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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.

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Date Created: Jan 19, 2021
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Senate leadership has released a proposed substitute for the House-passed American Health Care Act (AHCA) known as the Better Care Reconciliation Act of 2017 (BCRA) that eliminates enhanced funding for Medicaid expansion after a three-year phase out, establishes a cap on federal Medicaid funding for nearly all beneficiaries and services, and makes a number of other changes to Medicaid. Using the Manatt Medicaid Financing Model, this analysis estimates the state-by-state impact of the cap on Medicaid and elimination of enhanced funding for expansion, taking into account that states may respond to the proposed law in a number of different ways.

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Date Created: Jun 28, 2017
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American Indians and Alaska Natives could face a disproportionate impact in the event of ACA repeal. This report, authored by Dr. Donald Warne at North Dakota State University, in partnership with the National Indian Health Board, highlights the specific effects of ACA repeal.

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Date Created: Mar 24, 2017
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Despite improvements that have been made over the past several decades, lead poisoning remains a serious hazard for many children in the U.S., presenting significant risks to their health and learning. More than 4 million families with children live in homes with high levels of lead, and approximately half a million under the age of five require treatment. The Children’s Health Insurance Program (CHIP) can provide critical financial support to states as they seek to implement cost-effective lead abatement activities to protect children.

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Date Created: Jan 30, 2017
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As we approach the beginning of a new presidential administration, there has been continued debate regarding the future of the Affordable Care Act (ACA), much of which has focused on the marketplaces, the mandate, and health insurance reforms such as the ban on insurers’ blocking coverage to those with pre-existing conditions. A potential elimination of the law’s Medicaid expansion to low-income adults and other ACA Medicaid provisions, however, would have far-reaching implications for states and the Medicaid program.

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Date Created: Dec 12, 2016
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With the United States in the midst of a worsening opioid epidemic, an examination of the resources and tools available to states in combating this crisis is critical. With Medicaid serving as the largest source of coverage for behavioral health services, including those related to substance use disorders (SUDs), the role that it can occupy in addressing the epidemic is clear. An additional 1.2 million individuals with SUDs have gained access to coverage in states that have expanded Medicaid under the ACA. This issue brief, developed by Manatt Health, reviews Medicaid strategies to combat the opioid epidemic.

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Date Created: Jul 1, 2016
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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.

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Date Created: Jun 29, 2016
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As health insurance marketplaces continue to approach the fourth open enrollment period, the development of innovative models and partnerships for reaching consumers becomes increasingly important. During the third open enrollment period, MNsure, Minnesota’s state-based marketplace, designated and supported twenty broker-operated enrollment centers around the state, which made a series of special commitments to promote enrollment through the marketplace. Determining the efficiency and effectiveness of such efforts is critical for the planning and development of future efforts undertaken by marketplaces.

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Date Created: May 31, 2016
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Since the passage of the Affordable Care Act (ACA), thirty-one states plus the District of Columbia have expanded Medicaid, providing a substantial base of evidence for the impact of Medicaid expansion, from a variety of perspectives. Data available from these states and a growing research base provide key information about the benefits and the strategic value of expansion.

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Date Created: Apr 12, 2016
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Changes in population-based payment models in health care delivery have spurred enhanced efforts toward closer integration between state purchasers of health care and state, county, and local public health officials. This issue brief, developed by Bailit Health Purchasing LLC and Dr. Karen Hacker, investigates approaches that state agencies might employ in order to better integrate public health and health care delivery as a means of improving health and the value of health care, and it is organized according to seven features of integration. The issue brief is accompanied by three case studies providing additional detail to some of the examples cited in the brief.

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Date Created: Mar 30, 2016