Supreme Court Limits States' Ability to Collect Claims Data

The U.S. Supreme Court ruled 6-2 that efforts by Vermont and at least 17 other states to require that health insurers provide them with claims data conflict with self-insured health plans' reporting requirements in the Employee Retirement Income Security Act of 1974 (ERISA). Liberty Mutual Insurance Co., which operates a self-insured health plan for its employees, brought the suit against Vermont saying that the State's law requiring insurers, providers, medical facilities and government agencies to report cost, quality, and utilization data violates federal law. The majority opinion argued that a patchwork of different state regulations could impose significant burdens on healthcare providers that would open them to liability. The dissenting opinion said that ERISA is meant to ensure self-insured plans offer appropriate coverage, and that Vermont was gathering data to improve healthcare quality and reduce costs. States that are collecting claims data say their databases will be incomplete and much less useful without data from all payers, an argument that was supported by the American Hospital Association and the Association of American Medical Colleges in an amicus brief. Approximately 93 million people are covered under self-insured plans.

ACA Coverage Gains Shared Widely Across Racial and Ethnic Groups, 20 Million Fewer Uninsured

The uninsured rate for non-elderly adults dropped by 43% between the beginning of the first open enrollment period in October 2013 and early 2016, reducing the total number of uninsured by 20 million, according to a new HHS report. The uninsured rate declined by nearly 53% for non-elderly black non-Hispanic adults, by nearly 51% for white non-elderly non-Hispanic adults, and by 27% for Hispanics. The newly insured include 6.1 million young adults, including those who gained coverage through the ACA's provision to allow young adults to remain on their parents' coverage through age 26.

HHS Broadens Eligibility for Health Information Exchange Enhanced Funds

HHS announced an initiative that will allow states to request 90% enhanced matching funds to develop health information exchange connectivity among a broader set of providers than was previously eligible, including long-term care providers, behavioral health providers, substance abuse treatment centers, and other types of providers that have not yet adopted health information technology. HHS anticipates the additional funding will increase the sustainability of health information exchanges and enable seamless sharing of health information and coordination of care across clinicians.