The Scoop: February 12, 2020 Version

Welcome to this week’s round-up of state-level well being reform information, together with:

DC alternate gives SEP for residents not conscious of DC’s particular person mandate

Open enrollment for self-purchased medical health insurance has ended nationwide. (It begins once more in November, for protection efficient in 2021). However in the event you’re in Washington, DC and you discover out concerning the District’s individual mandate if you file your 2019 tax return – since you owe a penalty for being uninsured final yr – DC Well being Hyperlink is granting a one-time 60-day special enrollment period that can permit you to join 2020 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 told you about legislation into account in Virginia to sharply restrict short-term well being plans. Each chambers have now passed their respective legislation, 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 alternate

Virginia’s Senate has additionally handed bipartisan legislation that requires the state to create a state-run health insurance exchange that may be operational by 2023. There are 13 fully state-run exchanges as of 2020, however Virginia is certainly one of a number of states contemplating the potential of transitioning away from within the coming years and establishing a state-run alternate platform as an alternative.

Nebraska Medicaid enlargement on observe for Oct. 1 begin date

Nebraska voters authorised Medicaid expansion over a yr in the past. The state is slowly making its way towards implementation of the poll initiative, nevertheless it’s not scheduled to take impact till October. (Voters in Utah and Idaho authorised comparable poll initiatives on the identical time, and Medicaid enlargement has already taken impact in each states.)

Nebraska’s Division of Well being and Human Companies has indicated that the state is on track to satisfy the long-planned October 1 begin date for Medicaid enlargement. However legislation has also been introduced to codify that date as a tough deadline for the expanded eligibility guidelines to take impact.

Georgia’s reinsurance proposal prone to be authorised in time for spring fee filings

Final fall, Georgia unveiled 1332 and 1115 waivers designed to make radical modifications to its medical health insurance market and Medicaid program. However whereas some features of the state’s proposal are controversial, one provision – reinsurance – is just not. A dozen states have already implemented reinsurance programs, which convey down pre-subsidy premiums throughout the person insurance coverage market, making protection extra reasonably priced for individuals who don’t get subsidies. (It will possibly have the opposite effect for individuals who do get subsidies, relying available on the market dynamics within the space.)

Gov. Brian Kemp asked CMS to evaluate the reinsurance proposal individually and expeditiously, in hopes that it may be in place as of 2021 (and authorised by the point insurers are creating their charges for 2021, which is able to occur this spring). Final week, CMS notified Kemp that the federal government has paused its consideration of the rest of Georgia’s proposal with a view to deal with the reinsurance proposal. So whereas different features of Georgia’s proposal might or will not be authorised, and will undergo a prolonged evaluate course of, a call on the state’s reinsurance proposal could be anticipated within the pretty close to future — and it’s prone to be authorised, given the widespread approval of reinsurance applications in different states.

Wyoming Medicaid enlargement invoice dies in committee

Medicaid expansion legislation was filed in Wyoming final month, after receiving approval from a legislative committee final fall. However regardless of sturdy help from the state’s medical suppliers and medical students at the University 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 enlargement precisely because it’s outlined below 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 enlargement in a state-specific means.

One other expansion bill might still be introduced this week, nevertheless, so Wyoming continues to be a state to look at for Medicaid enlargement laws within the 2020 session.

Arizona GOP introduces laws to guard residents with pre-existing situations if state is profitable in its efforts to overturn the ACA

Because the Texas v. Azar lawsuit winds its means by way of the courtroom system, Arizona is the newest 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 introduced legislation ostensibly designed to guard individuals with pre-existing conditions – and at first look, it’d seem to do 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 had been widespread practices previous to the ACA.

But that is all the bill would do. It might not forestall insurers from basing premiums on candidates’ medical historical past, nor would it not lock in any of the ACA’s different client protections. Democrats in Arizona have launched a stronger version of legislation 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 enlargement, it’s not possible that states might preserve something even near the present stage of well being care protection and affordability.

Bipartisan Medicaid enlargement laws launched in Tennessee

Tennessee has not but expanded Medicaid, though the state is seeking federal approval for a Medicaid work requirement and block grant funding. However payments have been launched – with bipartisan help – that may get the ball rolling on Medicaid enlargement in Tennessee. The laws – launched in each the House and Senate – requires the state to submit a waiver proposal to CMS with a view to develop 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 certainly one of 13 high-cost specialty medication are given the choice of touring to Mexico – or Canada – with a view to get hold of their medication at a a lot decrease value. The state pays all of their journey bills and provides them an additional $500 in the event that they select to get their medicines exterior the U.S. Up to now, ten staff have taken Utah up on the supply, saving the state worker well being plan $225,000.

Louise Norris is an individual health insurance dealer who has been writing about medical health insurance and well being reform since 2006. She has written dozens of opinions and academic items concerning the Affordable Care Act for Her state health exchange updates are frequently cited by media who cowl well being reform and by different medical health insurance consultants.

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