health insurance marketplace or as part of a public option plan, issues to consider in developing standardized options, communicating with stakeholders, and leveraging standardized designs to improve affordability for enrollees and encourage maintenance of coverage. The webinar reviewed the development of standardized designs through state-based marketplaces, their role in Washington and other states’ public option proposals, operational requirements to improve the end-user experience, and data collection and analysis needs.
The Centers for Medicare & Medicaid Services (CMS) recently released the proposed annual Notice of Benefit and Payment Parameters for plan year 2020. The Notice proposes regulatory and financial parameters for qualified health plans on the Exchanges, plans in the individual, small group, and large group markets, and self-funded group health plans. State Health and Value Strategies hosted a webinar for states Friday, January 25 at 1:00 p.m. E.T. During this webinar, experts walked through key components of the notice and discuss potential state considerations and options for commenting on the proposed rule.
On Wednesday, November 28, State Health and Value Strategies hosted a webinar for state officials with technical experts to discuss the implications of the proposed health reimbursement arrangements (HRA) rule and possible state responses. The U.S. Departments of Health and Human Services, Labor, and Treasury recently released proposed regulations easing the rules governing HRA and other account-based, tax-preferred health care benefits. The webinar featured Jason Levitis, who led ACA implementation at the U.S. Treasury Department, as well as experts from Georgetown University’s Center on Health Insurance Reforms and from Manatt Health.
Improving Online Health Insurance Marketplaces: The Critical Nature of Direct Observation in Assessing the Consumer User Experience (UX)
As the fourth open enrollment period under the Affordable Care Act (ACA) approaches, online health insurance marketplaces must consider ways in which they can assess the consumer user experience in order to make continued improvements. Direct consumer observation, known as Consumer User Experience (UX) assessment, represents one such tactic that could serve as a very valuable tool for marketplaces as they continue their future strategic planning. This issue brief, prepared by Claudia Page, examines UX assessment channels and provides a closer look at what can be learned by directly observing actual consumers as they apply for coverage.
Webinar: Final 2017 Notice of Benefit and Payment Parameters and Letter to Federal Marketplace Issuers
The Department of Health and Human Services (HHS) recently published its final Notice of Benefit and Payment Parameters for 2017, as well as the final version of its 2017 letter to Qualified Health Plan (QHP) issuers participating in the federally-facilitated marketplace (FFM). The State Network team at Manatt Health led a webinar explaining this final rule and what it will mean for states.
The recently released Proposed Payment Notice for 2017 formalizes a fourth model of marketplace – State-Based Marketplace/Federal Platform. Along with State Based Marketplaces, State Partnership Marketplaces and the Federally Facilitated Marketplace, states have a range of choices for what their Marketplace looks like. A key question for states will be how these different models help to achieve coverage goals.
The State Network 1332 Waivers Affinity Group continued in October with a new presentation from the team at Manatt Health Solutions. This ongoing series has included presentations providing an overview of the basics around these waivers, including statutory guardrails, discussions on what can and cannot be waived, and potential opportunities available to states through the waiver process, while this presentation focused more deeply on potential coordination between 1332 and 1115 waivers, including general guardrails and budget neutrality.
Financing Shared Administrative Functions Between State-Based Marketplaces and State Medicaid Programs: Cost Allocation Methodologies
The Affordable Care Act (ACA) provides opportunities for expanded access to health coverage through both the expansion of Medicaid and the establishment of health insurance marketplaces. State-based marketplaces (SBMs), as pathways to both public and private health coverage, are required to perform cross-program functions that support access to both qualified health plans (QHPs) available through the marketplace, as well as coverage through Medicaid. While these shared functions create an opportunity for savings through enhanced efficiency, they also require states to properly attribute funding to both through a process known as cost allocation.
The State Network 1332 Waivers Affinity Group continued with another presentation from the team at Manatt Health Solutions. Following prior presentations providing an overview of the basics around these waivers, including statutory guardrails, a discussion on what can and cannot be waived, and potential opportunities available to states through the waiver process, this presentation investigated more deeply the potential coordination between Section 1332 and Section 1115 waivers.