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.
While millions of Americans have newly gained health insurance coverage under the Affordable Care Act (ACA), there is evidence that coverage alone does not necessarily translate into access to health care. This memo, prepared by the State Health Access Data Assistance Center (SHADAC), provides background information on health insurance literacy, summarizes the research around current consumer knowledge, and offers recommendations for marketplaces on how to build on it. Additionally, the State Network has compiled a library of health insurance literacy materials developed by four marketplaces.
As some states continue to debate whether to implement Medicaid expansion under the Affordable Care Act, early results from those that have done so show the impact this decision has had on their state budgets. States that expanded the number of people eligible for Medicaid are seeing big budgetary savings without reducing services. This report, prepared by Manatt Health Solutions, analyzes data from eight states, showing $1.8 billion in budget savings by the end of 2015 as a result of Medicaid expansion.
During the initial open enrollment period under the Affordable Care Act, the federal government and states operating state-based exchanges conducted various types of reporting on key indicators of interest to policymakers and the public.
As those interested in conducting surveys to measure the public’s participation and experience in health insurance marketplaces under the Affordable Care Act (ACA) continue to investigate the most effective ways of doing so, access to questions utilized in previously conducted surveys will be very useful.
Between October 2013 and April 2014 access to health insurance in Oregon expanded in two ways, leading to unprecedented changes in insurance coverage in the state. First, the state extended Medicaid coverage to many previously ineligible low-income adults. Second, the state created a health insurance marketplace that provided a resource where individuals could learn what they are eligible for, explore financial assistance options available to them, and compare commercial plans.
With the recent conclusion of the initial open enrollment period under the Affordable Care Act, opportunities now exist to examine the experiences and successes of several state-based marketplaces in order to evaluate how they reached consumers and enrolled them in Qualified Health Plans
As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and could have tax liability implications.
With full implementation of the health insurance coverage provisions of the Affordable Care Act (ACA) on January 1, 2014, there has been great interest in assessing the law’s early impact on health insurance coverage in Minnesota.
The State Health Access Data Assistance Network (SHADAC) at the University of Minnesota prepared this chartbook summarizing the findings of the 2012 Minnesota Comprehensive Health Association (MCHA) Enrollee Survey.