Illinois: Health Insurance CO-OP to Shut Down
Land of Lincoln Health will close “in the coming months,” requiring approximately 49,000 customers to find new coverage. Acting Department of Insurance (DOI) Director Anne Dowling is awaiting a court order that would allow the DOI to take control of Land of Lincoln to ensure an orderly mid-year liquidation. Dowling has also requested CMS permission to conduct a 60-day special enrollment period (SEP) for the CO-OP’s policyholders, who will be notifiedonce the SEP has been approved. Dowling attempted to prevent the CO-OP from closing by delaying the CO-OP’s required $31.8 million risk adjustment payment until it had received its risk corridor payment from the federal government, though CMS “didn’t agree with [the] plan." The CO-OP will become the 16th CO-OP to close.
Massachusetts: Marketplace Proposes FY 2017 Budget With Reduction in Deficit
The Massachusetts Health Connector, the State-based Marketplace, proposed an FY 2017 budget that would generate a deficit of $4.4 million, down from a $13 million shortfall in FY 2016. The Connector cited continued stabilization activities and higher expenses for HIX operations costs allocated to the Connector as some of the contributing factors of the deficit, which would be covered by cash reserves. Revenue and expenses are expected to increase relative to FY 2016. While federal funding for general operations is no longer available, federal funding will continue to support time-limited activities. Revenues drawn from the Commonwealth Care Trust Fund will increase to support operating expenses. The Health Connector projected nearly 245,000 members by June 2017, with a 25% increase in the State's subsidized Marketplace category.
Massachusetts: State-Based Marketplace Eliminates Cost-Sharing for Addiction Treatment in Subsidized Plans
The Massachusetts Health Connector, the State-based Marketplace, will require subsidized qualified health plans (QHPs) to eliminate copays for medication-assisted addiction treatments beginning in 2017, a change that will impact 169,000 enrollees. The subsidized QHPs will also be required to increase access to residential recovery programs known as clinical stabilization services by making a “good faith effort" to contract with all service providers in their coverage areas, according to The Boston Globe. The State's Opioid Addiction Working Group had identified cost-sharing as a barrier to addiction treatment and worked with Health Connector staff to identify solutions. The Health Connector Board of Directors approved the new product requirements at its monthly board meeting on July 14.