Welcome to this week’s round-up of state-level well being reform information, together with:
Open enrollment nonetheless underway in eight states and DC
Open enrollment for individual-market medical health insurance ended at three a.m. EST as we speak within the 38 states that use HealthCare.gov. However in eight different states and Washington, DC, enrollment continues to be ongoing, with various finish dates:
Minnesota: December 23
Washington: December 30
Rhode Island: December 31
Connecticut: January 15
Colorado: January 15
Massachusetts: January 23
California: January 31
DC: January 31
New York: January 31
January 1 efficient dates are nonetheless obtainable in most of these states (Minnesota, Rhode Island, Colorado, Massachusetts, California, and DC). (See extra particulars right here.) Within the others, residents can enroll with February 1 efficient dates.
In states the place open enrollment has ended, you’ll want a qualifying occasion so as to enroll or make a change to your protection for 2020. You'll be able to be taught extra in regards to the guidelines for qualifying occasions within the particular person market in our information to particular enrollment intervals.
Kentucky’s Medicaid work requirement is formally lifeless
Kentucky’s new governor, Andy Beshear took workplace final week. And as promised, one in all his first acts as governor was to formally terminate the Kentucky HEALTH waiver. The waiver, which referred to as for a Medicaid work requirement, premiums for some enrollees, and a termination of retroactive eligibility, was twice authorized by the federal authorities. However though the state initially supposed to implement the work requirement in mid-2018, a decide overturned it (twice) and it by no means took impact.
Controversy: Ought to Idaho’s enhanced short-term plans be on-exchange?
4 Democratic federal lawmakers have despatched a letter to CMS, asking the company to ban Idaho from providing the state’s new “enhanced” short-term well being plans on-exchange. The plans are at present solely obtainable off-exchange, however Idaho officers hope to have them on-exchange by mid-2020.
The improved short-term plans are way more sturdy than normal short-term plans, however they don't adjust to all the Inexpensive Care Act’s guidelines. As we defined in a Twitter thread, there are legitimate arguments on each side of this controversy.
South Carolina turns into the primary non-expansion state with an authorized Medicaid work requirement
CMS authorized South Carolina’s Medicaid work requirement proposal final week, marking the primary time a piece requirement has been authorized for a state that hasn’t expanded Medicaid beneath the ACA. As a result of protection hasn’t been expanded, the one able-bodied non-elderly adults with Medicaid protection in South Carolina are very low-income mother and father. Client advocates fear that 1000's of low-income mother and father might lose their protection because of the work requirement, which is predicted to be carried out by mid-2020.
Below the phrases of a separate waiver that was authorized concurrently, South Carolina plans to increase Medicaid eligibility for fogeys as much as 100 % of the poverty degree (from the present 67 % threshold). However these newly eligible mother and father must adjust to the work requirement so as to qualify for Medicaid.
Nebraska Medicaid enlargement waiver submitted
Nebraska has submitted its Heritage Well being Medicaid enlargement proposal to CMS for overview, greater than a 12 months after voters within the state authorized a Medicaid enlargement poll initiative. Though the poll initiative referred to as for straight enlargement beneath the phrases of the ACA, Nebraska is taking a way more difficult strategy. The state’s proposal calls for 2 tiers of protection, with enhanced advantages (dental, imaginative and prescient, and over-the-counter drug protection) for individuals who adjust to numerous necessities, together with a piece requirement that begins in 12 months two. Nebraska plans to start enrolling individuals in expanded Medicaid in August, for protection efficient in October 2020.
Georgia’s 1332 waiver would dramatically change state’s insurance coverage market
Final month, Georgia unveiled the small print of its proposed 1332 waiver, which might make a wide range of dramatic adjustments to the state’s insurance coverage market. Georgia’s proposal is the primary to include the extra relaxed 1332 waiver tips that the Trump administration revealed final 12 months. It requires the elimination of Georgia’s ACA market, and would permit premium subsidies for use for non-ACA-compliant well being plans.
On the Heart for Price range and Coverage Priorities, Aviva Aron-Dine, Tara Straw, and Sarah Lueck have carried out a deep dive into Georgia’s proposal, explaining the way it’s dangerous to individuals with low-to-moderate incomes and/or pre-existing situations. It’s properly price studying to realize an understanding of Georgia’s proposal and the consequences it might have.
Federal spending invoice protects Silver loading, repeals three ACA taxes
On December 17, the U.S. Home of Representatives handed H.R.1865. The $1.four trillion spending bundle – anticipated to be authorized by the Senate and signed into legislation by President Trump – is critical so as to keep away from a repeat of final winter’s authorities shut-down.
The invoice protects insurers’ skill to proceed so as to add the price of cost-sharing reductions to Silver plan charges for 2021. This strategy, referred to as Silver loading, is helpful for customers, however HHS had beforehand indicated that they could think about altering the principles round this (HHS is at present engaged on rule making for 2021 plans).
The spending invoice additionally repeals three ACA taxes:
The Cadillac tax, as of 2020 (this tax by no means took impact, because it was perpetually delayed)
The medical health insurance tax, as of 2021 (this tax was suspended in 2017 and 2019; will probably be collected in 2020)
The medical machine tax, as of 2020
New Jersey passes laws to cap out-of-pocket prescription prices
Final week, we informed you a couple of New Jersey invoice to cap out-of-pocket prescription prices that had been taken up within the state Senate. This week, the Senate handed the invoice unanimously. Assuming it’s signed into legislation, it would take impact 90 days after it’s enacted, and can apply to state-regulated (ie, non-self-insured) well being plans issued or renewed after that date. Out-of-pocket prescription drug prices shall be capped at $100 monthly per drug, or $200 monthly per drug if the coverage is a bronze or catastrophic plan. HDHPs are exempt from the brand new rule till the insured has met the minimal HDHP deductible required beneath IRS laws.
Louise Norris is a person medical health insurance dealer who has been writing about medical health insurance and well being reform since 2006. She has written dozens of opinions and academic items in regards to the Inexpensive Care Act for healthinsurance.org. Her state well being trade updates are repeatedly cited by media who cowl well being reform and by different medical health insurance consultants.
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