State Update

Reports of Interest December 2013

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The White House issued a United States map which identifies the states that have currently chosen not to expand Medicaid under the Affordable Care Act and provides data on the number of Americans in those states that will be impacted. According to the map nearly 5.4 million Americans will remain uninsured in states that do not expand their Medicaid program.

The Robert Wood Johnson Foundation issued a report analyzing premiums and cost sharing in the new health insurance marketplaces and found that almost half of those predicted to buy insurance on the exchange will be eligible for tax credits that would reduce their premiums.

The Urban Institute and the Robert Wood Johnson Foundation released a report which explores several strategies states could implement, beyond the federal requirements included in the Affordable Care Act, to protect consumers from health insurance premium increases caused by rate shock. The report uses policy decisions in 11 states—Alabama, Colorado, Illinois, Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island, and Virginia—to illustrate the mixed approaches states are using to mitigate rate shock. According to the report, states are implementing the following:

  • Colorado, Minnesota and Alabama have begun transitioning people with pre-existing conditions out of high-risk pools into plans with younger, healthier people.
  • Maryland, New York and Oregon are protecting against insurers undercutting the health insurance exchanges by “locking them out” in subsequent years if they don’t participate in year one—as well as limiting the sale of catastrophic plans.
  • Maryland, New York, Oregon and Colorado also standardized broker compensation inside and outside the exchange to prevent customers from being steered away from one market toward another.