Tag: States
New RWJF project examines health reform progress
Posted by mmcdowell 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…
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Commonwealth Fund releases issue brief tracking state action on early market reforms
Posted by mmcdowell 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.
Supreme Court grants request for more time
Posted by mmcdowell on February 21, 2012
The Supreme Court justices announced that they would lengthen the time allotted to hear the Anti-Injunction Act issue from 60 to 90 minutes. This issue surrounds whether the justices have the authority to decide whether the Affordable Care Act’s (ACA’s) minimum coverage provision is constitutional. This will bring the case to a total of six hours, making it the longest Supreme Court case in modern history. For the Anti-Injunction Act, the court will hear from a third-party attorney for 40 minutes, the Justice Department for 30 minutes, and the NFIB and the states will get 20 minutes. Next, the justices will hear two hours regarding whether the insurance mandate is constitutional. This issue of the severability of the individual mandate from the rest of the ACA will receive two and a half hours. The court will finally spend an hour on the states’ challenges to Medicaid expansion.
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RWJF report explores Exchange options for States
Posted by mmcdowell on December 20, 2011
The Robert Wood Johnson Foundation (RWJF) released a report today that explores three ways that states can comply with the Affordable Care Act’s (ACA’s) health insurance exchange provision. First, states can establish an exchange of their own; second, states can default to a federal exchange; or third, states can create a hybrid exchange. On behalf of the National Academy of Social Insurance (NASI), the authors evaluated the considerations associated with each option to help states determine which model may work best for the unique needs of their residents. Although the underlying goals are the same in all three Exchange models, there are differences in the amount of flexibility and autonomy granted to the States with each. State Exchanges, for example, offer the greatest independence in functions like coordinating plan enrollment, eligibility, and financial management. States cede much of this autonomy with the Federal Exchange model. As its name implies, the Hybrid Exchange allows states to retain responsibility for certain core functions, while importantly, also providing an interim pathway for an eventual State Exchange. The authors conclude that regardless of the model, success can only be achieved through intensive collaboration between individual states and the U.S. Department of Health & Human Services.
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GAO compares PCIP implementation with CHIP
Posted by Mark Dorley on December 15, 2011
The U.S. Government Accountability Office (GAO) has issued a report comparing the early stages of the federal Pre-Existing Condition Insurance Plan (PCIP) with the Children’s Health Insurance Program (CHIP). The federal PCIP was authorized by the Affordable Care Act (ACA), and is intended to provide insurance for individuals with previously existing medical conditions who have been unable to obtain health insurance coverage for at least 6 months. GAO was tasked by the Senate with comparing early enrollment and implementation across both PCIP and CHIP. GAO found that like CHIP, enrollment in PCIP was slow in the beginning, but increased over time. GAO also found that enrollment in PCIP was generally lower in States that had high risk pools than in States that did not.
For more information on pre-existing conditions, click here.
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HHS issues MLR interim final rule
Posted by Mark Dorley on December 2, 2011
The U.S. Department of Health and Human Services (HHS) has issued an interim final rule (IFR), with public comment, on the medical loss ratio (MLR) requirement under the Affordable Care Act (ACA). Beginning in 2012, the ACA requires that health insurers spend at least 80% (in some cases 85%) of premiums on health care services, or be required to pay rebates to plan members. HHS issued both the rule itself as well as a separate IFR on the rebate requirements, each allowing for public comment.
For more information on medical loss ratios, click here. An update to the previous brief is pending.
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CHIP open to children of low-income State employees
Posted by mmcdowell on November 7, 2011
Prior to passage of the Affordable Care Act (ACA), section 2110(b) of the Social Security Act excluded children who were eligible for health benefits coverage under a State health benefits program from CHIP. Over time, however, it became clear that in some States, children of State employees do not have access to affordable, comprehensive coverage options. Many of these children were within the income eligibility level of their State’s CHIP program. Section 10203(b)(2)(D) of the ACA amends the definition of a targeted low-income child by permitting States to extend CHIP eligibility to children of State employees who are otherwise eligible under the State child health plan. At least six states have taken advantage of the new provision.
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KCMU and HMA track Medicaid spending, coverage and policy trends in 11th annual report
Posted by mmcdowell on October 28, 2011
The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) along with Health Management Associates (HMA) recently published “Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends,” which summarizes the results from a 50-State Medicaid Budget Survey for State Fiscal Years 2011 and 2012. The report also includes background on the Medicaid program, as well as current issues facing the program including how states are preparing for the implementation of national health reform.
CRS releases report comparing health insurance coverage across states
Posted by mmcdowell on October 20, 2011
The Congressional Research Service (CRS) recently released the report “Health Insurance Coverage by State and Congressional District, 2010,” which employs the U.S. Census Bureau’s 2010 American Community Survey (ACS) to describe health insurance coverage and provide estimates of coverage by type at the national, state, and congressional district level. The report details the considerable differences in insurance status and coverage source across states, within states, and across demographic groups.
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Government tool promotes transparency regarding insurance rate increases
Posted by mmcdowell on October 7, 2011
Since September 1, 2011, health insurance companies have been required to inform the public whenever they want to increase health insurance rates for individual or small group policies by an average of 10% or more. Insurance experts in state or federal government will then review these rate increase requests in a process known as “rate review.” On Friday, the Obama administration released a Web-based tool that will allow consumers to track when health plans are considering steep premium hikes. The new tool enables insurance customers to search for potential hikes by state.
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- Update: Essential Health Benefits FAQs posted on May 9, 2012
- Update: Exchanges Establishment and Eligibility Final Rule posted on April 10, 2012
- Contraception Coverage under the ACA’s Preventive Services Coverage Requirements, and Employer Implementation: An Update posted on April 20, 2012
- State Health Insurance Exchange Navigators posted on February 28, 2011
- Update on the Final Rule: Standards Related to Reinsurance, Risk Corridors and Risk Adjustment posted on April 4, 2012
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