Exchange directors, the Centers for Medicare and Medicaid Services, and insurers have an enormous opportunity to help consumers choose the plan that is right for them and make the enrollment process more efficient by improving the display of plan information on marketplace websites.
Despite a divided Congress in Washington, many state policymakers around the country, supported by advocates, reached across the aisle to make needed improvements to the health care system.
Governors, lawmakers, and regulators made strides to expand health coverage, protect consumers in the insurance market, and address rising prescription drug prices. Here are some of the highlights of the 2016 sessions through June 1 and the Families USA allies whose advocacy was critical to making them happen.
Recently the Obama administration released new standards governing Medicaid managed care plans. These managed care rules haven’t been updated since 2002, and a lot has changed in the past 14 years. There are currently over 72 million people enrolled in Medicaid, and three-quarters are enrolled in managed care.
The new federal rules, which states must implement by 2018, are a step in the right direction toward ensuring that people with a Medicaid managed care plan can see the right health care provider when they need to.
This year we launched a campaign to enact standards to address this issue at the state and federal level. Our campaign supports the work of advocates in many states, including close partnerships with advocates in Georgia, Maryland, and Colorado. Read about the progress those states are making!
A year from now, consumers shopping for insurance on HealthCare.gov may be happy with some new plan choices and better protections for 2017. Earlier this month, the federal government released new proposed requirements for plans sold on the health insurance marketplaces. We applaud the government for encouraging insurers to sell “standardized plan” designs that cover more health care services before consumers meet their deductibles. But we urge the government to go further.
In November, the National Association of Insurance Commissioners (NAIC), the organization composed of insurance regulators from every state in the nation, will finalize a model law to help states ensure that consumers can get access to the right health care, at the right time, without unreasonable delay. Dubbed the Network Adequacy Model Act, this draft bill is designed to be used by any state to enact provider access standards for private health insurance plans.
Accurate health plan provider directories are critical to ensuring that coverage works for consumers. Health plans and policymakers can take steps to reduce the prevalence of inaccuracies in provider directories.
This checklist is designed to help advocates and consumers understand who makes decisions about private insurance in their states. It suggests questions to ask the insurance department, state legislators, and others.
Communities of color continue to face a limited availability of health care providers and facilities. By including at minimum these seven features in their provider networks, insurers can help consumers in communities of color gain access to timely, high-quality, language-accessible, culturally competent health care.