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.
After a dynamic few weeks of negotiations, President Trump signed into law on December 27, 2020 a nearly 6,000-page legislative package (The Consolidated Appropriations Act, 2021) that includes government appropriations through September 30, 2021; COVID-19 relief funding and targeted policy changes, a subset of which impact health programs; extensions of expiring health programs; a ban on surprise billing; and an amalgam of odds-and-ends health policy provisions. This analysis includes a summary of those health care provisions.
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 Tuesday, December 15 State Health and Value Strategies hosted a webinar on how states can support children and youth with special health care needs during COVID-19. The COVID-19 pandemic has created significant health and economic hardships for many children and families. Children who receive health services in school settings to support their education are losing access to those services. In addition, a pre-COVID-19 shortage of home health providers has worsened due to the pandemic, placing a significant burden on families who rely on home health services. The result can lead to gaps in care and caregiver burnout, putting children and youth with special health care needs at risk of regression and long-term negative health outcomes. Recognizing these risks, states and the federal government have broadly expanded telehealth coverage, established continuous coverage requirements and eased regulatory requirements for delivery of services. The webinar, produced by Manatt Health with the American Academy of Pediatrics, Family Voices, and the Georgetown Center for Children and Families with funding from the Robert Wood Johnson Foundation and the Lucile Packard Foundation for Children’s Health, explored strategies for state Medicaid agencies to enforce coverage requirements and make permanent the temporary regulatory flexibilities that have expanded access to services during the pandemic.
On Friday, October 30, State Health & Value Strategies hosted a webinar during which experts from Manatt Health and GMMB reviewed the trajectory of 2020 Medicaid enrollment growth to date and provide effective strategies related to communication with members and coordination across state Medicaid agencies and Marketplaces to support coverage access and retention in this dynamic environment.
On Wednesday, July 22, State Health and Value Strategies hosted part II of the Preparing for OEP 2021 webinar series that provided a deep dive into effective strategies to consider as states design their outreach and education campaigns for OEP 2021 in a shifting health care environment. Presenters from GMMB explored how the impacts of COVID-19 should inform the marketplace’s tactical campaign approaches for virtual outreach and partnership engagement, digital and social platform usage, and paid advertising and earned media. Participants also heard insights from several state officials from state-based marketplaces along the way. Topics for discussion included coordinating with state agencies, engaging micro-influencers, leveraging social media live streams, hosting virtual enrollment events, developing advertising buys, and considering new earned media hooks. This webinar included a question and answer session during which webinar participants can pose their questions to the experts on the line.
On Friday, June 12, State Health & Value Strategies hosted a webinar during which experts from Manatt Health and Georgetown reviewed the current telehealth policy landscape and considerations for states as they design their post-apex telehealth policies. This webinar included a question and answer session during which webinar participants posed their questions to the experts on the line.
On Thursday, May 14, State Health and Value Strategies, in partnership with technical experts from Manatt Health, Levitis Strategies, GMMB, and the Urban Institute, hosted a webinar for states to help address the rapidly-evolving changes to the coverage environment. As the COVID-19 crisis evolves, it has become clear that rising unemployment will substantially reduce employer sponsored health insurance. During the webinar, speakers discussed the models that have been published of where individuals are expected to gain coverage over the next 18 months, the impact on the Medicaid, individual, and employer-sponsored insurance markets, the role of special enrollment periods, and coordination with unemployment agencies. The webinar also highlighted communications opportunities and strategies for states to support enrollment.
On Friday, May 1 State Health and Value Strategies hosted a webinar during which experts from Manatt Health and Georgetown University’s Center on Health Insurance Reforms summarized recent federal legislation related to COVID-19 and distilled key takeaways from recent federal guidance. Topics included: a review of the recently passed stimulus bill, “Paycheck Protection Program and Health Care Enhancement Act;” a deep dive of recently released guidance on the disbursement of CARES Act funding including the Provider Relief and Coronavirus Relief Funds; and Medicaid strategies for providers and considerations for states.
In response to the COVID-19 pandemic, the federal government is moving rapidly to help states and health care providers respond to mounting needs for new sources of funding and flexibility. Congress has passed three COVID-19 stimulus bills, and the U.S. Department of Health and Human Services has issued guidance outlining new flexibilities available to states and providers, and is working to approve additional requests from states, to award funds appropriated by Congress, and to issue more guidance about such funding. This Q&A provides a moment-in-time update in response to questions SHVS has received about the federal government’s response.