Arizona: State Supreme Court Allows Challenge to Medicaid Expansion to Proceed

The Arizona Supreme Court unanimously overturned a Maricopa County Superior Court ruling that would have dismissed a challenge to the State’s method for financing the Medicaid expansion for lack of legal standing. The 36 Republican lawmakers that brought the case contended that the 2013 law financing the expansion through a hospital tax required a supermajority of votes. The case will now return to the county court for a full hearing.

Arkansas: CMS Approves Health Savings-Like Account Amendment to Private Option 1115 Demonstration

CMS approved an amendment to Arkansas's Private Option 1115 Medicaid expansion waiver. The amended Special Terms and Conditions permit Arkansas to:

  • Implement health savings-like accounts for Private Option enrollees with incomes from 50 to 133% of the federal poverty level (FPL)
  • Institute cost sharing for individuals with incomes between 50 to 100% FPL, and
  • Impose prior authorization requirements for non-emergency transportation

These changes were mandated by the Private Option enabling legislation and the State's 2014 Department of Human Services appropriations bill.

California: Insurance Commissioner Issues Emergency Regulation on Network Adequacy Requirements

Insurance Commissioner Dave Jones issued an emergency regulation to strengthen network adequacy requirements for health plans. Under the new regulation, health plans are required to monitor appointment wait times, provide accurate provider directories to the public, and make arrangements to provide in-network prices for out-of-network care when there is insufficient in-network provider capacity. The Commissioner issued the emergency regulation in response to concerns from consumers about appointment wait times and lack of access to in-network care.

Iowa and Nebraska: Insurance Departments Remove “CoOportunity Health” Health Plans from Marketplaces

Iowa’s and Nebraska’s Insurance Commissioners removed “CoOportunity Health” health plans from their State Marketplaces after Iowa Insurance Commissioner placed CoOportunity Health “in rehabilitation” due to financial concerns. In “frequently asked questions” documents for CoOportunity Health policyholders, both States indicate that current policyholders who enrolled on or before December 15 have insurance through CoOportunity Health beginning January 1; however, those who enrolled on or after December 16 are required to sign up for another plan before the end of the open enrollment period. According to USA Today, Iowa’s Insurance Commissioner explained that CoOportunity Health had 120,000 members in Iowa and Nebraska and approximately $17 million in cash and assets.

Montana: Republican Legislators Release Medicaid Reform Proposal, Including Partial Medicaid Expansion

Expansion debates continue in Montana, where Republican legislators released a Medicaid reform proposal that includes a partial expansion of coverage to the disabled, parents with incomes below the Federal Poverty Level, and some veterans. The proposal, according to a report from NPR, would not expand the program to most childless adults and would garner the regular Medicaid match rate, in contrast with Governor Steve Bullock’s (D) proposal, which would use a Third Party Administrator to expand the program to an estimated 70,000 Montanans and draw down enhanced federal matching funds. Legislators have not yet introduced a specific bill related to the proposed framework.

Rhode Island: Governor-Elect Appoints New Marketplace Director

Governor-elect Gina Raimondo (D) announced that Anya Rader Wallack will serve as the new executive director of HealthSource Rhode Island (HSRI), as reported by the Providence Journal. Wallack has an established career in health policy, having previously served under two Vermont governors, and worked on healthcare reform in Massachusetts. Wallack will replace Christine Ferguson, who has acted as HSRI director since its launch.

Texas: Governor-Elect's Private Inquiry about Utah's Medicaid Expansion Creates Buzz

During a private meeting with State lawmakers, Governor-elect Greg Abbott (R) requested information about the negotiations between CMS and Governor Gary Herbert (R) of Utah to expand Medicaid in a tailored state-specific way, according to The Houston Chronicle. The Chronicle’s report resulted in broad media coverage and speculation regarding the possibility of interest in Medicaid expansion in Texas. State Representative John Zerwas (R) is expected to lead a Medicaid expansion campaign this year that will push “The Texas Way” – which could include work incentives and required cost-sharing – though Legislative opposition to expansion remains high.

Wyoming: Governor Appoints New Insurance Commissioner

Paul Thomas Glause was appointed by Governor Matt Mead (R) as the new Wyoming Insurance Commissioner, replacing Tom Hersig. According to Wyoming Public Media, Mr. Glause, in one of his first statements as Commissioner, indicated interest in the State Innovation Waiver option under the Affordable Care Act, and noted that such a waiver could help provide financial aid to residents over 400% of the Federal Poverty Level. Mr. Glause was previously the vice chairman of the Wyoming Board of Equalization.