A Look at Two States’ Responses to the Association Health Plan Final Rule

Implementation of the new Federal Association Health Plan (AHP) Rule—and new options for associations seeking to offer health insurance coverage—is well underway. The new rule became effective for all fully-insured AHPs seeking to operate under the new rule in September, and will go into effect for existing self-insured AHPs seeking to operate under the new ...

Two Insurance Markets, Similar Stories to Tell

Massachusetts and New Hampshire held public meetings this past fall aimed at providing insights into the factors affecting health care costs in their respective states. The Massachusetts Health Policy Commission (HPC) held its sixth annual Cost Trend Hearing on October 16th and 17th. The New Hampshire Health Insurance Department (NHID) held its annual hearing at ...

A Preliminary Decision in the Newest Lawsuit Challenging the Affordable Care Act

On December 14th, a decision was published in the Texas v. U.S. case that challenged the validity of the Affordable Care Act (ACA). The case – which was brought by 20 states (“plaintiff states”) and later joined by two individual plaintiffs – contends that the “zeroing out” of the shared responsibility penalty through the 2017 ...

2018 Retrospective & Looking Forward to 2019

This past year brought increased flexibility for states related to both public health care programs and commercial health plans, with the Federal administration announcing numerous policies to give states more control over the design / regulation of the coverage offered to consumers. We saw first-of-their-kind waivers approved at the Federal level, including community engagement / ...

Early Lessons Learned from Implementing Community Engagement Requirements

Sixteen states have submitted Section 1115 Waivers to the Center for Medicare and Medicaid Services (CMS), requesting that a person’s eligibility to receive Medicaid be contingent on their participation in community engagement activities (also referred to as “work requirements”). States have flexibility to define the activities that would meet community engagement or work requirements, and ...

CMS Proposes Changes to the Regulations Governing Medicaid and CHIP Managed Care

On November 14, 2018, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule making changes to the Medicaid and Children’s Health Insurance Program (CHIP) Managed Care regulations. CMS had notified states in March 2017 that it was doing a thorough review of Medicaid and CHIP Managed Care regulations, which were last overhauled ...

CMS Issues Guidance on Medicaid Behavioral Health Delivery System Reform

On November 13, 2018, the Centers for Medicare and Medicaid Services (CMS) released a letter to State Medicaid directors outlining a wide range of opportunities for states to design innovative delivery systems for adults and children with serious mental health conditions. The CMS letter offers guidance on strategies to improve care for such individuals using ...

1115 Waiver Decisions issued by CMS

As we addressed in our report this past Spring, the use of Section 1115 Medicaid Waivers to address rising drug costs was a notable feature of the Federal administration’s recent drug proposal, and is an emerging policy trend.[1] The Federal administration’s 2019 budget proposes providing five states with Medicaid demonstration authority to test “drug coverage ...

Bipartisan Bill to Tackle the Opioid Epidemic Signed into Law

The Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (“SUPPORT Act”) was signed into law by the President on October 24, 2018, after passing the House and Senate with bipartisan support. A press release issued by the Senate explained that the Act aims to target the opioid epidemic ...

Health Policy News Hosts Round Table Discussion of Public Option Programs

On October 9th, Health Policy News held the second event in our 2018 Fall Webinar Series. This webinar featured a round table discussion on the history of public options, and the various design and programmatic options available to states crafting such programs. The webinar summarized and updated information included in the HPN report released this ...

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