Health Coverage and Access
FEATURED ARTICLE
State and Federal Resources to Address Surprise Medical Balance Billing
/in Policy Blogs, Toolkits Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs /by NASHP WritersSurprise medical balance bills – charges for unexpected, out-of-network medical care – affect thousands of consumers each year. These bills can leave consumers stuck with hundreds, if not thousands, of dollars in unexpected medical expenses. States are taking the lead in cracking down on surprise balance bills, passing consumer protection laws that range from strict […]
States Lead on Surprise Medical Billing Protections, Congress Poised to Follow
/in Policy Charts Consumer Affordability, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs /by Christina CousartInformation below references federal bills developed prior to January 2019. For an updated version of this chart, click here.
Is New Jersey’s Conversion to a State-Based Insurance Exchange a Harbinger?
/in Policy New Jersey Blogs Eligibility and Enrollment, Health Coverage and Access, State Insurance Marketplaces /by Trish RileyStates with state-based insurance marketplaces (SBMs) have consistently outperformed states that use the federal platform in enrollment, affordability, and increased plan offerings and competition, prompting states to consider launching their own marketplaces and Congress to propose new funding to support states that want to transition. New Jersey may become the next state to convert to an […]
Individual Enrollment in Federal and State Health Insurance Marketplaces 2018-2019*
/in Policy Charts Eligibility and Enrollment, Health Coverage and Access, State Insurance Marketplaces /by Maureen Hensley-QuinnRead a blog about state-based marketplace performance here and view slides comparing state-based and federally-facilitated marketplaces here. * State-based marketplaces (SBMs) design their enrollment websites, control outreach and marketing, and manage the health plans offered through the marketplace. This data came from publicly available sources or directly from the marketplace. States with federally-facilitated marketplaces (FFM) rely on […]
How the President’s Proposed Budget Impacts Critical State Health Programs
/in Policy Blogs Administrative Actions, Behavioral/Mental Health and SUD, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Healthy Child Development, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Prescription Drug Pricing, State Insurance Marketplaces /by NASHP WritersThe President’s 2020 budget request proposes a 12 percent reduction in the US Department of Health and Human Services (HHS) budget, compared to 2019 federal fiscal year (FFY) funding levels. The following highlights some of the key components of the President’s proposed $87.1 billion HHS budget proposal that could impact state health programs. Affordable Care […]
State-based Exchange Directors Share their Marketplace Successes with Congress
/in Policy Blogs Eligibility and Enrollment, Health Coverage and Access, Medicaid Expansion, State Insurance Marketplaces /by Trish RileyOn March 5 and 6, 2019, state-based exchange directors convened in Washington, DC for peer-to-peer discussions and meetings with Congressional staff and federal officials, hosted by the National Academy for State Health Policy (NASHP). The meeting has become an important annual event for the state-based exchanges – which provide the infrastructure, websites, and customer support […]
Considerations for States Crafting Budgets to Support Children’s Coverage
/in Policy Blogs Children/Youth with Special Health Care Needs, CHIP, CHIP, Chronic and Complex Populations, Eligibility and Enrollment, EPSDT, Health Coverage and Access, Healthy Child Development, Maternal, Child, and Adolescent Health, Medicaid Managed Care /by Anita CardwellAfter months of uncertainty and a three-month federal funding lapse, in early 2018 Congress passed the HEALTHY KIDS and ACCESS Acts, which appropriated federal funds for the Children’s Health Insurance Program (CHIP) through federal fiscal year (FFY) 2027. While the HEALTHY KIDS and ACCESS Acts’ long-term funding stabilizes CHIP programs and helps states develop forward-focused […]
Oregon’s Accountable Health Model Addresses Health Equity and Health-Related Needs: Four Lessons from CCO 2.0
/in Policy Oregon Blogs Accountable Health, Chronic and Complex Populations, Community Benefit, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Social Determinants of Health /by Amy ClaryStates developing accountable health models often look to Oregon for inspiration. Oregon established its Coordinated Care Organizations (CCOs) in 2012, pursuant to a Medicaid Section 1115 demonstration waiver. CCOs are local networks of all types of health care providers — including physical, behavioral, and oral health providers — that the state pays a global capitated […]
Hospital Price Transparency: The Next Frontier
/in Policy Colorado, Maine, Massachusetts, New Hampshire, Washington Blogs Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Health System Costs, Medicaid Managed Care, Value-Based Purchasing /by Josephine PorterThe Centers for Medicare & Medicaid Services (CMS) took an important first step toward increasing the transparency of hospital finances when it required hospitals to post their charge information, effective January 2019. But, these charges are not prices paid — they are typically the starting point against which commercial payers negotiate discounts. States with all-payer […]
What’s Brewing with Medicaid Expansion?
/in Policy Blogs Health Coverage and Access, Medicaid Expansion, State Insurance Marketplaces /by Anita CardwellWith many new governors in office and state legislatures in session, policymakers in nearly all of the 14 states that have not implemented the Affordable Care Act’s Medicaid expansion are considering various proposals to broaden coverage on their own terms. Additionally, states that recently expanded Medicaid through ballot initiatives are taking different approaches toward implementation, […]
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
Rhode Island Looks to Auto-Enrollment to Ease Transitions from Medicaid to Marketplace
/in Health Coverage and Access, Policy Rhode Island Blogs, Featured News Home State Insurance Marketplaces /by Gia Gould and Maureen Hensley-Quinn