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Issue Briefs

Since the passage of the Affordable Care Act (ACA), the design of state health insurance exchanges has evolved to include several distinct models. This evolution has led to the possibility that a state’s exchange development and operations could be delegated to a private vendor. States operating their own state-based marketplaces (SBMs) may begin to consider other options as they confront budget challenges and look to streamline operations.

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Date Created: Jul 29, 2015


Issue Briefs

Since implementation of the Affordable Care Act (ACA), the 30 states that have expanded Medicaid have enrolled more than 10 million people in Medicaid or the Children’s Health Insurance Program and the collective rate of uninsured individuals in these states has fallen from 18 percent to less than 11 percent. Recent research by Manatt Health Solutions looked at the fiscal implications of expansion and found that, in addition to coverage gains, expansion states experienced significant budget savings and revenue gains. This issue brief, the third in this series prepared by Manatt Health Solutions, examines early data on expansion-related decreases in uncompensated care costs and related state budget implications.

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Date Created: Jun 2, 2015


Issue Briefs

Health insurance brokers can play a unique role in helping all forms of marketplaces to reach out to uninsured households and assist residents with new enrollments, as well as coverage renewals. Recently, several marketplaces implemented pilot programs intended to leverage the resources of agencies that are particularly interested in building their direct enrollment business under the Affordable Care Act (ACA). The success of these initiatives is demonstrated by these marketplaces’ plans to expand their efforts for the upcoming open enrollment period.

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Date Created: May 21, 2015


Regulatory Analysis , Issue Briefs

In March of 2012, the U.S. Department of Health and Human Services issued a regulation defining student health plans as individual health insurance under federal law. As a result, they are now subject to the same consumer protections afforded to all those covered by individual health insurance set forth in the Public Health Service Act, as amended by the Affordable Care Act. This issue brief, prepared by the Center on Health Insurance Reforms at the Georgetown University Health Policy Institute, examines student health plans, which cover over 1 million students, and investigates the interplay between federal and state regulation with regard to these plans.

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Date Created: May 15, 2015


Issue Briefs

States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by authorizing states to rethink the law’s coverage designs. Under State Innovation Waivers, states can modify the rules regarding covered benefits, subsidies, insurance marketplaces, and individual and employer mandates.

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Date Created: Apr 15, 2015


Reports , State Materials , Issue Briefs

As some states continue to debate whether to implement Medicaid expansion under the Affordable Care Act, early results from those that have done so show the impact this decision has had on their state budgets. States that expanded the number of people eligible for Medicaid are seeing big budgetary savings without reducing services. This report, prepared by Manatt Health Solutions, analyzes data from eight states, showing $1.8 billion in budget savings by the end of 2015 as a result of Medicaid expansion.

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Date Created: Apr 6, 2015


Issue Briefs

As states continue to look for new ways to balance their budgets, early results from states that have expanded Medicaid show significant state budget savings after just the first year of expansion. Twenty-six states have expanded Medicaid—this brief focuses on the budget impact in two states: Kentucky and Arkansas.

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Date Created: Mar 4, 2015


Issue Briefs

The second open enrollment period (OEP) under the Affordable Care Act ended on February 15, with more than 11.4 million people enrolled in coverage through the Federal and state Marketplaces. Attention now turns to the 2014 tax filing season. Many tax filers who were uninsured for all or part of 2014 are learning for the first time that they must pay a penalty, and have missed the opportunity to enroll in 2015 coverage. These gaps in consumer awareness, combined with the timing of this year’s OEP, have led to several Marketplaces allowing certain uninsured consumers additional time to enroll in order to avoid paying a penalty next year.

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Date Created: Feb 25, 2015


Regulatory Analysis , Issue Briefs

Excepted benefits and short-term, limited-duration insurance are insurance products that are exempted from the Affordable Care Act’s (ACA) consumer protections. Recent questions from several states have indicated that some confusion exists about which insurance products qualify as “excepted benefits” and are therefore exempt from several requirements of the ACA, such as coverage for preventive health services, a prohibition on lifetime limits, and minimum value requirements…

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Date Created: Jan 23, 2015


Issue Briefs

Reference pricing is intended to reduce medical costs both for insurers and for purchasers of health care services, encouraging enrollees to obtain services from lower-cost providers and motivates higher cost providers to lower their reimbursement rates for those same services. This issue brief, prepared by the Georgetown Health Policy Institute’s Center of Health Insurance Reforms, provides an overview of this pricing method and federal guidance that has been issued to date…

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Date Created: Jan 23, 2015