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Health Reform Highlights

Welcome to KidsWell’s Health Reform Highlights! This page is updated weekly with the latest health care reform activity across the nation!


This website provides the most up-to-date, comprehensive information on children's coverage and healthcare reform implementation in all fifty states and nationwide.


To find out more about what’s happening in each state, click on State Spotlight. Go to Federal Focus for federal health care reform news and national children’s health insurance coverage data. Check out the National Snapshot maps to get fifty state comparison maps of major health reform news and trends. Finally, search the Health Reform Hub, which has over 4,000 state and federal health care reform and children’s coverage news entries!


After three and a half busy years, the KidsWell Weekly Update’s health care reform tracking effort is winding down. September 30th  will be our last weekly newsletter. It has been a pleasure monitoring state and federal health care reform implementation activity on behalf of Atlantic Philanthropies and our loyal readers. If you are looking for ongoing weekly health care reform updates we hope you will visit and sign up for our national KidsWell partners’ newsletters!

For a printer-friendly version of this report, click here.

Implementation and Opposition

  • Arkansas: GAO Released Report on Arkansas’s Private Option Demonstration

    The U.S. Government Accountability Office (GAO) released a report, criticizing the process that HHS used to assess budget neutrality in Arkansas’s Medicaid Section 1115 Private Option demonstration. Specifically, GAO believes that HHS's waiver approval process did not ensure that the demonstration will be budget neutral to the federal government. HHS disagreed with GAO’s assessment, citing the unique benefits associated with premium assistance, such as increased access to care and decreased churn, which Arkansas’s approach takes into account.
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  • Arkansas: Coalition Formed to Conduct Outreach for Marketplace and Private Option Enrollment

    Five health care organizations in Arkansas formed Arkansans For Coverage, a new coalition to educate Arkansans about their health insurance options according to UALR Public Radio. The group was formed in response to state legislation that prohibits state agencies from funding or conducting outreach for the state Marketplace and Private Option. The coalition’s budget will be approximately $300,000.
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  • Arkansas: Marketplace Board Voted to Delay Establishment of State-Based Marketplace until 2016

    Citing additional time needed to establish technology infrastructure, Arkansas’s Health Insurance Marketplace Board voted to delay the state’s full transition from a Partnership Marketplace to a state-based Marketplace from 2015 to 2016, according to the Associated Press. The delay means that individual coverage through the state-based Marketplace will not be available until 2017 although the Board is still considering establishing its SHOP Marketplace next year.
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  • California: Medicaid Agency Director Announced Resignation

    Toby Douglas, Director of the California Department of Health Care Services (California’s Medicaid Agency), announced his intention to resign from the Department in January 2015. Douglas was appointed to the position by Governor Jerry Brown in 2011 and led the state’s efforts to expand Medi-Cal (California’s Medicaid program). Previously, Douglas served as Chief Deputy Director under Governor Schwarzenegger and held several other leadership positions within the Department.

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  • Iowa: Insurance Division Released RFP for ACA Consumer Education and Outreach

    The Insurance Division released a request for proposals (RFP) for Marketplace outreach and education for the next open enrollment period. Proposals are due on October 1, 2014 for an initial contract term running approximately from October 13, 2014 through April 1, 2015.
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  • Massachusetts: Connector Board Approved 2015 Insurance Plans and Extended Temporary Medicaid Coverage

    The Health Connector Board approved medical and dental plan offerings for the Marketplace from fifteen different insurers for the 2015 plan year. Premium rates for the approved plans will increase by 1.6 percent, about half the rate of average premium increases for insurance statewide. In addition, the Board extended temporary Medicaid coverage for nearly 300,000 people who were unable to enroll through the old Marketplace website due to technical issues. In order to avoid a large volume of individuals transitioning from temporary coverage to Marketplace plans at once, temporary Commonwealth Care coverage will now end on January 31, 2015 and temporary MassHealth coverage will now end in three waves on January 15, January 31, and February 15.
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  • Nevada: Silver State Exchange Board to Review Supported State Based Marketplace Transition Updates

    The Silver State Exchange Board met this week to discuss:

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  • Vermont: Marketplace Advisory Board Discussed Updates to Vermont Health Connect

    The Medicaid and Exchange Advisory Board (MEAB) discussed the 2016 MEA budget and a Vermont Health Connect data dashboard. The MEAB also reviewed updates on Vermont Health Connect, noting that since Optum transitioned to the lead IT vendor, there have been a 30% reduction in errors and a 25% reduction in change of circumstances backlog. Additional topics included the MEAB work group updates, the MEAB operational review, an update on the rate review process, and a proposed meeting schedule for 2015.
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  • Virginia: Governor Releases Plan to Expand Healthcare Coverage

    Governor McAuliffe announced a 10-point plan for the State to address critical healthcare needs of its population. The plan may result in an estimated 200,000 Virginians gaining health coverage through enhanced outreach efforts to enroll residents in the existing Medicaid program and in private coverage through the federally facilitated Marketplace and new coverage options for adults with severe mental illness, children of low income state workers, and providing dental benefits to pregnant women. The plan draws on $40 million remaining in the state budget and would require approval by the State legislature for renewal after the end of the fiscal year, ending July 2015.
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  • Washington: Policy Committee and Outreach TAC Discussed QHP Renewal and Outreach Activities

    The Washington Health Benefit Exchange (HBE) Policy Committee reviewed the QHP renewal and notices timeline and notices messaging, Healthplanfinder releases, and July and August 2014 customer trends on invoice and financial issues, carrier questions, the special enrollment process, and application malfunctions. The Outreach Technical Advisory Committee also met to discuss HBE budget updates, health literacy efforts and messaging, and HBE business updates on branding, approved carriers, marketing efforts, and outreach activities.
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Federal News

  • HHS Announced $60 Million in Navigator Grant Awards in Advance of Next Open Enrollment Period

    HHS announced $60 million in Navigator grant awards to 90 organizations in states operating federally-facilitated and state-partnership Marketplaces. The awards will support outreach and enrollment before during the next Marketplace Open Enrollment period, and build upon lessons learned during the first Open Enrollment period. These lessons include more robust training on individuals with complex eligibility scenarios and renewal, as well as additional reporting requirements. Navigators and other assister entities were responsible for helping 10.6 million people apply during last year’s Open Enrollment season.
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  • HHS Awarded $295 Million in ACA Funding to Expand Health Center Capacity and Access

    HHS awarded more than $295 million in ACA funds to 1,195 health centers across the country to increase access to primary care services. The funds will be used to expand capacity through hiring an estimated 4,750 new staff, expanding hours of operation, and expanding care services to include behavioral health, pharmacy, vision, and dental services.
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  • Report Found Children's Uninsurance Rate Remains Steady

    The uninsured rate for children did not change significantly in the first six months of 2014, leading researchers at the Urban Institute and Georgetown Center on Children and Families to suggest that the ACA did not significantly impact children’s coverage rates. While the uninsured rate for adults fell by four percentage points during the past year, the rate for children has remained at 7% for children over the last several years. This disparity may be due to the fact that the ACA’s coverage expansion provisions are primarily geared towards adults. Notwithstanding, the authors argue that issues around children’s coverage remain, with 55% of remaining uninsured children eligible but not enrolled in Medicaid/CHIP, and with CHIP reauthorization currently being debated in Congress.
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Other Public Coverage News

  • North Carolina: Medicaid Program Ended Fiscal Year with Funding Surplus

    The North Carolina Department of Health and Human Services (DHHS) announced the Medicaid program ended the year with $63 million in reserve funding that will be reverted to the state's General Fund. This is the first time in five years the Medicaid program did not end the fiscal year in a deficit. The state's Medicaid Director, Dr. Cummings, credited the firm Alvarez and Marsal for making programmatic changes to DHHS to create this funding surplus.
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