Alaska: Supreme Court Allows Medicaid Expansion to Proceed

Alaska's Medicaid expansion launched today, after the State's Supreme Court rejected the Legislature's request for a temporary restraining order or injunction to halt Governor Bill Walker's (I) plans for expansion. The Supreme Court's ruling came after a Superior Court judge also rejected the Legislature's request. Both courts' rulings only addressed the requested injunction and did not offer full legal opinions on the case. Alaska House and Senate leadership said their request for an injunction was only the first step in their legal challenge but did not announce their future plans.

Arizona: Court Rules Hospital Assessment Not a Tax, Upholds Medicaid Expansion

A Maricopa Superior Court judge ruled that Arizona’s Medicaid expansion plan was passed legally, concluding that the expansion’s financing mechanism, a hospital assessment, was not a tax and therefore did not require a two-thirds supermajority vote in the Legislature, reports the Arizona Capitol Times. The judge explained that the assessment is transaction-based and dependent upon each hospital’s number of discharge patients and imposed by the Arizona Health Care Cost Containment System, not the Legislature itself. The plaintiffs have indicated they plan to appeal the decision.

Arkansas: Report Indicates Private Option Performing Well Across Indicators

The Arkansas “Private Option” Medicaid expansion has lowered the State’s uninsured rate by almost half, reduced premiums due to increased Marketplace competition, decreased hospitals’ uncompensated care costs, and improved beneficiary access to care, according to a new report by the Kaiser Family Foundation, co-authored by Manatt. In 2013, Arkansas was the first State to receive federal approval to enroll individuals newly eligible for Medicaid under the Affordable Care Act into Marketplace plans with premium assistance. Early data indicate that the Private Option provides coverage to 220,000 individuals and is projected to meet federal budget neutrality requirements. Interviews with State officials, providers, insurance carriers and advocates reveal that early, close coordination between State officials and stakeholders during implementation was a large factor in the program’s success.

Massachusetts: Delayed Medicaid Redeterminations Lead to Coverage Terminations

State officials at MassHealth, the State’s Medicaid agency, have ended coverage for more than 200,000 people as part of the redetermination process the agency initiated in January of 2015, reports Though states are required to redetermine enrollees’ eligibility annually, a technical glitch prevented the Massachusetts Health Connector from conducting redeterminations between October 2013 and this year. According to data from early August, more than half a million beneficiaries have been contacted for updated information to demonstrate eligibility; approximately 80% have responded, and of those who submitted complete information, approximately 83% (just fewer than 300,000 people) were determined eligible for continued Medicaid. By the end of the year, the agency will have reached out to an additional 260,000 individuals, and Governor Charlie Baker's (R) administration estimates a total savings to Medicaid of $400 million.

Washington: State Submits Medicaid Transformation Waiver Application to CMS

Washington's Health Care Authority and Department of Social and Health Services submitted an 1115 waiver proposal to CMS, requesting $3 billion to support Medicaid payment and delivery system reform between 2017 and 2021. The proposal aims to improve population health, encourage the transition to value-based payment, reduce avoidable hospital use and maintain Medicaid per-capita cost growth at 2 percentage points below the national average. If approved, the initiative would complement other payment and delivery system reform initiatives in Washington, including a State Innovation Model (SIM) grant to build “accountable communities of health,” partnerships in local communities focused on social determinants of health, and an effort to integrate Medicaid purchasing for physical and behavioral health. In its application, the State said it hopes to reach agreement on terms and conditions with CMS by April 2016, with a proposed January 2017 start date for the waiver demonstration.