The Scoop: January 29, 2020 Version

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

New York extends open enrollment (enrollment additionally continues in DC, CA)

Open enrollment for individual market health insurance continues till Friday in Washington, DC and California. It was scheduled to finish on Friday in New York as effectively, however a last-minute extension was issued this week, giving residents till February 7 to join protection. The enrollment window ended final month in a lot of the nation, however states that run their very own exchanges have flexibility to extend enrollment, and most did so.

California’s trade has been reminding residents that not solely does enrollment proceed till January 31, however {that a} new state regulation requires residents to have health coverage or pay a penalty. California additionally enacted laws this 12 months that gives new state-funded subsidies to assist make protection extra inexpensive.

Laws launched in Maryland would create state-based premium subsidies

In most states, premium subsidies are solely obtainable by way of the Reasonably priced Care Act’s tax credit. However lawmakers in Maryland are considering legislation that will create a state-based premium subsidy program. California began offering state-based premium subsidies this 12 months, and Washington plans to do so subsequent 12 months. Massachusetts and Vermont each have applications (which pre-date the ACA) that present supplemental subsidies to sure enrollees. Lawmakers in Colorado have beforehand thought-about laws that will have created state-based subsidies.

Single-payer laws launched once more in Vermont

Quickly after the Affordable Care Act was enacted, Vermont started shifting ahead with a plan to make use of a 1332 waiver to create a single-payer system that will have taken impact in 2017. However by 2014, the state had scrapped the idea amid considerations over the price. A new bill has been launched in Vermont that will resurrect the single-payer plan with a 2024 efficient date, though related laws was additionally thought-about in 2019 and didn’t advance.

Illinois is second state to enact laws to cap out-of-pocket insulin prices

Final fall, we informed you about legislation in Illinois to cap out-of-pocket costs for insulin on state-regulated well being plans. That legislation was signed into regulation final week, making Illinois the second state to enact a regulation to cap out-of-pocket prices for insulin. Colorado’s law was enacted last year and took impact this month. A number of different states are contemplating related payments. The American Diabetes Affiliation has applauded state legislation to cap out-of-pocket prices for insulin, however the caps aren’t a panacea: Most very massive employers have self-insured protection, which is regulated on the federal stage somewhat than the state stage. And naturally, individuals who don’t have medical health insurance in any respect aren’t helped by legal guidelines that tackle out-of-pocket prices underneath insurance policy.

New Jersey enacts laws to cap prescription prices

Final month, we informed you about New Jersey legislation to cap out-of-pocket prescription costs. The laws, which handed unanimously within the state’s legislature,  was enacted last week, after initially being rejected by Gov. Phil Murphy over considerations about its impression on New Jersey’s state worker well being plan. As of 2021, state-regulated plans in New Jersey should cap out-of-pocket prices at $150 monthly per prescription ($250 within the case of Bronze plans, and there are exceptions for catastrophic plans and HSA-qualified plans).

New Jersey joins several other states which have caps on out-of-pocket prescription prices. And the state is now additionally considering legislation that would further limit out-of-pocket costs for insulin – as are quite a few different states.

Bipartisan laws would shield Delaware residents from shock steadiness payments

Surprise balance bills occur when a affected person inadvertently sees an out-of-network supplier – both in an emergency state of affairs or in a state of affairs the place a affected person makes use of an in-network facility however a number of the providers are carried out by out-of-network suppliers. Delaware already protects sufferers from shock steadiness billing in emergency conditions, however new bipartisan legislation has been launched that will prolong protections to individuals who obtain providers from out-of-network suppliers whereas at in-network services.

Indiana laws would enable Farm Bureau to promote medically underwritten plans

Indiana SB184 is scheduled for a listening to at present within the Senate’s Insurance coverage and Monetary Establishments Committee. The laws would enable Indiana Farm Bureau to supply medically underwritten well being plans to sole proprietors within the state who’re Farm Bureau members. Tennessee has lengthy allowed medically underwritten Farm Bureau plans to be sold. Kansas and Iowa have just lately adopted swimsuit. The laws into account in Indiana calls for the same strategy, with medically underwritten plans that gained’t be regulated as insurance coverage, and thus wouldn’t be topic to regular insurance coverage guidelines. (Nebraska’s Farm Bureau takes a different approach, providing guaranteed-issue short-term plans to members who’re actively engaged in agriculture.)

Medicaid growth laws filed in Wyoming

Final fall, lawmakers on Wyoming’s Joint Interim Income Committee voted in favor of a draft Medicaid expansion bill, agreeing to ship it to the complete legislature for consideration in the course of the 2020 session. The legislation was filed this week, and the session will get underway subsequent month. Moderately than merely calling for Medicaid to be expanded underneath the phrases of the ACA, the laws directs state officers to work with CMS to “discover choices” for Medicaid growth, and authorizes the governor to hunt waivers from CMS if needed.

A gaggle of Wyoming well being organizations has joined together to lobby for Medicaid expansion within the state, and medical students from the University of Wyoming have lengthy urged lawmakers to develop protection within the state.

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 usually cited by media who cowl well being reform and by different medical health insurance specialists.

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