The Scoop: August 16, 2019 Version


On this version:

This week, customers in additional than two dozen states can anticipate excellent news – both within the kind codified shopper protections, via expanded insurer participation in state marketplaces and or via completely prolonged open enrollment durations. Right here’s the rundown:

Delaware codifies ACA shopper protections into state legislation

Delaware has enacted laws to codify varied ACA shopper protections into state legislation, making certain they’ll stay in impact in Delaware no matter modifications on the federal stage. Delaware’s new legislation contains provisions comparable to guaranteed-issue protection, mandated important well being advantages, limits on out-of-pocket prices, guidelines pertaining to how insurers can set charges, and a ban on lifetime and annual profit limits. Delaware additionally enacted separate laws that provides grownup dental protection to the state’s Medicaid program.

Insurers enter market or increase change participation in 15 states

For the second 12 months in a row, insurer participation within the ACA’s particular person market medical health insurance exchanges is rising for 2020:

Vibrant Well being is becoming a member of the change in Florida, North Carolina, Nebraska, Oklahoma, and South Carolina, and increasing their protection space in Colorado.
Anthem is rejoining the change in Nevada.
Anthem, Blue Defend of California, and Chinese language Neighborhood Well being Plan are all increasing their protection areas in California.
Celtic, Cigna, and Blue Cross Blue Defend of Tennessee are all increasing their protection areas in Tennessee.
Centene plans to increase its protection areas in Arizona, Florida, Georgia, Kansas, North Carolina, Ohio, South Carolina, Tennessee, Texas, and Washington (Centene already affords protection in all of those states — typically below the title Celtic or Ambetter — however may have plans accessible in additional areas in every state in 2020).

Montana accepts public feedback on Medicaid work requirement

Montana plans to hunt federal approval for a Medicaid work requirement, and is accepting public feedback on the proposal till August 23. Learn extra about Montana’s Medicaid growth program.

4 states enact new guidelines for short-term well being plans

Indiana used to restrict short-term medical health insurance plans to 6 months and prohibit renewals, however that modified final month. Indiana’s new guidelines permit short-term plans to have preliminary phrases of as much as 364 days, and plans could be renewed for as much as a complete of 36 months. However Indiana can also be requiring all short-term plans to have profit caps of a minimum of $2 million.
Arizona and Oklahoma have additionally enacted laws to permit short-term plans with longer durations to be offered in these states. Arizona’s new guidelines take impact in late August, whereas Oklahoma’s will take impact in November. Each states beforehand restricted short-term plans to 6 months.
On the opposite finish of the spectrum, Maine has enacted a legislation – which takes impact in January 2020 – that requires short-term plans to terminate no later than December 31 of the 12 months during which they’re issued. Maine’s laws additionally imposes a wide range of different new restrictions on the advertising and sale of short-term plans.

Colorado affords SEP to residents with a terminating short-term plan

Colorado applied strict new guidelines for short-term well being plans in April 2019, and in consequence, there are not any short-term insurers providing plans within the state. The state has finalized a brand new particular enrollment interval, efficient September 1, 2019, that can permit folks with a terminating short-term plan (or one which has terminated since April 2019) to buy an ACA-compliant particular person market plan.

Missouri activity drive will encourage insurers to increase protection areas

Final month, Missouri’s governor created a activity drive designed to provide you with progressive options for enhancing Missouri’s insurance coverage market. The objective is to enhance affordability and entry to care, and to encourage insurers to increase their protection areas, significantly into rural areas of the state. Relying on what the duty drive recommends, Missouri might submit a 1332 waiver proposal to CMS, looking for to carry progressive options to the state’s insurance coverage market.

Colorado, Rhode Island be part of problem to healthcare sharing ministries

Following go well with with a number of different states, Colorado’s Division of Insurance coverage has issued stop and desist orders for Aliera Healthcare and Trinity Healthshare. Regulators are involved that these corporations are advertising their healthcare sharing ministry merchandise in a deceptive approach, permitting customers to mistake them for ACA-compliant well being protection.
Rhode Island’s insurance coverage commissioner can also be investigating Aliera to see if the corporate has been deceptive residents.

Two states and DC completely lengthen open enrollment durations

Though open enrollment for ACA-compliant 2020 protection runs from November 1 to December 15  in all states that use and a few of the states that run their very own exchanges, California, Colorado, and DC have completely prolonged their open enrollment durations.

California: October 15 to January 15
Colorado: November 1 to January 15
DC: November 1 to January 31

Learn our 2020 Information to Open Enrollment.

Louise Norris is a person medical health insurance dealer who has been writing about medical health insurance and well being reform since 2006. She has written dozens of opinions and academic items concerning the Reasonably priced Care Act for Her state well being change updates are often cited by media who cowl well being reform and by different medical health insurance consultants.


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