State Refor(u)m

Ministry, Association, and Short-Term Health Plans: What’s a State to Do?

The Trump Administration is expanding the availability of alternatives to Affordable Care Act-compliant health insurance. Rules to expand association health plans and short-term limited duration health plans are imminent. So what’s a state to do to prepare consumers and insurance markets for these alternative plans? The Administration asserts these alternatives will provide choice and lower-cost […]

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  • The Roadmap Ahead: New York’s Value-Based Payments Reward Communities and Providers for Addressing the Social Determinants of Health
    State Health Policy Blog

    Medicaid payment models in many states are shifting away from rewarding providers for the quantity of care they provide to models that reward high-quality, coordinated care that addresses some of the broader social factors that influence health and well-being. One example is New York’s Value-Based Payment (VBP) Roadmap, which rewards Medicaid providers and community-based organizations […]

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  • Medicaid Expansion in Maine Moves from the Legislature to the Courts
    State Health Policy Blog

    A successful citizens referendum to expand Medicaid stalled in the state Legislature and moved to the courts this week. Over the past five years, the Maine Legislature has passed several bills to expand the state’s Medicaid program – MaineCare – under the provisions of the Affordable Care Act to cover a greater number of low-income […]

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  • State-Based Marketplaces See Enrollment Growth in 2018, Despite Roadblocks and Confusion
    State Health Policy Blog

    While national enrollment in Affordable Care Act (ACA) marketplaces reached 11.8 million for 2018 – about 3.7 percent less than in 2017 — enrollment in states that have more control over their marketplaces grew by 0.2 percent. Meanwhile, enrollment fell by 5.3 percent in states that use the federally-facilitated marketplace, according to data released by […]

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    February 13, 2018 | Filed under: Front Page, State Health Policy Blog, State Refor(u)m
  • State Health Policy Blog

    Earlier this year, the U.S. Supreme Court’s decision in Gobeille v. Liberty Mutual dealt a blow to the 18 existing state-run all-payer claims databases (APCDs) by holding that ERISA prevents states from compelling self-funded insurers to report to their data systems. In response to the Court’s decision, a number of state APCDs and/or payers have […]

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  • State Health Policy Blog

    On April 25, the Centers for Medicaid and Medicare Services (CMS) released a long-awaited final rule that updates the regulations for managed care organizations in the Medicaid and Children’s Health Insurance Programs (CHIP). These new requirements represent the first major updates to Medicaid and CHIP managed care since 2002. In the intervening years, the percentage […]

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  • Publications

    States are significant purchasers of health care for Medicaid, inmates in correctional facilities, and public employees. Despite considerable efforts to maintain affordability, drug pricing continues to vex state budgets. While Medicaid is the largest single health expenditure in state budgets, spending on health care for public workers including state employees and retirees, legislators, judicial employees, […]

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  • As described in a recent NASHP blog, the Supreme Court’s decision in Gobeille v Liberty Mutual, which denied the state’s ability to mandate claims submission from self-funded ERISA health plans, may have started us down a slippery slope.  In light of this new approach to what state requirements are preempted by ERISA, the Supreme Court asked […]

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    April 6, 2016 | Filed under: Charts, Payment Reform, State Refor(u)m
  • State Health Policy Blog

    Engaged in multi-payer payment reforms? Seeking information about the cost of care? About the rate of opioid prescribing? Assessing carriers to generate needed revenue to support state activities like vaccines for children? You might soon hit a federal stoplight. The Supreme Court’s recent decision in Gobeille v Liberty Mutual, which denied the state’s ability to […]

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  • States are increasingly looking at housing as a component of health and well-being, particularly for individuals who are homeless or at risk of becoming homeless. Numerous studies show that housing supports for certain populations can improve health and reduce hospital expenditures and other costs for state and local governments. Some states are leveraging federal health […]

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    March 29, 2016 | Filed under: Charts, Population Health, State Refor(u)m