A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

Studies examine insurance rates of children and parents under the ACA

Posted on September 10, 2014 | Comments Off

Two studies by the Urban Institute show that the provisions of the Affordable Care Act (ACA) have in many cases helped to insure more parents, but have not been as successful at increasing coverage for their children. The studies found that nationally, between September 2013 and June 2014, the estimated uninsured rate for parents fell 2.4 percentage points from 16.7 percent to 14.3 percent. However, for the same time period, no statistically significant change was found in the estimated uninsured rate for children under age 17. Additionally, findings suggest that the majority of uninsured children are eligible for Medicaid or the Children’s Health Insurance Program (CHIP)  but are not yet enrolled. The implications of these studies could be important as Congress considers whether to reauthorize funding for CHIP beyond 2016.

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CAP proposes model to control health care costs

Posted on September 8, 2014 | Comments Off

The Center for American Progress released a report proposing an approach known as the “Accountable Care States” in order to control health care costs. The model will keep costs down by giving states flexibility and incentives to control costs. A state that designates itself an Accountable Care State will be accountable for health care costs, quality of care, and access to care with sizable financial rewards for keeping overall costs low. Using Congressional Budget Office (CBO) data, the report estimates that if half of the states participate, the Accountable Care States model would yield $1.7 trillion in savings on total health care spending over 10 years.

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HHS releases final rule on ACA eligibility and re-enrollment

Posted on September 3, 2014 | Comments Off

The US Department of Health and Human Services (HHS) released a final rule on eligibility and re-enrollment for the second open enrollment season of the Affordable Care Act (ACA).  The rule specifies additional options for annual eligibility redeterminations and renewal and re-enrollment notice requirements for qualified health plans offered through the Exchange, for benefit year 2015.  This final rule provides additional flexibility for Exchanges, including the ability to propose unique approaches that meet the specific needs of the state.

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CMS approves PA Medicaid waiver

Posted on August 29, 2014 | Comments Off

The Centers for Medicare and Medicaid Services (CMS) approved Pennsylvania’s waiver application to receive matching funds under the Affordable Care Act (ACA) for extending Medicaid eligibility to residents who earn up to 133 percent of the federal poverty level.  Although substantially revised from the original proposal, the approved waiver creates a five-year Medicaid demonstration, entitled “Healthy Pennsylvania.”  Starting in January, as many as 600,000 Pennsylvanians could be eligible for new coverage on the private market, according to Pennsylvania Governor Tom Corbett’s office..

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IRS posts employer mandate filing instructions

Posted on August 29, 2014 | Comments Off

The Internal Revenue Service (IRS) posted a set of draft instructions to accompany the employer mandate and exchange filing forms released last month. The instructions are directed at marketplaces that have to report enrollees in qualified health plans, as well as employers and others that provide minimum essential coverage or are subject to the employer mandate.

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OIG releases report on federal exchange contracts

Posted on August 26, 2014 | Comments Off

The US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a report which provides an overview of the contracts that contributed to the development of the Federal Marketplace. The Centers for Medicare and Medicaid Services (CMS) relied, and continues to rely, extensively on contractors to operate the Federal Marketplace under the Affordable Care Act (ACA). The report analyzes the planning, acquisition, management, and performance oversight of these contracts, but does not make recommendations.

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HHS publishes rules on contraception coverage

Posted on August 25, 2014 | Comments Off

The U.S. Department of Health and Human Services (HHS) published an interim final rule which provides an alternative process for an eligible organization to provide notice of its religious objections to providing contraceptive coverage.  It will allow qualifying organizations to notify HHS of their religious objections to providing coverage and the government will in turn contact their insurers, which are to provide contraceptive benefits to the employees without any cost sharing.  HHS additionally released a proposed rule which changes  the definition of an eligible organization that can avail itself of an accommodation with respect to coverage of certain preventive services. These rules come in response to recent decisions against the Affordable Care Act’s (ACA) birth control mandate from multiple federal courts. HHS also released a coinciding fact sheet on the rules.

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CBPP releases report on alternative Medicaid expansion approaches

Posted on August 22, 2014 | Comments Off

The Center on Budget and Policy Priorities (CBPP) released a report to help state policymakers design waiver proposals for alternative approaches to expanding Medicaid. Arkansas, Iowa, and Michigan have all been granted waivers by the federal government to expand their Medicaid programs through alternative methods. The report outlines what federal officials have previously permitted and refused to help newly interested  states successfully obtain a waiver.

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CMS announces updated training program for ACA navigators

Posted on August 15, 2014 | Comments Off

The Centers for Medicare and Medicaid Services (CMS) released a bulletin updating the Navigator, non-Navigator assistance personnel, and certified application counselor training curriculum for the Federally-facilitated and State Partnership Marketplaces in preparation for the next Open Enrollment Period beginning November 15, 2014.  The expanded curriculum will include more information on immigration, household income calculations and help for specific populations, including victims of domestic abuse and college students.  All assisters, whether they are seeking recertification or initial certification, will be required to complete the new training program.

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Study finds less market competition contributes to higher premiums

Posted on August 13, 2014 | Comments Off

A study by the Urban Institute analyzed marketplaces in 10 states finding that in states largely dominated by one insurer, such as Alabama, Arkansas, Rhode Island and West Virginia, premiums are generally higher. In the more competitive markets- Colorado, Maryland, Massachusetts, New York, Oregon, and Virginia, the authors often found limited provider networks, which allows insurers to keep premiums low. However, these limited networks may hinder access to certain providers

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