Expert Perspectives

Apr 12, 2024 

The Final 2025 Notice of Benefit and Payment Parameters: Implications for States

On April 2, 2024, the Centers for Medicare & Medicaid Services released the final Notice of Benefit and Payment Parameters for 2025, the annual rule which governs core provisions of the Affordable Care Act. This expert perspective focuses on provisions of the final rule of interest to state officials, including requirements for State-Based Marketplaces to adhere to standards that align more with the Federally Facilitated Marketplace, improvements to the processes for states to determine and update essential health benefits, and initiatives designed to streamline the eligibility and enrollment process for consumers.

Apr 2, 2024 

Short-Term, Limited Duration Insurance Final Rule: Considerations for States

On March 28, 2024, the U.S. Departments of Health and Human Services, Labor, and Treasury released a final regulation that updates the definition of short-term, limited duration insurance (STLDI) and requires consumer disclosures for STLDI and hospital and fixed indemnity policies. These changes are designed to help consumers more clearly distinguish the differences between STLDI/fixed indemnity policies and comprehensive health insurance coverage that must comply with consumer protections under the Affordable Care Act and other federal laws. This expert perspective discusses the implications of the final rule for state regulators.

Mar 29, 2024 

CMS Releases Expansive Final Rule on Medicaid and CHIP Eligibility, Enrollment, and Renewal

On March 27, the Centers for Medicare & Medicaid Services released a final rule, “Medicaid Program; Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment and Renewal Processes.” The expansive final rule, initially proposed in September 2022, is the first large-scale eligibility and enrollment rule released since two Affordable Care Act implementing regulations were finalized in March 2012 and July 2013. This expert perspective provides a high level summary of the Medicaid Eligibility and Enrollment final rule.

Mar 15, 2024 

Insights on Federal Healthcare Priorities

Two recent events provided insight into federal priorities in Medicare, Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act Marketplaces. On March 9, Congress passed and the President signed a “minibus” funding bill, funding about half of the government agencies for fiscal year (FY) 2024 and deferring action until March 22 for remaining agencies. And on March 11, the White House released the President’s Budget for FY 2025, articulating the Biden administration’s healthcare policy priorities for the upcoming year. This expert perspective reviews the healthcare policies and programs recently funded by Congress for FY 2024 as well as the Biden administration’s stated healthcare priorities for FY 2025.