October 15 Update

In This Week’s Update:

  • New SHVS Webinar on Standardized Plans
  • State Updates: CO, DE, NJ, NM, NY, PA, & WI
  • Medicaid MCOs and Health Equity Webinar
  • Standardizing Health Plan Benefit Design in the Individual Market: Opportunities and Implications
  • Report on Transitioning to a State-based Marketplace
  • Call for Papers on ACA Implementation in the States


New SHVS Webinar on Standardized Plans

Last week, State Health and Value Strategies announced a new webinar on the opportunities for states to implement standardized benefit designs, either through their health insurance marketplace or as part of a public option plan. The topic is timely, as eight states require or will require insurers to offer health plans with standardized benefit plans in the individual market, and several more are considering requiring such standardization in the future. See below for the link to register (required) for the webinar, which is scheduled for Wednesday, November 6.


State Updates: CO, DE, NJ, NM, NY, PA, & WI

  • Colorado
    • The Colorado Division of Insurance and the Department of Health Care Policy & Financing released a draft report that describes the state’s public option proposal. Carriers in the state over a certain size will be required to offer the public option and the plans will be offered through Connect for Health Colorado, the state-based marketplace, and in the traditional off-exchange, individual market.
    • Governor Jared Polis announced that for 2020, Coloradans shopping for an individual health insurance plan will see an average statewide decrease of 20.2 percent in premium rates. The state attributes the lower premium rates to Colorado’s reinsurance program.
  • Delaware – The Department of Health and Social Services is seeking applications from health care providers for one-time health information exchange support mini-grants to adopt the full range of health information exchange tools offered by the Delaware Health Information Network (DHIN). The mini-grants are an opportunity for practices to expand their use of data in preparation for new payment models.
  • New Jersey
    • First Lady Tammy Murphy and New Jersey Human Services Commissioner Carole Johnson announced a new family planning benefit program for individuals with incomes that are higher than traditional Medicaid eligibility. The benefit, Plan First, provides coverage for birth control, the HPV vaccine, family planning-related lab testing, and other targeted family planning-related health care needs to individuals up to 205 percent of the federal poverty level.
    • The New Jersey Department of Banking and Insurance released rates for health insurance plans in the individual market effective January 1, 2020. On average, rates for 2020 will remain 1.4 percent lower than they were in 2018.
  • New Mexico – The New Mexico Human Services Department released a new map showing which pharmacies across the state carry Naloxone. The map is currently available through New Mexico’s anti-opioid addiction website and is integrated with Google Maps so individuals can get directions from their location to selected pharmacies.
  • New York – NY State of Health, the state’s official marketplace, announced a new partnership with the New York State Office of Temporary and Disability Assistance to make it easier for individuals and families to access the Supplemental Nutrition Assistance Program (SNAP). As of September 26, people who are determined eligible for Medicaid are able to opt in to receive information about SNAP and how to apply for benefits when applying for or renewing coverage through the marketplace.
  • Pennsylvania – The Wolf Administration is expanding home visiting supports to first-time mothers and mothers of children with special needs covered by Medicaid. The expansion, made possible in collaboration with Medicaid managed care organizations, will guarantee at least two home visits to new parents and families with children with additional risk factors across Pennsylvania.
  • Wisconsin – Governor Tony Evers and the Wisconsin Office of the Commissioner of Insurance announced that many Wisconsin consumers will have more options for health insurance on the individual market during this open enrollment period. In 2020, 61 counties will be served by three or more insurers, compared to only 46 counties with three or more insurers in 2018.


The Medicaid MCO Experience in Addressing Health Equity

Tuesday, October 22, 2:00 to 3:00 p.m. ET

State Health and Value Strategies is convening the fifth, and last, webinar in its series SHVS Health Equity Through Managed Care. For many states, eliminating disparities in Medicaid managed care programs means working with their MCO contractors and implementing contractual requirements that advance health equity. The upcoming webinar, The Medicaid MCO Experience in Addressing Health Equity, will profile the work of one MCO, HealthPartners, in addressing equity issues within its Medicaid line of business. SHVS will hear from Brian Lloyd, who manages Health Partners’ organization-wide equity initiative, which includes collecting data to eliminate disparities in care, supporting language access, partnering with communities, and building an organizational understanding of equity, diversity, inclusion, and bias. 

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=ee00973dbf7a8247a1e8626da3962c699


Standardizing Health Plan Benefit Design in the Individual Market: Opportunities and Implications

Wednesday, November 6, 1:00 to 2:00 p.m. ET

State Health and Value Strategies will host a webinar on the opportunities for states to implement standardized benefit designs, either through their health insurance marketplace or as part of a public option plan. The webinar will explore issues to consider in developing standardized options, communicating with stakeholders, and leveraging standardized designs to improve affordability for enrollees and encourage maintenance of coverage. The webinar will also review the development of standardized designs through state-based marketplaces, their connection to public option proposals, operational requirements to improve the end-user experience, and data collection and analysis needs.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e3cade0aaf60b554a6a16870264d01a07


New Report on States Transitioning to State-Run Marketplaces

Georgetown University’s Center on Health Insurance Reforms, in partnership with the Urban Institute, published a report assessing the benefits and risks associated with a transition to a state-based marketplace (SBM). Eleven states and the District of Columbia currently operate their own health insurance marketplace eligibility and enrollment websites under the Affordable Care Act (ACA), but that number is slated to grow. Several states are in the midst of, or are contemplating, a transition from the federally facilitated marketplace (FFM) platform, HealthCare.gov, to a state-run platform. The report outlines critical considerations for state policymakers considering a future transition.


Call for Submissions for Special ACA Issue of INQUIRY Focused on States

INQUIRY: The Journal of Health Care Organization, Provision, and Financing will be publishing a special collection on the ACA commemorating the tenth anniversary of the law. The special issue will examine the ACA’s implementation in the states and will be guest edited by Katherine Hempstead, Senior Policy Advisor at the Robert Wood Johnson Foundation. For more information, and to submit your manuscripts by November 1, 2019, see here