Mitigating the Loss of the Individual Mandate: State Based Health Insurance Mandates

In December 2017, the federal administration’s tax bill – the Tax Cuts and Jobs Act, phased out the individual mandate requirements, with the penalty for failing to have qualified insurance eliminated starting in 2019. For 2018, the mandate remains, with the penalty set at $695 per adult or 2.5% of household income, whichever is higher.  ...

CMS Proposes Changes to Rules related to Medicaid Access to Care Requirements

On March 23rd, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would exempt states from requirements to analyze and monitor access to care in the Medicaid program under certain circumstances. The proposal seeks to amend 42 CFR 447.203(b), which sets forth the process for states to document whether Medicaid payments ...

CMS Releases Final Exchange Guidance

On April 9, 2018, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited final Exchange guidance for the 2019 plan year – the final Notice of Benefit and Payment Parameters for 2019 (NBPP) and the final Letter to Issuers in the Federally-facilitated Exchanges (Letter). Together, the NBPP and Letter set forth changes to ...

Health Policy News March 2018

This month's edition focuses on efforts underway across the country to protect consumers from rising prescription drug costs and reduce or cap state drug spending. Health Policy News subject matter experts released a special report and legislative tracking tool outlining state and federal efforts, along with suggestions for states on how to approach this high ...

CDC issues new report on the growing opioid crisis

On March 6, 2018, the Centers for Disease Control and Prevention (CDC) released a report which shows that from July 2016 - September 2017, hospital emergency department visits for opioid overdoses rose about 30 percent in 52 reporting jurisdictions in 45 states. They rose 54 percent in large cities, and 70 percent in mid-western states. ...

Tackling Rising Prescription Drug Costs – a report on state and federal efforts

On March 29th, subject matter experts from Health Policy News held a webinar and Q&A to discuss efforts at the state and federal level to address the rising cost of prescription drugs.  Many states are in the midst of their legislative cycles, with the issue of rising pharmaceutical costs on agendas across the country. Topics ...

Health Policy News February 2018

In this month's edition of Health Policy News, we highlight legislative, regulatory, and administrative developments at the federal level. Just last week, on February 20, 2018, several federal departments jointly released a proposed rule seeking to expand access to Short-Term Limited-Duration Insurance (STLDI) plans. Also, on February 9, 2018, the President signed H.R. 1892, the ...

Insights and suggested activities for State Flexibility Grant Program applications

The State Flexibility to Stabilize the Market Grant Program (“State Flexibility Grant Program”) was developed to support states as they implement several of the market reforms and consumer protections under Title I of the Affordable Care Act (ACA). This new funding opportunity builds upon many of the efforts currently underway in states related to the ...

New federal grant opportunity to support state efforts to strengthen the private health insurance market

On February 5, 2018, the Center for Consumer Information and Insurance Oversight (CCIIO) released a new Notice of Funding Opportunity to support states as they implement several of the market reforms and consumer protections under Title I of the Affordable Care Act (ACA). This grant program is a follow-up to the Health Insurance Enforcement and ...

Administration budget proposal includes health care changes

The administration released its budget proposal on February 12, 2018. As expected, the proposal includes a number of changes related to health care. The budget plan revives the Affordable Care Act (ACA) repeal, with a proposal similar to the Graham Cassidy Heller Johnson bill. Specifically, the budget plan proposes a staged repeal and replace, with ...

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