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Enrollment 1.0: State Reflections on ACA’s First Year and What’s Next
/in Policy Webinars /by NASHPTuesday, July 22, 2014
2:00 – 3:30 pm ET
Beginning in October, 2013, states initiated their first open enrollment period for health coverage under the ACA. While state approaches varied, all states implemented new rules, system interfaces, and data reporting methods required under the ACA. What are states learning so far about what works to enroll eligible individuals and what are their top-line priorities getting ready for the next open enrollment period in November 2014? This webinar provides an opportunity to learn about promising strategies and innovations states are piloting related to enrollment and retention into insurance affordability programs, including through state-based exchanges and coordination with the federally facilitated marketplace (FFM). State panelists from Kentucky, Montana and Washington share experiences and enrollment successes. NASHP also shares new findings from research with 10 states documenting promising strategies, common challenges and trends in state enrollment experience as part of the Enrollment 2014 project.
Speakers:
- Anne Gauthier, Director, State Health Exchange Leadership Network, National Academy for State Health Policy (Moderator)
- Alice Weiss, Director, Enrollment 2014 Project, National Academy for State Health Policy
- Carrie Banahan, Executive Director, Office of Kentucky Health Benefit Exchange (Kynect)
- Christina Goe, General Counsel, Montana Commissioner of Insurance
- Nathan Johnson, Division Director, Health Care Policy, Washington Health Care Authority
Shared Responsibility in Consumer Assistance: Examples from Federally Facilitated and Partnership Marketplace States
/in Policy Reports /by NASHP, Jackie LeGrand, Julien Nagarajan, Rachel Dolan and Katharine WitgertThis brief explores ways that states are sharing the responsibility of consumer assistance with the federal marketplace in three key areas: marketing and advertising initiatives, the work of navigators and other in-person assisters, and the development of a system for eligibility decision appeals. It also provides specific examples of states utilizing the Federally Facilitated Marketplace (FFM) or those partnering with it (SPM) for consumer assistance, and illustrates some of the ways that FFM and SPM states can work with their existing consumer assistance structures and with the federal government to help consumers find their way in a new coverage landscape.
Rachel Dolan
Julien Nagarajan
February 2014
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Early State Experiences with the First Open Enrollment Under the Affordable Care Act
/in Policy Reports Health Coverage and Access /by NASHP and Keerti KanchinadamThe Affordable Care Act (ACA) expands health insurance coverage options to millions of uninsured individuals, and makes significant changes to state eligibility and enrollment processes. Many of these changes were implemented by October 1, 2013, with the beginning of the first open enrollment period for health insurance marketplaces. This brief describes states’ experiences—including challenges and strategies to address them—during the first three months of open enrollment. These early state experiences help to document the evolution of health reform in the states and may prove instructive for states at different stages of ACA implementation as well as for planning for the next open enrollment period.
| Click for the Publication | 737.7 KB |
State Sharing of Insurance Exchanges: Options, Priorities, and Next Steps from the West Virginia Regional Exchange Study
/in Policy Reports Health Coverage and Access /by NASHP, Anne Gauthier and Abigail AronsSharing certain insurance exchange functions across states holds promise for cost savings and other benefits to consumers, states and additional stakeholders. This NASHP report highlights findings and next steps from a study supported by the West Virginia Offices of the Insurance Commissioner, which included interviews and an in-person meeting with officials from several states and national experts. The report lays out priority functions for sharing, benefits and drawbacks to various sharing arrangements, and next steps to implement sharing.
| Click for the Publication | 201.8 KB |
Advancing Children’s Coverage Toolkit
/in Policy Toolkits Maternal, Child, and Adolescent Health /by NASHP StaffAs states take different approaches to implementing the Affordable Care Act (ACA) and new coverage options primarily designed for adults, they may be challenged to maintain and further the progress made in children’s coverage. When the Children’s Health Insurance Program (CHIP) was enacted in 1997, 25 percent of low-income children were uninsured in the United States.1 Since then, CHIP and Medicaid have significantly reduced the number of uninsured low-income children and youth to as low as 14 percent in 2012.2 The ACA brings significant change to the health insurance landscape, with the goals of expanding insurance coverage, streamlining enrollment processes, and increasing access to care. Within the new insurance landscape, it is important that states take into consideration the impact of their health reform-related decisions and approaches on children’s coverage.
Using the Toolkit
To begin exploring the Toolkit for Advancing Children’s Coverage through Health Reform Implementation use the right side navigation to explore specific topics.
Through longstanding work on Medicaid, CHIP, and private sector coverage, NASHP has supported, analyzed, and reported on state efforts to implement effective children’s coverage policies and programs. NASHP draws on years of experience fostering collaborative learning and serving as a key resource for state policymakers and other stakeholders.
Toolkit Goals:
- Provide a centralized source of information and tools relevant to the impact of the ACA on children’s coverage.
- Draw attention to some of the challenges states may be facing in maintaining and advancing children’s coverage while implementing the ACA.
- Assist states in considering policy actions to advance children’s coverage by compiling relevant research and state examples.
The Toolkit for Advancing Children’s Coverage through Health Reform Implementation complements NASHP’s June 2013 report, Health Care Reform and Children: Planning and Design Considerations for Policymakers. The report and toolkit highlight ideas learned through NASHP’s Children in the Vanguard initiative. Since 2011, this initiative has convened a network of state officials and children’s advocates to support their work in strengthening children’s coverage as health care reform decisions are made in their states. This work is supported by The Atlantic Philanthropies, dedicated to bringing lasting change to the lives of vulnerable or disadvantaged people.
Footnotes:
1Margo Rosenbach, et al., National Evaluation of the State Children’s Health Insurance Program: A Decade of Expanding Coverage and Improving Access. (Washington DC: Mathematica, September 2007)
2The Kaiser Family Foundation, statehealthfacts.org. Health Insurance Coverage of Low Income Children 0-18 (Under 200% FPL) (2011-2012). Accessed March 10, 2014.
The State Buzz from AcademyHealth’s Annual Research Meeting
/in Policy Annual Conference /by Staff10/11/2013 8:45am
Speakers:
Cheryl Roberts
Enrique Martinez-Vidal
Lindsey Leininger
Sharon Long
Tami Mark
NASHP is pleased to present a selection of state-oriented health services research from AcademyHealth’s 2013 Annual Research Meeting. Millions of Americans will become newly eligible for health insurance coverage in 2014 through Medicaid expansions or through the health insurance exchanges. It is likely that many of these newly insured individuals will have a host of untreated medical and behavioral health needs, which could put a strain on states’ health system capacity. Health services research can help states understand this population and their needs. This session will feature research that focuses on predicting the health status and unmet health needs of this population and the potential implications for state health policymakers.
How Are We Going to Pay for Long Term Care? Another Look at Long Term Care Insurance
/in Policy Reports Chronic and Complex Populations /by NASHPAlthough the debate over Medicare reform has had significant public exposure, the proposed cuts in Medicaid have received little attention. Yet these cuts could seriously impact the lives of millions of elderly citizens and their families.
Medicare has done an admirable job of providing coverage for physician and hospital care, however, it does not provide for the custodial long term care services that so many elderly need. The responsibility for paying for these services rests on individuals and the Medicaid program. Of the $107.8 billion spent in 1993 on V nursing home and home care services, individuals paid $38.5 billion (36%) and Medicaid paid $43.7 billion (41%). Private long term care insurance accounted for less than 1% of these expenditures.
Sixty-four percent of people over 55 have incomes below $20,000, and their ability to pay directly for long term care services is limited. One visit from a home health aide can cost $50, and over the long term this expense can become unmanageable for persons with modest income. A year of nursing home care costs an average of $38,000, depleting the life savings of many middle class elders. Medicaid is the safety net many elders find they must rely on once they have exhausted their resources on formal care. The projected increased need for long term care that will come with the aging of the population combined with the proposed budget cuts in Medicaid are prompting the Federal government, individuals, and states to look for other means of covering long term care expenditures. One such alternative is long term care insurance.
Long term care insurance has the potential to decrease Medicaid expenditures through helping individuals avoid or delay exhausting their own resources on long term care services and becoming eligible for Medicaid coverage.
| 1995.Sept_.how_.going_.to_.pay_.long_.term_.care_.look_.insurance.pdf | 1.6 MB |
The Health Insurance Portability and Accountability Act of 1996: A Guide for State Action
/in Policy Reports /by NASHPThe purpose of this paper is to highlight the major issues that states have considered and will consider in their current and upcoming legislative sessions regarding insurance reform and implementation of the Health Insurance Portability and Accountability Act (HIPAA). This paper explains, in brief, what changes are included in HIPAA and what effect they have had and will have on states. The paper also highlights issues that were not addressed in HIPAA, but that remain at the forefront of reform for many states. Remaining questions about HIPAA and its impact are included.
| 1997.Sep_.health.insurance.portability.accountability.guide_.state_.action.pdf | 3.5 MB |
Health Care of Children in Foster Care: Who’s Keeping Track?
/in Policy Reports Maternal, Child, and Adolescent Health /by NASHPAccording to the data from the Administration on Children Youth and Families there are an estimated 600,000 children residing in foster care in our country. Each of these children enter foster care with a background of abuse or neglect sufficient to warrant being removed from their families. The children entering care present complex medical and emotional conditions that are taxing the capacity and the ability of the foster care system.
| 1997.Oct_.health.care_.children.foster.pdf | 2.5 MB |
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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. 
