Coverage

Medicaid Managed Care Rule: Improving the Enrollment Experience

In April, the Obama administration issued sweeping new standards to guide the operation of state Medicaid managed care plans. The new rules are a big deal in part because they affect so many people: T...

Brokers and Agents and Health Insurance Exchanges

Health insurance brokers and agents can play an important role in health insurance marketplaces by helping consumers shop for and enroll in health coverage. But brokers and agents may not always act i...

Medicaid Managed Care Rule: Quality Ratings and Delivery System Reforms

This is the second in a series that looks at what advocates should know about the newly released standards for Medicaid managed care plans. The first analysis explained changes to the enrollment pro...

Talking about the Individual Mandate

In June 2012, the Supreme Court's decision on the Affordable Care Act ruled that the penalty for states that don't expand Medicaid is unconstitutional. By removing the penalty, the court's decision ch...

Medicaid Managed Care Rule: Network Adequacy Standards

Recently the Obama administration released standards for the operation of Medicaid managed care plans. This is the final analysis in a series looking at what advocates should know about the new standa...

How the Supreme Court’s Decision Affects Medicaid and the Affordable Care Act

Medicaid Managed Care Rule: What Advocates Should Know

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. ...

The Trump Administration Marketplace Rule—and How States Can Respond

In April 2017, the Department of Health and Human Services (HHS) finalized a rule creating sweeping changes to health insurance marketplaces. Many of these changes could make it more difficult or more...

Worry No More: Americans with Pre-Existing Conditions Are Protected by the Health Care Law

The Affordable Care Act protects all Americans from being denied health insurance, charged more in premiums, or sold a policy that excludes coverage for necessary treatments based on pre-existing cond...

Per Capita Caps in Medicaid: Shifting Health Care Costs to the States

Changing Medicaid to a per capita cap payment system would radically change the way the program has been funded since 1965. It’s a change that would shift costs and risks to states and children, sen...