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

HHS publishes rules on contraception coverage

Posted on August 25, 2014 | No Public Comments

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 | No Public Comments

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 | No Public Comments

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 | No Public Comments

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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Report proposes theoretical ACA alternative

Posted on August 13, 2014 | No Public Comments

Manhattan Institute Senior Fellow Avik Roy proposed a health care plan that guarantees “near universal coverage and permanent fiscal solvency.” The Universal Exchange Plan would repeal the Affordable Care Act’s (ACA) individual and employer mandates and would transition Medicaid beneficiaries and future retirees into reformed health exchanges. The Manhattan Institute predicts the plan would expand coverage to 12.1 million more Americans than the ACA by 2025 and decrease individual market premiums 17 percentage points by 2020.

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CMS publishes Medicare pay final rule

Posted on August 5, 2014 | No Public Comments

The Centers for Medicare and Medicaid Services (CMS) issued a final rule revising the Medicare hospital inpatient prospective payment systems (IPPS). In adherence to the Affordable Care Act (ACA), part of the rule would effectively reduce payments to disproportionate share hospitals (DSH), which serve the most vulnerable patients. DSH payment reductions are a result of the expansion of Medicaid, however in states that chose not to expand, hospitals still risk losing some payment for uncompensated care.

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Issue brief examines health plan quality improvement efforts

Posted on July 29, 2014 | No Public Comments

In a new issue brief published by the Commonwealth Fund, researchers from Georgetown’s Center on Health Insurance reforms reviewed state action in selective contracting, informing consumers about health plan quality, and collecting data on insurers’ quality improvement efforts. The study found that 13 state-based marketplaces have taken action to implement the Affordable Care Act’s (ACA) quality improvement goals. The authors also assess technical and operational challenges states face in using the Marketplace to help drive system wide change in health care delivery.

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Study looks at remaining uninsured

Posted on July 29, 2014 | No Public Comments

A new study by the Urban Institute funded by the Robert Wood Johnson Foundation finds that two-thirds of the nation’s remaining uninsured adults have incomes at or below 138 percent of the federal poverty level (FPL). While this is the target population of the Affordable Care Act’s (ACA) Medicaid expansion, 40 percent of the uninsured live in states that chose not to expand Medicaid. The study found that affordability was the main reason people did not get health insurance, yet many uninsured individuals had limited awareness of potential financial help available to them.

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CMS issues regulations on premium payment

Posted on July 24, 2014 | No Public Comments

The Center for Consumer Information and Insurance Oversight (CCIIO) and the Centers for Medicare & Medicaid Services (CMS) issued Federal guidance which gives individuals a three-month grace period to pay a premium without losing coverage. However, the same guidance states that if individuals choose enroll in a new policy for 2015, insurance companies cannot apply new premiums to outstanding 2014 debt. Some have suggested that this inconsistency could allow consumers to avoid paying their December premiums. However, nothing bars an insurer from making a bona fide effort to collect any unpaid premiums, as the consumer would still owe this amount to the insurer.

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IRS releases final rules on tax credit and drug fee

Posted on July 24, 2014 | No Public Comments

The Internal Revenue Service (IRS) published a final rule clarifying its premium tax credit policy for those enrolling in health plans through Affordable Insurance Exchanges with complicated family and household situations. The rule clarifies that certain married individuals, including spouses in abusive relationships, and divorced or separated taxpayers, can be considered not married for the purposes of the Internal Revenue Code, under Section 7703(b).

The agency also released a final rule regarding the implementation of the Affordable Care Act’s (ACA) branded prescription drug fee. The rule  provides guidance on the annual fee imposed on covered entities engaged in the business of manufacturing or importing branded prescription drugs.

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