All posts by Margot Thistle

Margot Thistle, Esq. is a managing editor of Health Policy News who has spent much of her career working directly on Affordable Care Act policy and implementation, including having lead plan management operational and policy planning for Vermont Health Connect, a state-based exchange. During her time at PCG, Ms. Thistle has worked extensively with state insurance departments and state agencies on health policy, market stabilization, and regulatory compliance matters. Ms. Thistle 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. Ms. Thistle still has her admission ticket to the signing of Chapter 58 of the Acts of 2006, the historical Massachusetts health reform bill that preceded the ACA.

Impact of recent federal policy changes on open enrollment

Open Enrollment Period (OEP) The fifth open enrollment period (OEP 5) kicked off on November 1, 2017, with a shortened enrollment window compared to previous years. With only until December 15th to make eligibility and enrollment changes, states have been urging consumers to make selections early and seek assistance from application assisters, insurance agents or ...

Insights from the annual National Academy for State Health Policy (#NASHPCONF17)

PCG subject matter experts were in Portland, Oregon last week at the 30th annual #NASHPCONF17. With a focus on guiding state policy makers though the changing health policy landscape, #NASHPCONF17 provided a break from the day to day, reactionary work to adjust to federal policy. The conference served as an opportunity for state health policy ...

Balance billing – a new report on recent efforts by state

PCG subject matter experts recently completed a survey report entitled “Balance Billing: Report of Recent Efforts to Protect Consumers.” The practice of balance billing is historically commonplace, but increased scrutiny on rising out of pocket health care costs is driving efforts to provide greater transparency into the practice. For those states contemplating crafting consumer balance ...

CMS releases final Market Stabilization Rule

On April 13, 2017, the Centers for Medicare and Medicaid Services (CMS) released the final Patient Protection and Affordable Care Act; Market Stabilization Rule. The final rule is aimed at stabilizing the individual and small group markets by tightening enrollment standards and providing increased flexibility related to standards for Qualified Health Plans (QHPs), as outlined in detail ...

Update on House v Burwell case

On December 5, 2016, the District of Columbia Circuit Court of Appeals accepted a Congressional request to postpone further proceedings in House v Burwell pending motions due February 21, 2017, turning the continued proceedings in this case over to the next administration and Congress. In November 2014, the House of Representatives filed suit against the current administration claiming the ...

Insights from the annual National Academy of State Health Policy Conference #NASHPCONF16

From October 17th to 19th, members of PCG’s Health Policy team attended the annual National Academy of State Health Policy (NASHP) Conference in Pittsburg, PA. The theme for this year’s event was “Where Ideas and Action Converge,” with particular focus on Delivery System Reform Incentive Payment (DSRIP) waivers, Medicaid expansion and payment and delivery system ...

Consumer assistance for open enrollment 2017

This year, for the first time since the health insurance marketplace began, states will not have the support of consumer assistance funding from the Centers for Medicare and Medicaid Services (CMS) to educate the public about marketplace plan offerings. Without federal funding, many states are scrambling to find ways to assist consumers in the upcoming ...

Alabama’s Regional Care Organization 1115 waiver approval

In May 2013, Act-2013-261, Ala. Code §§ 22-6-150 was passed, advancing the move from a fee-for-service (FFS) system to a managed care program. According to the Alabama Medicaid Advisory Board report issued in January 2013, based on 2011 data, 22 percent of Alabama’s population was Medicaid eligible for a portion of the year.  Additionally, Alabama’s ...

CMS announces the release of $22 Million in Health Insurance Enforcement and Consumer Protections grant funding

On June 15, 2016, the Centers for Medicare and Medicaid (CMS) announced the release of $22 million in grant funding for State planning and implementing of the health insurance market reform provisions of the Affordable Care Act (ACA). The grants are aimed at helping States ensure their laws, regulations and procedures are in line with ...

CMS announces extension of SHOP direct enrollment transition

On April 18, 2016, CMS released guidance entitled “Extension of state-based SHOP Direct Enrollment Transition,” which extends the option of direct enrollment until the end of 2018 giving state based SHOPs more time to make online enrollment available. In order to allow facilitation of enrollment without SHOP portal functionality, CMS has allowed states to direct ...