Inside Health Policy referenced Joel Ario, a managing director with Manatt Health Solutions, for an article about Republican state lawmakers voicing their enduring skepticism of the Affordable Care Act (ACA) at a panel hosted by the National Conference of State Legislatures.
While many of these Republican lawmakers call for broader state oversight of their own healthcare systems, some states, such as Colorado, are also looking into Section 1332 innovation waivers, which would allow states to eliminate central ACA provisions as long as they can provide coverage to the same number of people at the same cost without those mandates. The waiver could help to eliminate costs for easier long-term sustainability, as well as fix coverage issues like the "family glitch."
Ario even suggested that one Marylander in the audience use a 1332 waiver to continue defining the small-group market as employers with up to 50 workers, since that number is set to grow to 100 employees next year.
Medicaid expansion is also a front-and-center issue for many of these state lawmakers, as they consider its costs. Ario stated that he believes states that have not yet broadened the scope of their Medicaid programs to include more low-income people will not do so unless the government is more flexible. That could include loosening requirements on who the expansion range covers, employment and other aspects like premiums, deductibles and funding sources.
Ario recommended that states retain more on-the-ground control, hoping that Medicaid will one day look like the exchanges and Medicare Part D, where insurers compete under government guidelines to deliver the best choices.
Narrow and value-based networks are the future, Ario added.