All posts by Lisa Kaplan Howe

Lisa Kaplan Howe (J.D.) is a Senior Advisor who has spent her career working in health law and policy. At PCG, she focuses on statutory and regulatory analysis and strategic advising, particularly related to health care policy. Lisa has provided subject matter expertise to support state health care reform efforts, including policy development and regulatory support for health insurance Marketplaces and state insurance plan management efforts, Medicaid expansion and Medicaid Waivers (including DSRIP Waivers) and State Innovation Waivers. Lisa led PCG’s work with the New Hampshire Insurance Department relative the state’s Section 1115 Medicaid Waiver to provide coverage to newly-eligible adults through the Marketplace and continues to support the states’ Marketplace plan management work. In those roles, Lisa has served as the chief advisor and policy expert related to Medicaid and private insurance law to the New Hampshire Insurance Department, helping to identify, analyze and lead strategic consideration of federal opportunities and requirements. Lisa is also part of the team helping to design Colorado’s Delivery System Reform Incentive Payment (DSRIP) program. Ms. Kaplan Howe also provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Lisa is a managing editor of PCG’s monthly health practice area newsletter, Health Policy News. Prior to joining PCG, Lisa served as Policy Director at New Hampshire Voices for Health, where she led legislative and regulatory analysis, strategic planning, and implementation of the organization’s policy agenda. Her work included drafting bills, amendments, testimony, and communications and testifying at hearings. Lisa also held the positions of Private Market Policy Manager and Consumer Health Policy Coordinator at Health Care for All of Massachusetts. While there, she managed private insurance market policy work and was a member of the organization’s internal health reform team. Lisa also practiced law in the Ropes & Gray health care department, advising health care provider and insurer clients.

The Obamacare Replacement Act

Senator Rand Paul introduced the Obamacare Replacement Act on January 25th, which would repeal much of Title 1 of the Affordable Care Act (ACA), including: Most consumer protections (except as outlined below) Rating restrictions Rate review requirements Essential Health Benefits Medical loss ratio requirements Individual and employer coverage mandates The bill would restore certain market rules: Coverage ...

The House considers health policy bills

As debate continues over the future of the Affordable Care Act (ACA), the House has held hearings on four piecemeal bills aimed at making incremental changes to the ACA: The State Age Rating Flexibility Act of 2017 would expand permissible age rating bands to 5:1 (currently 3:1) under the ACA or a different ratio adopted by the ...

Roundup of federal health policy developments

The debate over the future of the Affordable Care Act (ACA) is well-underway and there are a number of significant developments that warrant a closer look. Here we provide a roundup of recent developments. Administrative Action Upon entering office, President Trump signed two Executive Orders. The first, on January 20, entitled “Minimizing the Economic Burden ...

Administrative Action

Immediately upon entering office, President Trump signed an Executive Order on January 20th entitled “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal” stating his commitment to repealing the Affordable Care Act (ACA) and directing administration officials to avail themselves of existing authority to provide flexibility in administration of the ACA. While ...

Looking ahead: Key considerations for the future of health policy

There has been much discussion on the future of the Affordable Care Act (ACA) and health policy in general, since the election. While it is tempting to try to predict the future of health policy, in reality it is still too early to know how policy will change, via which vehicles, and according to what ...

CMS releases 2018 draft Letter to Issuers in the Federally-Facilitated Marketplaces (FFM) early

The Centers for Medicare and Medicaid Services (CMS) released a draft of its 2018 Letter to Issuers in the Federally-Facilitated Marketplaces (Letter) on November 10, 2016. The Letter – updated annually – provides operational and technical guidance for issuers seeking to offer Qualified Health Plans (QHPs) and Standalone Dental Plans (SADPs) on Federally-Facilitated Marketplaces (FFMs) ...

Innovative approaches to Medicaid expansion within the Medicaid managed care delivery system

Much attention has been paid to innovative approaches to coverage of the Medicaid expansion population that leverage the private commercial insurance market for coverage through “premium assistance” programs.  However, other states have turned to the Medicaid managed care delivery system as the vehicle for implementing innovative coverage designs for the newly eligible population.  As outlined ...

Final Medicaid Managed Care Rules

CMS released a proposed overhaul of the regulations governing Medicaid and CHIP Managed Care last May and accepted comments through July. In addition to their sweeping impact, these rules are particularly meaningful as they are the first major changes to the rules governing Medicaid Managed Care since 2002. As states agencies and others review the ...

Supreme Court issues decision on major health care case

Members of PCG Health’s Health Innovation Policy Information Technology (HIPIT) center of excellence have been keeping an eye on Gobeille vs Liberty Mutual Insurance Company given its direct impact on All-Payer Claims Databases (APCD), which many PCG state clients rely on to gather data necessary to analyze data on health care services and impact rising ...