This expert perspective, the first in a three-part series, outlines strategies state Medicaid agencies can take to identify people with high health needs and provide them with additional support to retain or transition their health coverage in order to maintain access to essential healthcare services when the current Medicaid continuous coverage requirement ends. A second expert perspective identifies complementary strategies state-based marketplaces (SBMs) and departments of insurance can implement to help these individuals transition without gaps in care, and a third expert perspective will discuss strategies for the SBMs and their partners to help ensure continuity of coverage.

State updates as of May 27, 2022.

State updates as of May 20, 2022.

State health updates as of May 13, 2022.

On May 3, 2022, the Federal Communications Commission (FCC) opened a public comment period for feedback on a letter submitted by the Department of Health and Human Services Secretary Xavier Becerra and Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure. The letter requests the FCC’s opinion on the use of text messages and automated calls to enrollees as states resume regular operations at the end of the COVID-19 Public Health Emergency. The public comment period is an opportunity for states to share how text messages and automated phone calls are needed to reach enrollees. This expert perspective provides model comments to inform and support state responses to the FCC’s public comment period. States must submit all comments by Tuesday, May 17, 2022.

State health updates as of May 6, 2022.

On April 28, 2022, the Centers for Medicare & Medicaid Services released its final Notice of Benefit & Payment Parameters for plan year 2023. This annual regulation governs core provisions of the Affordable Care Act, including operation of the health insurance marketplaces, standards for insurers, and the risk adjustment program. This expert perspective focuses on provisions of the final rule that are of particular import to the state-based marketplaces and state insurance regulators.

On April 5, 2022, the Treasury Department and the Internal Revenue Service (IRS) released proposed regulations to address the so-called “family glitch” under the premium tax credit (PTC). The family glitch prevents certain dependents of employees from qualifying for PTC, and by extension for advance payments of PTC and cost-sharing reductions, through the Affordable Care Act’s Marketplaces. Addressing the family glitch is an important step towards making affordable health insurance universally available. While fixing it has long been a key priority of state health officials and other stakeholders, the change will also create new work for states with little time to prepare for its rollout. This expert perspective reviews the proposed regulations and discusses the potential implications for states.

As state insurance regulators and marketplace officials prepare for the substantial transitions in coverage that will occur in the wake of the eventual expiration of the public health emergency, they will want to ensure that brokers and enrollment assisters are doing all they can to help new marketplace consumers understand their coverage options and enroll in a plan that suits them. This expert perspective reviews the options available to state marketplaces and insurance regulators to protect consumers and take action to prevent carriers from implementing compensation schemes for brokers that discourage mid-year enrollment. The ability of brokers and assisters to facilitate smooth transitions from Medicaid to the marketplaces will have direct consequences for the well-being and security of the transitioning population and significant ramifications for health equity.

State health updates as of April 29, 2022.