November 2018

Last Monday, the Treasury Department and the Internal Revenue Service released additional guidance regarding health reimbursement arrangements (HRAs) and other account-based health benefits. The guidance addresses the interaction between the tri-department HRA proposed regulations released October 23 and existing provisions such as the employer mandate. State Health and Value Strategies will be addressing the implications for states of these proposals in a webinar on Wednesday, November 28.

During the opening plenary at the National Association of Medicaid Directors fall conference, HHS Secretary Alex Azar announced a new opportunity for states to receive authority to pay for short-term residential treatment services in an institution for mental disease (IMD) for Medicaid beneficiaries with serious mental illness. Following Secretary Azar’s speech, the Centers for Medicare & Medicaid Services (CMS) released a letter to State Medicaid Directors outlining both existing and new opportunities for states to design innovative service delivery systems for adults with SMI and children with serious emotional disturbance. 

Last week, on the state-level, three states approved expanding their Medicaid programs and the results of several gubernatorial elections signal potential changes in state health policy. For a synopsis of what the election results mean for health care, see this Health Affairs blog post. In addition, the Kaiser Health News podcast What the Health? includes an analysis of midterm election results. Also last week, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule related to program integrity of Exchange operations. This Health Affairs blog post summarizes this rule, including implications for states. CMS also announced a proposed rule for Medicaid and Children’s Health Insurance Program (CHIP) managed care programs. CMS released a fact sheet explaining the goals of this proposed rule. Updates follow.

Open enrollment has officially begun! To kick off the OEP season, Georgetown University just launched an updated Navigator Resource Guide this week. The guide provides information on recent policy changes, a list of enrollment tools for consumers and assistors, and answers to hundreds of frequently asked questions (FAQs), ranging from questions about eligibility for marketplace subsidies to post-enrollment issues and small employer coverage. In addition, Kaiser Family Foundation put together a list of over 300 FAQs for consumers, navigators, brokers and other assistors. The FAQs cover a wide range of topics, including the 2019 repeal of the individual mandate tax penalty and a new section on short-term health insurance policies. Updates follow.