Arkansas: Marketplace Releases Request for Proposals to Create SHOP Marketplace
The Arkansas Health Insurance Marketplace released a request for proposals (RFP) to solicit a vendor to “implement a fully functioning state-based Health Insurance Marketplace for the Small Business Health Insurance Options Program (SHOP).” Arkansas is planning to transition from using the federal SHOP to its own SHOP Marketplace in plan year 2016. Responses to the RFP are due on December 8, 2014 and the project period is expected to begin on March 2, 2015.
California: Medicaid Enrollment Expands to 11.3 Million Beneficiaries
California’s Medicaid program expanded its enrollment by 2.7 million enrollees since October 2013, bringing total enrollment to 11.3 million beneficiaries, as reported by California Healthline. Toby Douglas, the State’s Medicaid Director, noted in Senate testimony that 18% of the 11.3 million beneficiaries were newly eligible under the State’s Medicaid expansion and that approximately 56% were adults.
Idaho: Medicaid Redesign Workgroup Discusses Two Delivery System Options for Expansion Population
The Governor’s Workgroup on Medicaid Redesign reviewed two proposals for covering Idaho’s Medicaid expansion population. The first proposal, called the Blended Model, provides coverage to new adults below 100% FPL through care management that promotes patient centered medical homes; new adults 100-138% FPL would be covered in qualified health plans on the State’s Marketplace, Your Health Idaho. The second proposal, called Direct Primary Care (DPC), would pilot a State-funded program to purchase “direct primary care medical home plans” for the expansion population, providing them with primary care services at specific provider sites.
Illinois: Marketplace Announces Qualified Health Plans for 2015
Get Covered Illinois announced that the Marketplace will offer more than 400 qualified health plans (QHPs) from ten insurers for the 2015 Open Enrollment Period. The plan offering includes 235 more QHPs than the previous year and three additional insurers, including IlliniCare Health Plan, Time Insurance Company, and UnitedHealthcare of the Midwest. The announcement also noted that premiums for the lowest cost silver plans will increase by an average of 2.6%, while the lowest cost Bronze plans will increase by an average of 11% across the state.
Indiana: CMS Renews Healthy Indiana Plan for 2015
CMS approved a one-year extension of Indiana’s waiver program, the Healthy Indiana Plan (HIP), and plans to continue discussions on Governor Pence’s (R) Medicaid expansion proposal, “HIP 2.0.” HIP has enrolled more than 60,000 Indiana residents with incomes below the federal poverty level (FPL) who would otherwise not qualify for Medicaid over the last seven years; HIP 2.0 could provide coverage for an additional 350,000 newly eligible residents and is based on similar principles as HIP, including consumer cost-sharing. CMS noted in the approval letter that the State may be permitted to end the one-year extension of HIP early should the State and CMS reach an agreement to transition to HIP 2.0 before December 31, 2015.
Kansas: Hospital Association Moves Forward with Medicaid Expansion Efforts
Tom Bell, the CEO of the Kansas Hospital Association — an organization that has worked for months on a Medicaid expansion plan — reported to the Hays Daily News that he believes Governor Brownback’s (R) administration and legislative leaders will be more open to discussing the expansion now that the election is over. Bell noted that the Kansas Medicaid expansion proposal is likely to include elements that appeal to Republicans, including subsidizing the purchase of private insurance and working with KanCare, the State’s Medicaid managed care delivery system. The Association is also considering various funding options, including raising a state assessment fee on hospitals that would bolster Medicaid rates paid to hospitals and trigger an increase in federal matching funds.
Minnesota: Report Indicates Marketplace Errors in Eligibility Determinations
According to Minnesota’s Office of the Legislative Auditor (OLA), in FY 2014, Minnesota Department of Human Services officials failed to ensure that individuals were correctly determined eligible for public health insurance, neglecting to verify federal and State eligibility criteria, such as Social Security numbers, citizenship, income, and household sizes for Medicaid, MinnesotaCare (a publicly subsidized health care program) and CHIP. Based on a sample tested by the OLA, 17% of individuals were found eligible for public insurance in error.
Montana: Governor Announces Healthy Montana Plan for Medicaid Expansion
As part of the release of his proposed 2017 biennium budget, Governor Bullock (D) announced his proposal for the Healthy Montana Plan, an alternative approach to Medicaid expansion. The Healthy Montana Plan would “contract with an insurer to provide healthcare through a private provider network at negotiated rates,” an approach that is modeled after the Healthy Montana Kids CHIP program. Approximately 70,000 Montanans would gain coverage under expansion. In 2013, the legislature failed to bring multiple bills that would have enacted Medicaid expansion to vote, reports the Associated Press.
New Mexico: Exchange Hires Four Firms to Promote Outreach Campaign
Amy Dowd, director of the New Mexico Health Insurance Exchange (NMHIX), announced the hiring of four firms to promote the Exchange’s “Be Well New Mexico” marketing and outreach campaign. The four firms, Garrity Group Public Relations, K2MD Health, Research + Polling and Bluespire Marketing, will provide public relations, communications, advertising, research and website design services. Altogether, the four contracts are worth approximately $6.1 million and are the result of a recent decision by NMHIX to rebid the advertising and marketing contract it awarded to BVK in July.
New York: Marketplace Hosts Renewal Webinar for Agents and Brokers
The New York State of Health hosted a webinar to brief agents and brokers on the State’s varying levels of “administrative renewal” processes to be implemented during the Open Enrollment Period for current enrollees. “Administrative renewal” refers to a redetermination of eligibility based on information the State has or can obtain without requiring enrollee action. The State outlined the following three types of renewal: full administrative renewal for those whose coverage remains unchanged; partial administrative renewal for those who have changes in eligibility, who age out of their plan, or whose 2014 plan is unavailable in 2015; and manual renewal for those who cannot be administratively renewed.
Texas: Governor-Appointed Institute Recommends Beginning Negotiations for State-Specific Medicaid Expansion
According to the Texas Tribune, the Texas Institute of Health Care Quality and Efficiency, a 15-member board of medical professionals appointed by Governor Perry (R) following the Institute’s 2011 establishment, recommended that Texas state leadership consider negotiating with CMS a Texas-specific solution to Medicaid expansion, to combat high uninsured rates and maximize federal funding. The Institute’s recommendations, which are not binding, leave decision-making with the Republican-led legislature, which, to date, has opposed Medicaid expansion.
Texas: Upcoming 1115 Waiver Renewal Expected to Raise Medicaid Expansion Questions
With the final year of Texas’ 1115 waiver — one of the earliest Delivery and System Reform Innovation Program waivers to support Medicaid transformation — drawing near, speculation on the upcoming negotiations with CMS note an opportunity for renewed discussion of Medicaid expansion. According to the Texas Tribune, policy experts believe CMS may use the Medicaid 1115 Waiver renewal process as leverage to pressure Texas to expand Medicaid, taking a similar approach to CMS’ recent decision to renew Florida’s Medicaid waiver for only one year, rather than the standard three.
Virginia: Emergency Legislation Allows Insurers to Renew Non-Compliant Health Plans
In a Congressional Special Session, the Virginia General Assembly passed SB 5014, emergency legislation that will permit insurers to renew individual and group health insurance plans scheduled to be terminated due to noncompliance with the Affordable Care Act. According to the Greenfield Reporter, supporters assert the legislation will prevent an estimated 250,000 Virginians from losing coverage, while some legislators question the accuracy of the estimation, claiming it is difficult to ascertain and that the number of people impacted is inflated.
Washington: Exchange’s Policy Committee Reviews Consumer Rating System and Consumer Assistance Tools
The Washington Health Benefit Exchange (WHBE) Policy Committee considered the development of a consumer rating system that would display ratings in Healthplanfinder during Open Enrollment for coverage year 2016, in addition to the ACA-mandated quality rating system. The consumer rating system would focus on three areas—enrollee satisfaction, care management and prevention—using HEDIS and CAHPS measures. Additionally the Committee reviewed proposed strategies to assist consumers in selecting Qualified Health Plans, including limiting the number of plan choices offered by each carrier and providing consumers with tools to narrow down plan options.