Washington and Iowa report surges in insurer participation in Marketplaces for 2016; Maine considers legislation to maintain premium subsidies regardless of King v. Burwell; and Manatt offers a free Medicaid webinar series.
KING V. BURWELL ACTIVITY:
Maine: Committee Passes Bill to Maintain Insurance Premium Subsidies Regardless of King v. Burwell Outcome
The Maine Joint Standing Committee on Insurance and Financial Services unanimously voted in favor of a bill that would protect the health insurance premium subsidies provided under the ACA, regardless of the outcome of King v. Burwell, the Supreme Court case that could potentially ban subsidies for consumers enrolled in insurance through the Federally-facilitated Marketplace. The bill would create a supported State-based Marketplace, in which Maine would run its Marketplace but utilize federal eligibility and enrollment services. According to the Portland Press Herald, the bill is likely to pass through the legislature, but it is unclear if Governor Paul LePage (R) will sign the bill into law.
New Study Reveals High Stakes for Non-Expansion States in King v. Burwell
The twenty states that have chosen both to rely on the Federally-facilitated Marketplace and not to expand Medicaid are at risk of losing net $721 billion of federal spending between 2016 and 2025 if the Supreme Court finds in favor of the plaintiffs in King v. Burwell, according to a new report by the Robert Wood Johnson Foundation and the Urban Institute. The report estimates that states that have elected not to expand Medicaid are already losing $483 billion in federal spending over the next ten years. If King v. Burwell is found for the plaintiffs and these states do not establish a state-based Marketplace, the residents of those states are at risk of losing an additional $238 billion in financial assistance during that same timeframe. This sceniario would also result in an estimated 9.8 million additional uninsured individuals in 2016.
MEDICAID EXPANSION NEWS:
Alaska: Governor's Medicaid Expansion Bills Stall in Legislature
Governor Bill Walker’s (I) Medicaid expansion bill, HB 148, hit a roadblock this week when the House Finance Committee announced it would not move forward with the legislation due to concerns with backlogs in the State’s Medicaid provider payment system, as reported by Alaska Dispatch News. Governor Walker had called the Legislature into a special session at the end of April after lawmakers failed to pass a budget and encouraged the Legislature to take up expansion. The Governor noted his disappointment with the Committee's decision, and administration officials contend that problems with the Medicaid system have been fixed. Meanwhile, the Senate has yet to hold a hearing on its Medicaid expansion bill during this special session.
Louisiana: House Agrees to Financing Mechanism for Medicaid Expansion
The Louisiana House voted 96-0 in support of a financing mechanism that could help pay for Medicaid expansion if the State were to expand by April 2016, a deadline imposed in the legislation. House Concurrent Resolution 75 would allow Louisiana hospitals to assess fees on themselves to generate the State's share of Medicaid expansion costs and draw down billions of federal dollars in matching funds. The Resolution must be passed by the Senate, but does not require the governor’s signature. While Governor Bobby Jindal (R) has repeatedly refused to expand Medicaid, he is not permitted to run for re-election next year. The four lead gubernatorial candidates have, at a minimum, expressed interest in exploring options for expansion.
MARKETPLACE UPDATES:
California: Marketplace Releases Proposed Budget
Covered California released a proposed $332 million budget for fiscal year 2015-2016, in which the Marketplace begins the fiscal year with nearly $200 million in reserve funding and ends it with $194 million. While Covered California will use approximately $100 million in remaining federal establishment funding, the Marketplace plans to transition to relying solely on qualified health plan assessments to support ongoing operations. The Covered California Board will vote on the proposed budget during the next monthly Board meeting.
Hawaii: Marketplace Addresses Non-Compliance
Governor David Ige's (D) administration has announced that the Hawaii Health Connector (HHC) will address ACA non-compliance issues identified in its marketplace—including unresolved IT issues, a non-integrated eligibility enrollment system, and lack of financial sustainability—through a plan developed jointly by the State and HHC in time for the fall 2015 open enrollment. If CMS determines that the State's plan is inadequate, Hawaii risks losing $1 billion in federal Medicaid matching funds in addition to grant funding for HHC, which has already been restricted. According to reports by the Associated Press, Hawaii’s plan calls for using the Federal government's information technology system to run Hawaii’s State-based Marketplace.
QHP SUBMISSIONS FOR OPEN ENROLLMENT:
District of Columbia: Insurers File Higher Plan Rates for 2016
Four insurance companies submitted proposed health insurance plans for D.C.’s individual and SHOP marketplaces with rates that are generally higher than last year’s, though DC Health Link clarified that due to the changes in numbers and types of plans being offered, comparing from year-to-year may be misleading. In the individual market, increases in plan premiums ranged from 2.7% to 18.1%, with the exception of one bronze product’s premium that decreased by 7.8%. The number of plans offered in the individual market, however, decreased from 227 to 162 for next year’s open enrollment period. DC Health Link noted that carriers are making an effort to tailor their products based on market experience.
Iowa: Seven Insurers Give Consumers More Marketplace Choice
Seven insurance companies have applied to offer individual plans, small group plans, or both through Iowa’s Federally-facilitated Marketplace, giving Iowans more choice in the coming year. Coventry Health Care was previously the only option for most Iowans. Two insurers, Coventry Health Care of Iowa, Inc. and Medica Insurance Company, will offer plans statewide, and United Healthcare of the Midlands will sell plans in most counties. Wellmark, the dominant insurer in Iowa, announced it will continue not to offer policies on the Marketplace.
Washington: Surge in Marketplace Participation by Insurers for 2016
The State Office of the Insurance Commissioner announced that 17 health insurers filed 246 individual plans for purchase both on and off the Marketplace, with a requested average rate increase of 5.4%, the lowest in nearly a decade. On the Marketplace, 13 insurers filed 188 plans, a huge jump from the 10 insurers and 90 plans offered in 2015. In addition, three insurers filed 47 plans with the State’s small business Marketplace, Washington Healthplanfinder Business.
MORE STATE HEALTH NEWS:
Florida: Governor Continues Activity on Uncompensated Care Funding
Governor Rick Scott (R) appointed nine members to his Commission on Healthcare and Hospital Funding and sent a letter to HHS asking whether it would consider supplying a block grant to provide coverage to uninsured Floridians or allow a segment of this population to receive coverage through the State’s Federally-facilitated Marketplace. He also sent a to letter to hospital and insurance administrators requesting information about their payer-mix, financial standing, and executive salary levels, according to the Herald Tribune. Earlier in the week, Governor Scott met with a group of members of Congress to urge them to publicly support his efforts to renew funding for Florida’s Low-Income Pool, resulting in the House Energy and Commerce Committee agreeing to hold a hearing on the issue this summer, reports the SunSentinel.
Hawaii: Judy Mohr Peterson Named Medicaid Administrator
The Hawaii Department of Human Services announced that Judy Mohr Peterson has been selected as the new Administrator of the Med-QUEST Division (MQD). Since 2009, Dr. Peterson has served as Oregon's State Medicaid Director, where she presided over the creation of State’s delivery system transformation and development of coordinated care organizations.
OTHER FEDERAL NEWS:
HHS to Provide Tools to Help Consumers Avoid Unexpected Health Insurance Costs
The Department of Health and Human Services (HHS) announced the creation of an out-of-pocket cost calculator and a new requirement to update monthly qualified health plan (QHP) provider directories, strategies to assist consumers select plans best suited for their needs. According to the New York Times, the out-of-pocket cost calculator will enable consumers to consider not just premium costs and subsidies, but also the costs of co-payments and deductibles when selecting a health insurance plan. Additionally, the Administration will require QHP issuers to update provider directories at least once a month in an electronic format, allowing software developers to create tools that will help consumers select a plan based on provider network. Insurers who fail to update directories will face a fine of up to $100 a day for each person adversely affected.