Expert Perspectives

Oct 27, 2020 

COVID-19 and MLR Guidance on Risk Corridor Recoveries: State Options for Restoring Funds to Policyholders and the Public

In April 2020, the Supreme Court ruled that the federal government must restore to health insurers approximately $12.3 billion in risk corridor payments under the Affordable Care Act (ACA). On September 30, the Center for Consumer Information and Insurance Oversight (CCIIO) proposed instructions on how to allocate these risk corridor payments under the ACA’s medical loss ratio (MLR) formula. This guidance means that policyholders will receive an estimated 2.4 percent ($298 million) of the risk corridor payout in the form of MLR rebates. This expert perspective considers ways states could potentially redirect insurers’ extra cash to benefit policyholders and the public.

Oct 20, 2020 

Collaborating to Connect Consumers to Coverage

This year has presented many unique and unexpected challenges, but as open enrollment approaches states are making concerted efforts to connect residents with public and private health coverage options and are anticipating more churn between programs than ever before amid the COVID-19 public health crisis. Millions have filed for unemployment since the pandemic began, many losing their employer-sponsored health coverage or experiencing income loss in the process. As consumers navigate ongoing changes in their income or health coverage, it is more important than ever to clearly communicate with consumers what health coverage options are available for the remainder of 2020 and heading into 2021. This expert perspective lays out key takeaways on messaging to consumers to enroll in coverage this OEP and highlights examples from two states.

Oct 13, 2020 

Equitable Recovery Strategies

As state officials shift their focus towards loosening social distancing policies and reopening, they must now grapple with balancing both economic and public health concerns while also considering how reopening policies will impact residents in very different ways, possibly mitigating or exacerbating preexisting disparities. This expert perspective provides a survey of actions that state and local governments have taken to intentionally incorporate equity into their recovery and reopening policies.

Oct 1, 2020 

Exploring Strategies to Fill Gaps in Medicaid Race, Ethnicity, and Language Data

As states seek to address the social determinants of health and advance health equity, they face longstanding and persistent challenges in collecting complete, accurate, and consistent race, ethnicity and language (REL) data. This expert perspective provides an overview of current REL data collection standards; ideas for increasing completeness in data by engaging the enrollee and enrollment assisters, and modifying enrollment and renewal interface; and provides suggestions for how states could leverage alternative sources of data in order to improve REL data completeness.

Sep 24, 2020 

Maintaining Medicaid and CHIP Coverage Amid Postal Delays and Housing Displacements

In light of recent postal delays and housing displacements caused by the COVID-19 pandemic and related economic crisis, and a wave of natural disasters across the country, state Medicaid and Children’s Health Insurance Program (CHIP) agencies face new challenges communicating with their enrollees about their health coverage. Acting now to mitigate these challenges is essential as states are preparing for the end of the public health emergency (PHE) and “catching up” on coverage renewals for a large portion of their enrollees. This expert perspective reviews strategies that state Medicaid and CHIP agencies may consider to help mitigate coverage losses.