On this version
- DC trade gives SEP for residents who weren’t conscious of DC’s particular person mandate
- Virginia lawmakers approve payments to restrict short-term well being plans
- Virginia strikes a step nearer towards a state-run trade
- Nebraska Medicaid growth on observe for Oct. 1 begin date
- Georgia’s reinsurance proposal prone to be accredited in time for spring price filings
- Wyoming Medicaid growth invoice dies in committee
- Arizona GOP introduces laws to guard residents with pre-existing circumstances, in case Arizona is profitable in its efforts to overturn the ACA
- Bipartisan Medicaid growth laws launched in Tennessee
- Utah pays state staff for journey to Mexico to fill prescriptions
Welcome to this week’s round-up of state-level well being reform information, together with:
DC trade gives SEP for residents not conscious of DC’s particular person mandate
Open enrollment for self-purchased medical insurance has ended nationwide. (It begins once more in November, for protection efficient in 2022). However if you happen to’re in Washington, DC and you discover out concerning the District’s particular person mandate while you file your 2022 tax return – since you owe a penalty for being uninsured final yr – DC Well being Hyperlink is granting a one-time 60-day particular enrollment interval that may permit you to enroll in 2022 protection and keep away from having to pay one other penalty in your tax return subsequent yr.
Virginia lawmakers approve payments to restrict short-term well being plans
Final month, we instructed you about laws into account in Virginia to sharply restrict short-term well being plans. Each chambers have now handed their respective laws, bringing Virginia one step nearer to being among the many states with strict limits on short-term plans.
Virginia strikes a step nearer towards a state-run trade
Virginia’s Senate has additionally handed bipartisan laws that requires the state to create a state-run medical insurance trade that may be operational by 2023. There are 13 absolutely state-run exchanges as of 2022, however Virginia is one in all a number of states contemplating the potential of transitioning away from HealthCare.gov within the coming years and establishing a state-run trade platform as an alternative.
Nebraska Medicaid growth on observe for Oct. 1 begin date
Nebraska voters accredited Medicaid growth over a yr in the past. The state is slowly making its method in the direction of implementation of the poll initiative, but it surely’s not scheduled to take impact till October. (Voters in Utah and Idaho accredited comparable poll initiatives on the identical time, and Medicaid growth has already taken impact in each states.)
Nebraska’s Division of Well being and Human Providers has indicated that the state is on observe to fulfill the long-planned October 1 begin date for Medicaid growth. However laws has additionally been launched to codify that date as a tough deadline for the expanded eligibility guidelines to take impact.
Georgia’s reinsurance proposal prone to be accredited in time for spring price filings
Final fall, Georgia unveiled 1332 and 1115 waivers designed to make radical modifications to its medical insurance market and Medicaid program. However whereas some facets of the state’s proposal are controversial, one provision – reinsurance – is just not. A dozen states have already applied reinsurance applications, which carry down pre-subsidy premiums throughout the person insurance coverage market, making protection extra reasonably priced for individuals who don’t get subsidies. (It might probably have the other impact for individuals who do get subsidies, relying available on the market dynamics within the space.)
Gov. Brian Kemp requested CMS to guage the reinsurance proposal individually and expeditiously, in hopes that it may be in place as of 2022 (and accredited by the point insurers are creating their charges for 2022, which is able to occur this spring). Final week, CMS notified Kemp that the federal authorities has paused its consideration of the remainder of Georgia’s proposal in an effort to concentrate on the reinsurance proposal. So whereas different facets of Georgia’s proposal might or might not be accredited, and will undergo a prolonged assessment course of, a choice on the state’s reinsurance proposal could be anticipated within the pretty close to future — and it’s prone to be accredited, given the widespread approval of reinsurance applications in different states.
Wyoming Medicaid growth invoice dies in committee
Medicaid growth laws was filed in Wyoming final month, after receiving approval from a legislative committee final fall. However regardless of robust assist from the state’s medical suppliers and medical college students on the College of Wyoming, the laws died in committee this week, on the primary day of the legislative session.
The invoice wouldn’t have referred to as for Medicaid growth precisely because it’s outlined underneath the ACA, however would have given the governor the authority to work with CMS to “discover choices” for increasing protection. Lawmakers within the state have lengthy stated that they need a Wyoming-specific resolution, and the invoice that died on Monday would have given the governor leeway to craft Medicaid growth in a state-specific method.
One other growth invoice would possibly nonetheless be launched this week, nonetheless, so Wyoming continues to be a state to observe for Medicaid growth laws within the 2022 session.
Arizona GOP introduces laws to guard residents with pre-existing circumstances if state is profitable in its efforts to overturn the ACA
Because the Texas v. Azar lawsuit winds its method by way of the court docket system, Arizona is the most recent plaintiff state scrambling to attempt to craft an answer for state residents, in case the lawsuit the state is backing is profitable. (Sure, the irony is powerful.) GOP lawmakers in Arizona have launched laws ostensibly designed to guard individuals with pre-existing circumstances – and at first look, it would seem to try this. The invoice would prohibit individual-market insurers from rejecting candidates based mostly on their medical historical past or imposing pre-existing situation exclusions, each of which have been frequent practices previous to the ACA.
However that’s all of the invoice would do. It could not forestall insurers from basing premiums on candidates’ medical historical past, nor would it not lock in any of the ACA’s different shopper protections. Democrats in Arizona have launched a stronger model of laws to guard state residents from the potential of the ACA being overturned, however the elephant within the room is the lack of federal funding that may outcome if the ACA is finally dominated unconstitutional. With out federal funding for premium subsidies and Medicaid growth, it’s most unlikely that states might keep something even near the present stage of well being care protection and affordability.
Bipartisan Medicaid growth laws launched in Tennessee
Tennessee has not but expanded Medicaid, though the state is searching for federal approval for a Medicaid work requirement and block grant funding. However payments have been launched – with bipartisan assist – that may get the ball rolling on Medicaid growth in Tennessee. The laws – launched in each the Home and Senate – requires the state to submit a waiver proposal to CMS in an effort to broaden Medicaid as referred to as for within the state’s beforehand thought-about Insure Tennessee proposal. However they make clear that the state would additionally proceed to hunt federal approval for the work requirement and block grant funding.
Utah pays state staff for journey to Mexico to fill prescriptions
This fascinating story by the Salt Lake Tribune’s Erin Alberty is a must-read. Utah authorities staff who take one in all 13 high-cost specialty medication are given the choice of touring to Mexico – or Canada – in an effort to get hold of their medication at a a lot decrease value. The state pays all of their journey bills and offers them an additional $500 in the event that they select to get their medicines exterior the U.S. Thus far, ten staff have taken Utah up on the provide, saving the state worker well being plan $225,000.
