Medicaid Expansion and Criminal Justice Costs: Pre-Expansion Studies and Emerging Practices Point Toward Opportunities for States
The expansion of Medicaid under the ACA in many states has generated substantial interest in the potential role that Medicaid may play in tackling pressing criminal justice issues. Recent research by Manatt Health Solutions has examined the fiscal implications of Medicaid expansion. This issue brief, the fourth in this series, examines state experiences prior to expansion, focusing on state savings associated with providing health care services and social support to justice-involved individuals through state-funded programs, and also highlights some of the new approaches being adopted by states with Medicaid expansion to connect justice-involved individuals to coverage and care.
Building on Year One 1095-A Form Success: Marketplaces’ Recommendations for Future Tax Seasons
Tax year 2014 marked the first year during which all health insurance marketplaces were required to report information about Advance Premium Tax Credits (APTCs) to enrollees through Form 1095-A, which was developed by the Internal Revenue Service (IRS) and used by enrollees to fill out new tax forms. In order to address potential concerns leading up to the execution of this process, the State Network convened a workgroup of states, led by Manatt Health Solutions, which enabled discussion of implementation challenges and solutions. Many of the expected challenges associated with this process were addressed in advance, allowing the marketplaces to provide most forms in a timely fashion and develop solutions to challenges as they arose.
Qualified Health Plan Review in Marketplaces with State Plan Management: An Analysis of the Division of Labor Between State Exchanges and Other State Agencies
States have implemented a variety of different methods to handle the review and certification of qualified health plans (QHPs). The Health Insurance Exchanges (HIX) Research Group at the Leonard Davis Institute of Health Economics at Wharton (LDI) recently collected data from 30 states, including those with State Based Marketplaces (SBMs), State Partnership Marketplaces (SPMs), Supported State Based Marketplaces (SSBMs), and Federally Facilitated Marketplaces (FFMs) with state plan management. This brief summarizes the findings within this dataset, which outlines the various plan management and certification functions assumed by different state agencies across these marketplace models.
Improving Care for Medicaid Beneficiaries Experiencing Homelessness
Nationwide on a given night in January 2014, more than 578,000 people were homeless, and one third of these people were sleeping on the streets, in cars, or other places not meant for human habitation. Over the course of a year, about 1.42 million people used a shelter or transitional housing program for homeless individuals or families. Homeless people often have significant health and behavioral health needs that can be very difficult to manage without stable housing, and many people who experience homelessness are Medicaid beneficiaries. As purchasers of health care, state Medicaid agencies have critical roles to play in the delivery of more appropriate and cost-effective care for people with complex health and behavioral health care needs who experience homelessness.
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.
Assessing a New Option: The Feasibility of Contracting With a Single Firm to Build and Operate a State’s Marketplace
Since the passage of the Affordable Care Act (ACA), the design of state health insurance exchanges has evolved to include several distinct models. This evolution has led to the possibility that a state’s exchange development and operations could be delegated to a private vendor. States operating their own state-based marketplaces (SBMs) may begin to consider other options as they confront budget challenges and look to streamline operations.
The Impact of Medicaid Expansion on Uncompensated Care Costs: Early Results and Policy Implications for States
Since implementation of the Affordable Care Act (ACA), the 30 states that have expanded Medicaid have enrolled more than 10 million people in Medicaid or the Children’s Health Insurance Program and the collective rate of uninsured individuals in these states has fallen from 18 percent to less than 11 percent. Recent research by Manatt Health Solutions looked at the fiscal implications of expansion and found that, in addition to coverage gains, expansion states experienced significant budget savings and revenue gains. This issue brief, the third in this series prepared by Manatt Health Solutions, examines early data on expansion-related decreases in uncompensated care costs and related state budget implications.
Enhancing Broker Engagement: New Strategies for Marketplaces to Expand Enrollment
Health insurance brokers can play a unique role in helping all forms of marketplaces to reach out to uninsured households and assist residents with new enrollments, as well as coverage renewals. Recently, several marketplaces implemented pilot programs intended to leverage the resources of agencies that are particularly interested in building their direct enrollment business under the Affordable Care Act (ACA). The success of these initiatives is demonstrated by these marketplaces’ plans to expand their efforts for the upcoming open enrollment period.
Regulation of Student Health Plans Under Federal and State Law: An Overview
In March of 2012, the U.S. Department of Health and Human Services issued a regulation defining student health plans as individual health insurance under federal law. As a result, they are now subject to the same consumer protections afforded to all those covered by individual health insurance set forth in the Public Health Service Act, as amended by the Affordable Care Act. This issue brief, prepared by the Center on Health Insurance Reforms at the Georgetown University Health Policy Institute, examines student health plans, which cover over 1 million students, and investigates the interplay between federal and state regulation with regard to these plans.
Innovation Waivers: An Opportunity for States to Pursue Their Own Brand of Health Reform
States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by authorizing states to rethink the law’s coverage designs. Under State Innovation Waivers, states can modify the rules regarding covered benefits, subsidies, insurance marketplaces, and individual and employer mandates.