2013
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Medicaid Payment Provision Seeks to Address Access
By Anne Edwards, M.D., FAAP, Chair of the American Academy of Pediatrics Committee on State Government Affairs Pediatricians and other child advocates continue to work with their state Medicaid programs to implement a significant provision in the Patient Protection and Affordable Care Act (ACA) to increase access to care in the program. Long sought by the…
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Emerging Policies on Dental Coverage for Kids
By Joe Touschner With the final rule on EHBs, another on market reforms, and some additional guidance from HHS, we’re getting a clearer picture of how one important set of benefits—dental care—will work for kids in EHB-covered plans next year. As readers know, those are new private plans in the individual and small group market. …
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More Research Needed on Medicaid Wellness Programs
By Tara Mancini Increasingly, the idea of programs that aim to modify the health behavior of participants through the use of incentives has surfaced as a way to cut medical costs and improve health outcomes. However, there is a paucity of research on the effectiveness of such programs, particularly in Medicaid. Fortunately, the ACA authorized…
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Children Need Exchange Coverage Too
By Maureen Hensley-Quinn, National Academy for State Health Policy As state and federal government officials race to meet Affordable Care Act (ACA) implementation deadlines much of their attention has been focused on adults who will be newly eligible for health coverage. Health insurance exchanges (exchanges) or marketplaces need to be prepared to serve children’s needs as…
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Obama Administration Releases FY2014 Budget
By Tara Mancini President Obama (finally) released his budget recommendations for fiscal year 2014. Although the budget was postponed for two months, there aren’t too many surprises here as we’ve heard many of his considerations during the delay. The good news is that as promised the budget does not contain any significant cuts to Medicaid,…
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HHS Release Its FMAP Claiming Regulation
By Jocelyn Guyer On April 2nd, 2013, HHS released the “final” version (more on that below) of its FMAP claiming rule. It outlines the process states must use to figure out the matching rate that applies to adults who are covered by the expansion of Medicaid to 138 percent of the federal poverty line. This…
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Senate HELP Committee Examines Upcoming Market Changes Under ACA
It was a strange feeling testifying before the Senate Health, Education, Labor and Pensions (HELP) Committee., given that, about 15 years ago, I was sitting on the other side of the dais as a staff member of the Committee. Today, my role was dramatically different, as I was called to speak as a witness at a…
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Federal Navigator Funding Opportunity Announced
At long last, organizations can now apply for federal navigator funding in 33 states where the federal government will run the Health Insurance Marketplace or there is a State Partnership Exchange. The program will fund a total of $54 million dollars in grants (actually cooperative agreements). Grants will range from $600,000 to $8.1 million based…
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National Survey Finds Strong Support for Medicaid Option & Concern About ‘Coverage Gap’
Today we joined the National Women’s Law Center (NWLC) in releasing a national survey that found a majority (62%) of Americans want to see their state accept federal dollars offered by the Affordable Care Act (ACA) to cover more uninsured people through Medicaid. The survey also found that a majority (70%) are concerned about the “coverage…
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Colorado Puts an End to CHIP Waiting Period – Let’s End the Wait for All Kids
Colorado children and families can breathe a little easier now that the Governor signed into law a commonsense bill that ends CHIP waiting periods. Colorado had required families to wait for three months from the end of their employer-sponsored insurance before enrolling their children in Child Health Plan Plus, Colorado’s CHIP program. Cody Belzley of the…
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CMS Releases Proposed Standards for Navigators and In-Person Assisters
Organizations interested in applying for navigator grants and other stakeholders will want to take a close look at the proposed rules on navigator conflict of interest, training and meaningful access standards. While subject to a 30-day comment period and final rulemaking, the proposed rules add some clarity regarding expectations for federally-funded navigators and in-person assisters…
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Vermont Preliminary Rate Filings Offers First Look at Exchange Pricing
By Christine Monahan, Georgetown University Center on Health Insurance Reforms In the midst of much analysis of the impact of the Affordable Care Act (ACA) on health insurance premiums, Vermont became the first state to release preliminary rate filings for plans to be sold in their health insurance exchange in 2014. The good news is that people generally haven’t…
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CMS Issues Guidance on Arkansas Type Premium Assistance Plans
So as Tricia Brooks blogged about yesterday while I was taking the day off, CMS issued some interesting Q and A’s last Friday on how a state might consider taking a premium assistance approach to expanding their Medicaid program. The Q and A’s, to my mind, were a helpful contribution to the ongoing discussions in…
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Diving Deep on Two New Rate Studies
By Christine Monahan and Katie Keith, Georgetown University Center on Health Insurance Reforms With many of the Affordable Care Act’s (ACA) most significant reforms expected to go into effect in 2014, policymakers and the media have increasingly turned their attention to the law’s price tag for consumers. Republican lawmakers, for example, sounded the alarm about…
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Building the New Insurance Marketplaces: Future of One State-Based Exchange Threatened
By Sabrina Corlette, Center on Health Insurance Reforms The District of Columbia is not technically a state, but it is one of the few that plans to run its own health insurance marketplace (called the “Exchange”) under the Affordable Care Act. Early on, however, DC planners realized that they had a very small pool from…
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New Options for Young Invincibles
By Christina Postolowski, Young Invincibles The Affordable Care Act (ACA) will provide enormous new benefits to young Americans – in fact, it already has. Last month, Gallup released a poll showing that the uninsured rate for young adults under 26 decreased yet again, a drop of six percent since 2009. The drop is due in…
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CMS Q&A Shines Light on “Arkansas Plan”
Just in time for the holiday weekend, CMS issued a Q&A regarding the state option to expand Medicaid by using premium assistance to buy coverage through a qualified health plan in the new insurance marketplaces. Over the past few weeks, “the Arkansas plan” worked itself into a media frenzy and had Medicaid stakeholders concerned over…
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Medicaid Presumptive Eligibility Coming to a Hospital Near You
Beginning in January 2014, hospitals that provide Medicaid services can begin making presumptive eligibility (PE) decisions giving temporary Medicaid (and/or CHIP) coverage to children, pregnant women, parents and adults covered under the Medicaid expansion. The Affordable Care Act permits this action without regard to whether the state has adopted PE as a policy (as 32…
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Proposed Medicaid and CHIP Performance Indicators Offer Hope of Transparency and Accountability
It’s nice to have reason to take off my navigator hat for a change of pace. And a Request for Information (RFI) on proposed performance indicators for Medicaid and CHIP released earlier this year gave me a great opportunity to focus on another passion of mine – data to assess the effectiveness of our public…
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Affordable Care Act Celebrates Third Anniversary
If the saying “what doesn’t kill you makes you stronger” is true, the Affordable Care Act should be the “Ironman” of laws by now. As the new law gains strength, so does our health care system and that it worth celebrating. In the last year, the Affordable Care Act withstood a Supreme Court challenge, a…