Massachusetts: Consideration of 1332 Waiver Underway

The Massachusetts Health Connector, in response to a directive from the Governor, has identified potential policy areas of interest for a Section 1332 waiver and begun engaging waiver stakeholders. The Health Connector plans to further explore such policy areas as: streamlining the federal individual mandate to better align with the State’s individual mandate; refining employers’ and employees’ choices in the Small Business Health Options Program; streamlining eligibility and income rules between MassHealth and the Health Connector; modifying its subsidy mechanism to buffer enrollees from complexities of premium tax credits and reconciliation; incorporating the total cost of family coverage when measuring affordability of employer sponsored insurance; and modifying the approach to “grace periods” for enrollees receiving premium tax credits to prevent retroactive terminations of coverage. Contingent on support and interest from stakeholders, the Connector aims to submit a waiver application to CMS by March 2016.

Kentucky: Outgoing Governor Urges Continuation of Medicaid Expansion and State-Based Marketplace

Governor Steve Beshear (D) encouraged Governor-elect Matt Bevin (R) to maintain Medicaid expansion and kynect, the State’s health insurance Marketplace, pointing to the economic and health benefits derived from the programs as demonstrated in a progress report on kyhealthnow, the Governor’s wellness initiative. During the gubernatorial campaign, Governor-elect Bevin had pledged to repeal Medicaid expansion and to dismantle kynect, though in more recent interviews he expressed openness to maintaining expansion through an 1115 Medicaid waiver. In his speech, Governor Beshear also cited a new report by the Kentucky Center for Economic Policy, which found that over 73,800 working Kentuckians received coverage through Medicaid expansion, with the restaurant industry, construction industry, and temp agencies seeing the greatest number of individuals covered. The Cabinet for Health and Family Services and the Office of the State Budget Director have said it would cost at least $300 million over the next two years to roll back Medicaid expansion.

New Mexico: Legislative Finance Committee Highlights Decline in Uncompensated Care After ACA

Upon request by the Legislature, the New Mexico Legislative Finance Committee released a report studying the effect of the ACA on uncompensated care in the State's hospitals. The Committee found that "by all measures, the costs of uncompensated care have dropped in New Mexico" since 2013. Alongside a 4.1% drop in the share of New Mexicans without insurance, uncompensated care as a percent of hospital expenses dropped 12.5% and uncompensated care in CMS hospital cost reports dropped 3.6% from 2013 to 2014. In addition, applications for reimbursement from the State's Safety Net Care Pool dropped 30.4% from 2014 to 2015.