Proposed Standards for Navigators and Consumer Assistance Counselors: Preemption of Certain State Navigator Regulatory Laws
Posted by Mark Dorley on March 19, 2014
On March 17, 2014, HHS released a proposed rule in public view form that addresses a variety of issues including Exchanges, Navigators and Non-Navigator consumer assistance personnel, and other matters. The rule will appear in the Federal Register on…
Report finds states spending more on Medicaid due to drop in federal funding
Posted by Michal McDowell on December 16, 2012
According to a report released by the National Association of State Budget Officers (NASBO) and the National Governors Association (NGA), state Medicaid spending increased by an estimated 16.2 percent in fiscal year 2012, due in part to a decrease in enhanced federal funding available to states during the recession. The report found that Medicaid accounted for 24% of total state spending in 2012. The significant increase reflects the termination of the temporary increase in federal match rate, enacted as part of the American Recovery and Reinvestment Act of 2009, which was in effect from October 2008 to June 2011. Compounded with the end of the increased federal matching rates, the recession also resulted in a significant increase in Medicaid enrollment. In response, 33 states have enacted Medicaid funding increases for FY 2013 and 12 states have enacted cuts in their Medicaid programs for FY 2013.
Essential Health Benefits Update: Proposed Regulations Implementing the ACA; and Application of the Proposed EHB Regulations to Medicaid Benchmark Plans
Posted by Mark Dorley on November 29, 2012
On November 26, 2012, the Obama Administration published a series of proposed rules implementing many of the Affordable Care Act’s (ACA) most important insurance reforms, including Health Insurance Market Rules and Rate Review (77 Fed. Reg. 70584), Nondiscriminatory Wellness Programs in Group Health Plans (77 Fed. Reg. 70620), and Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70644). In addition, the Administration issued informal guidance that add to and amplify on the provisions of the proposed rules.
This Implementation Brief Update examines the proposed rule implementing the Act’s essential health benefits…
American Action Forum report finds ACA implementation has large price tag for states, private companies
Posted by Michal McDowell on October 11, 2012
In a new analysis, the conservative think tank, the American Action Forum, reported that new Affordable Care Act (ACA) regulations have cost states and private companies over $27 billion. The report found that about $20 billion in ACA compliance costs will fall to private businesses, while $7.2 billion will fall to to state governments. Medicaid eligibility expansion will cost states approximately $580 million while private businesses will spend $757 million complying with new menu-labeling provisions, for example. State initiatives will include creating an insurance exchange, while the total for private employers is attributable to complying with the new healthcare requirements and coverage mandate.
Already, the federal government has awarded billions of dollars in grants to help states establish exchanges and comply with other ACA provisions.
Commonwealth publishes paper on choosing health plans in State Exchanges
Posted by Michal McDowell on August 24, 2012
Beginning in 2014, the health insurance exchanges created under the Affordable Care Act (ACA) will be available in every state as marketplaces for individuals without employer insurance and small employers. All plans will include the same package of essential health benefits, but will vary by four different levels of “actuarial value,” or the percentage of medical costs that a plan pays for on average. The actuarial value of a plan will be indicated by the tiers of bronze, silver, gold, and platinum, and comparative information will be available to help people select plans. A new study recently published by the Commonwealth Fund looks at out-of-pocket costs that might result from plans with various designs and actuarial values. The study found that average out-of-pocket expenses decline as actuarial values rise, but two plans with similar actuarial values might result in different out-of-pocket costs for a given person. The overall affordability of a plan also will be influenced by age rating, income-related premium subsidies, and out-of-pocket subsidies, report the authors.
Sebelius sends letter to governors encouraging Medicaid expansion
Posted by Michal McDowell on July 11, 2012
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius published a letter on Tuesday urging governors to participate in the Affordable Care Act’s (ACA’s) Medicaid expansion, which the Supreme Court ruled must be optional for states. Under the Medicaid expansion provision, the ACA offers coverage to everyone at or below 133 percent of the federal poverty line. The letter also announced meetings for both state and federal officials to discuss ACA implementation.
Urban paper examines how many adults would remain uninsured if states opt out of Medicaid expansion
Posted by Michal McDowell on July 10, 2012
The Supreme Court’s ruling on the Affordable Care Act (ACA) upheld the individual mandate and made the expansion of Medicaid coverage to nonelderly adults with incomes below 138 percent of the federal poverty level optional for states. In a new brief, authors from the Urban Institute estimate the number of uninsured Americans in each state who could be eligible for Medicaid if every state takes advantage of the option of expanding Medicaid coverage. According to the report, almost half of the nation’s uninsured could qualify for Medicaid under the ACA. Of 22.3 million low-income uninsured Americans who could be potentially eligible for Medicaid under the ACA, 67 percent (15.1 million) are adults not currently eligible for Medicaid. Of this group, 11.5 million have incomes below poverty and would not qualify for any other subsidized coverage.
States comment on ACA decision
Posted by Michal McDowell on July 2, 2012
The National Association of Medicaid Directors (NAMD) Executive Director Matt Salo released a statement, focusing on the Supreme Court’s Thursday decision to rule Medicaid expansion as optional for states.
The National Conference of State Legislatures (NCSL) released this statement following the Court’s decision.
Dan Crippen of the National Governors Association (NGA) wrote this letter to Health and Human Services (HHS) Secretary Kathleen Sebelius regarding the ruling.
New RWJF project examines health reform progress
Posted by Michal McDowell on March 30, 2012
A series of in-depth case studies based on site visits and reports from national data sets tracks how the Affordable Care Act (ACA) is being implemented in states and establishes a baseline for measuring progress over the coming years. The reports, prepared by researchers at the Urban Institute and Georgetown University’s Health Policy Institute, are designed to share background information, processes, and learnings that can inform the work of state government agencies, policy-makers, and others across the country as ACA implementation progresses.
In the first reports, the authors found that…
Commonwealth Fund releases issue brief tracking state action on early market reforms
Posted by Michal McDowell on March 22, 2012
The Affordable Care Act (ACA) includes numerous consumer protections that took effect on September 23, 2010. This issue brief examines new state action on a subset of these “early market reforms.” The analysis finds that 49 states and the District of Columbia have passed new legislation, issued a new regulation, issued new subregulatory guidance, or are actively reviewing insurer policy forms for compliance with these protections. These findings suggest that states have required or encouraged compliance with the early market reforms, and that efforts to understand how states are responding cannot focus on legislative action alone. The findings also raise important questions regarding how states may implement the ACA’s broader 2014 market reforms, and suggest the need for continued tracking of state action.