Marketplace
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Blended Match Rate Proposal Raises Red Flags
By Jocelyn Guyer Last week just as Representative Cantor was making his dramatic exit from deficit reduction talks with Vice President Biden, rumors started to emerge that the idea of adopting a “blended matching rate” for Medicaid and CHIP was gaining currency. The Obama Administration first put forth the idea in a deficit reduction proposal…
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KidsWell Campaign Launches Online Resource for Health Reform Implementation
By Kimberley Chin, Programme Executive, Atlantic Philanthropies State advocates face enormous challenges–shrinking resources, entrenched politics, an often disinterested press. Yet somehow, we manage to get it done.Just about every major federal policy initiative begins and ends at the state.It was the states that conceived of what became CHIP, launched the first health benefit exchanges with…
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A Disappointing Rollback of Consumer Protections on Appeals
Imagine you’re a parent and your child has been diagnosed with cancer and is going through painful, debilitating treatment. You can imagine the sleepless nights, the worry, the exhaustion, the fear. Now imagine that your insurance company denies some of the claims for your child’s treatment – treatment that the doctors assure you are essential…
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Exchange Implementation Work Underway Across the Country
By Joe Touschner Don’t believe everything you read in the newspaper — while the national media has reported that states are moving “gingerly” to implement the Affordable Care Act, in fact there’s been a great deal of activity of late, especially around exchanges. No fewer than 16 state legislatures have acted favorably on measures that…
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It Can Be Complicated to Be A Kid
By Martha Heberlein Health reform creates many new options for children and families to secure coverage; however, as more options become available, children may face more complex coverage arrangements. In fact, recent estimates suggest that 20 million children live in situations that may make accessing coverage challenging due to differing eligibility status within their families. As…
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Out of the Shadows: Exchange/Medicaid IT 2.0 Guidance Says No Need for Duplicate Eligibility Systems
In this week’s release of the Exchange/Medicaid IT 2.0 guidance, the Centers for Medicaid and Medicare Services (CMS) firmly squashed speculation that states will need to operate a “shadow eligibility system” for determining who is newly eligible for Medicaid and therefore qualifies for 100% federal funding. Future federal rulemaking is expected to propose other methods…
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Three States Move to Next Phase of Building their Health Benefits Exchanges
This week, the Department of Health and Human Services (HHS) awarded the first round of grants to help states establish health insurance exchanges. State officials in Washington, Indiana and Rhode Island were granted a total of $35 million to begin building their exchanges. In announcing the grants HHS said that the states “will use the…
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Affordable Care Act Protecting Consumers from Premium Spikes
Health insurance premiums and gas prices have one thing in common – they are both rising at a time when oil and insurance companies are earning record profits. Most of us can figure out ways to cutback on our energy consumption to reduce our expenditures at the gas pump but cutting back on health care…
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Arkansas Lawmakers Ensure Kids Keep Coverage as Private Plans Leave the State
By Elisabeth Wright Burak, Arkansas Advocates The legislative session in Arkansas ended last month with many accomplishments for kids’ health on the books. We spend a lot of time talking about measures to improve access to ARKids First and promising new oral health accomplishments, including better availability of fluoridated water and preventive dental services. …
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Keeping Up with the California Health Benefit Exchange Board: Starting Off On the Fast Track
By Nicette Short of Children Now and Kathleen Hamilton of The Children’s Partnership California’s Health Benefit Exchange Board, created under the Affordable Care Act, held its inaugural meeting on April 20, 2011 in Sacramento, California. Even with one of the five Board seats vacant (the California Senate has not yet selected its appointee), the California…
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Oklahoma Makes U-Turn and Rejects Early Innovator Grant
By David Blatt, Director of Oklahoma Policy Institute In the new national health care law (the Affordable Care Act, or ACA), exchanges are state-level competitive marketplaces for individuals and small businesses to purchase insurance. After winning a $54 million Early Innovator grant earlier this year, Oklahoma was poised to become a national leader with a…
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Presumptive Eligibility: Providing Access to Health Care Without Delay and Connecting Children to Coverage
Presumptive eligibility is a state policy option that gives states the flexibility to train health care providers, schools and other community-based organizations and programs to screen eligibility and temporarily enroll eligible persons in Medicaid and CHIP. Currently 31 states use presumptive eligibility for pregnant women and 16 states enroll children presumptively. The following issue brief…
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Alphabet Soup: ACOs under ACA
By Joe Touschner We’ve long been familiar with CHIP and FMAP, while health reform has given us PPACA (ACA for short) and CLASS. You’ve probably also heard a lot recently about ACOs–Accountable Care Organizations which may be the concept of the year for many of our friends in the physician, hospital, and insurance communities. (Atul…
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Colorado Takes Step to Eliminate ‘Stair Step’
By Gretchen Hammer, Colorado Coalition for the Medically Underserved Some people say stair stepping is good for your health. Well, that may be true when you are exercising, but it is not true for families with children enrolled in public health insurance programs in Colorado. Currently, a Colorado family can have kids on two different…
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HHS Engages Communities to Address Racial and Ethnic Health Disparities
HHS’s National Partnership for Action to End Health Disparities (a project of the Office of Minority Health) recently hosted a conference call announcing a new new initiative focused on reducing health disparities in the U.S. The National Stakeholder Strategy for Achieving Health Equity was developed after engaging communities across the country around the priorities and…
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90/10 Rule is Final: Time to Upgrade to a More Reliable & Efficient Model
Remember driving an older model car that generally got you from point A to point B but not without stalling at a traffic light or having the heater cut out in the dead of winter? That‘s a bit like the old, tired legacy systems currently being used to determine eligibility for Medicaid (and other programs)…
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Senate Approves Bill to Change ACA’s 1099 Reporting Requirements
The Senate passed H.R. 4 today to remove the Affordable Care Act’s enhanced 1099 reporting requirements. President Obama has not yet indicated whether or not he will sign the bill into law. The White House supports the bill’s goal of eliminating the enhanced reporting requirements for businesses but has expressed concerns about the offset that was included…
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A Closer Look at Florida’s Medicaid Program
The Florida legislature is in the midst of a hot and heavy debate about the future of the state’s Medicaid program. One of the key questions being discussed is whether or not to expand the state’s controversial Section 1115 Medicaid waiver across the state and across all populations. The waiver is coming to the end…
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Legislative Attacks on ACA Continue
There was a lot of bark but not much bite this week in Congress surrounding the Affordable Care Act. In a Senate Appropriations Subcommittee hearing, HHS Secretary Sebelius once again defended the ACA against attacks from opponents, including one who was concerned that it was “too popular”. Chairman Tom Harkin (D-IA) reassured the Secretary of…
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Utah and MA health exchanges: Not Opposite Sides of Coin
By Joan Alker and Sabrina Corlette, Georgetown University Health Policy Institute A sad reality of working on health care policy at the moment is the incredible politicization of the debate. This climate has the unfortunate byproduct of obstructing compromise and preventing constructive dialogue about different approaches states may take to implementing the Affordable Care Act. Along…