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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!


What’s up in Montana? Enrollment numbers! Over 30,000 Montanans gained health insurance coverage during the open enrollment period – 26,000 through the individual insurance Market and 8,700 through Medicaid -- cutting the uninsured rate from 20% to 17%! Check out more health reform news with KidsWell’s state-by-state highlights below!

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Implementation and Opposition

  • Arkansas: Senator Indicated Intent to File Legislation to Pursue Innovation Waiver Sooner

    Senator Sanders (R), one of the champions of Arkansas’s Private Option, indicated that he plans to file legislation during the 2015 legislative session to allow Arkansas to pursue a Section 1332 waiver, reported the Times Record. Section 1332 waivers, a new type of innovation waiver authorized under the Affordable Care Act, become an option for states beginning in 2017, but Sanders is hoping that Congress will make the waiver authority available  sooner. Sanders has not yet indicated what type of flexibility he anticipates the state would pursue under the 1332 waiver.
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  • California: Medicaid Agency Outlined Plan to Address Application Backlog

    The Department of Health Care Services (DHCS) released a letter to the Centers for Medicare and Medicaid Services (CMS) outlining a plan to address the state’s Medi-Cal application backlog (California’s Medicaid program). The letter described the causes of the state’s current backlog of 600,000 Medi-Cal applications and outlined a plan to address it. The letter also described the state’s efforts to proactively inform consumers who are in the backlog about temporary coverage options. The state developed the plan in response to a request from CMS.
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  • Idaho: Marketplace Executive Director and Operations Project Manager Both Leaving the Marketplace for New Opportunities

    Amy Dowd has announced she is stepping down as Your Health Idaho's Executive Director. Ms. Dowd has accepted the position of CEO for the New Mexico Marketplace and will work with the Marketplace on a transition plan. Alberto Gonzalez, Operations Project Manager, has also chosen to pursue an opportunity outside of the Marketplace with a consulting firm in the state.
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  • Maryland: Board Reviewed Marketing and Outreach Plan

    The Maryland Health Connection Board reviewed the Marketing and Outreach plan for the coming open enrollment period. Maryland will conduct a statewide survey to inform consumer messaging and begin an advertising campaign in November 2014 that includes traditional forms of media as well as region targeted enrollment events, internet search engine marketing, and social media. The Board also received an update that transitions implementation operations are on schedule to have the online portal ready for open enrollment.
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  • Minnesota: MNsure Board Received IT System Update From Lead Contractor Deloitte

    The MNsure Board of Directors discussed IT priorities that need to be addressed prior to the next open enrollment period, which include fixes to change in circumstance functionality and Medicaid and Marketplace renewals. Lead contractor Deloitte led a presentation on the issue that provided: an assessment of MNsure’s current products and system architecture; a map of MNsure’s IT system key challenges; and observations of progress. Full versions of Deloitte’s technical assessment and program and project management assessment submitted to the state were made available. The MNsure Board additionally discussed a policy statement proposing design changes to MNsure’s consumer assistance program; recommendations from the Small Business and Advisory Committee on data collection; and updated enrollment metrics.
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  • Montana: Insurance Commissioner Released Data Showing 30,000 Net Increase in Insured from Open Enrollment

    During open enrollment, approximately 30,018 Montanans gained health insurance coverage according to data released by Insurance Commissioner Monica Lindeen (D). Commissioner Lindeen’s office obtained enrollment figures by conducting a survey of insurance companies. Approximately 26,429 individuals purchased coverage in the individual market, of whom about 5,150 had previously had coverage through the small group market. An additional 8,739 individuals obtained Medicaid coverage.
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  • Rhode Island: Health Insurance Commissioner Approved 2015 Premiums

    Rhode Island’s Health Insurance Commissioner, Kathleen Hittner, announced 2015 premium rates for individual, small and large group coverage with lower premium increases than requested by most insurers. Commissioner Hittner approved single-digit increases for three of the State’s insurers and a decrease for one, and cited the efforts of the State-based Marketplace, HealthSource RI, as contributing to next year’s increased competition and plan choice in the individual market.
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  • Utah: Legislative Health Reform Task Force Discussed Updates to Medicaid Expansion Plan and Medicaid Coverage Gap

    The Legislative Health Reform Task Force met to discuss updates to Governor Herbert’s (R) Medicaid expansion initiative, known as the Healthy Utah Plan. As part of this discussion, the task force considered a new report from the University of Utah that estimated approximately 75 percent of Utahans earn less than 100 percent FPL (77,127 of the 103,124) would be served by the expansion proposal. These findings conflict with previous state estimates of 54,000, according to the Salt Lake Tribune. The task force additionally discussed: recommendations as to whether employers with 51 to 100 employees could participate in the SHOP Marketplace, Avenue H, starting in 2015; a letter to the U.S. Department of Health and Human Services (HHS) requesting they address Marketplace implementation issues raised by Utah issuers; recommendations from the task force’s Behavioral Health workgroup including the integration of physical and behavioral health in the State Innovations Model Grant due to HHS July 21; and follow-up from its May discussion on Utah’s Premium Partnership for Utah Insurance.
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  • Washington: State Legislature’s Joint Select Committee on Health Care Oversight Received Updates on Health Benefit Exchange, Medicaid Program and Office of Insurance Commissioner

    The Washington State Legislature Joint Select Committee on Health Care Oversight held their annual meeting on July 17, 2014, to receive updates from the Health Benefit Exchange, the Health Care Authority (state Medicaid program), and the Office of the Insurance Commissioner.

    • The Health Benefit Exchange presented an overview of the 2013-2014 open enrollment period, including enrollment figures and lessons learned, as well as projected enrollment figures for the 2014-2015 open enrollment (148,000 for November 2014 and 233,000 for March 2015), and an action plan to address invoice and payment issues. The Exchange also presented their draft 2015 budget, being developed to inform a supplemental and biennial budget request to the legislature, along with anticipated 2015 funding sources and a list of required and not required operational components; among the not required components were outreach and marketing, referrals to Medicaid, and consumer decision/shopping tools.
    • The Health Care Authority presented updates on Medicaid expansion progress and success factors, the state’s application for a CMMI State Innovation Models (SIM) testing grant and the associated state-level Communities of Health planning grants, and Medicaid Managed Care FY2012 costs ($3.6 billion in federal and state funds) and forecasts for FY2015 ($4.1 billion, due to increased caseload, Hepatitis C treatment and state health care innovation plan implementation).
    • The Office of the Insurance Commissioner presented the status of 2015 Exchange plan review, including the number and types of plans offered, next steps and innovations in plan design in 2015. 
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  • Wisconsin: State Provided Update on Entitlement Reform Enrollment

    Of the nearly 63,000 individuals who were expected to transition from Medicaid to Marketplace coverage under Governor Walker’s “Entitlement Reform” plan, nearly 25,000 actually selected a Marketplace plan. The other 35,000 individuals were expected to transition to a Marketplace plan under Entitlement Reform because they no longer qualified for Medicaid, were unaccounted for, according to a Department of Health Services press release.
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Federal News

  • Congressional Budget Office Lowered Estimate of Growth in Federal Spending on Health Care

    The growth of federal spending on health care programs will decline as a proportion of the overall economy, according to the Congressional Budget Office’s annual 25-year forecast. The latest revision reduces CBO’s 10 year spending estimate on Medicare, Medicaid, and other health programs by $1.23 trillion, and estimates savings of $250 billion a year by 2039.
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  • Kaiser Family Foundation Survey Found More than 28,000 Assisters Helped 10.6 Million People During ACA’s First Open Enrollment Period

    More than 28,000 assisters helped 10.6 million people during the ACA’s first Open Enrollment period, according to a new survey released by Kaiser Family Foundation. The survey, which examines experiences of ACA Assister Programs across states, offers the first nationwide assessment of the type and number of sssisters, as well as the nature of consumer needs throughout Open Enrollment. Among the findings, the survey shows that 80% of consumers who sought help did so because they did not understand the ACA or health insurance fundamentals, and 64% of Assister Programs reported spending between one and two hours helping each consumer.
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  • Two U.S. Appeals Courts Issued Contradictory Rulings on Subsidies in States using the Federal Marketplace

    On July 22, the U.S. Court of Appeals for the D.C. Circuit ruled that the government could not subsidize healthcare premiums for people living in States that utilize the Federal Marketplace, The 2-to-1 decision would eliminate financial assistance to millions of people who gained coverage through the Federal Marketplace and were determined eligible for subsidies. Rejecting the decision, the White House said the Department of Justice intended to request that the entire appeals court rehear the case.

    Just hours later, the U.S. Court of Appeals for the 4th Circuit in Richmond issued an opposing ruling, deciding unanimously that subsidies could be used to obtain coverage through any of the Marketplaces, including the Federal Marketplace. With the federal appeals courts split, the issue could end up at the Supreme Court.
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Other Public Coverage News

  • California: Article Reported Lower Provider Participation in Medicaid

    Healthy Cal reported that 25 percent fewer physicians registered to participate in Medi-Cal (California’s Medicaid program) compared to last year. The total number of Medi-Cal providers dropped from 109,000 last year to 82,605 this spring. The article noted that some providers were removed from the program due to failing to meet Medi-Cal’s application requirements or due to not billing for Medi-Cal services in the previous year.
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  • Minnesota: State Medicaid Reform Effort Delivered $10.5 Million in Savings First Year of Operation

    Governor Dayton (D) announced that the Integrated Health Partnership (IHP) initiative consisting of six health care providers serving 100,000 low-income Minnesotans spent $10.5 million less than projected in the first year of operation. The IHP, a key component of a $45 million federal State Innovation Model (SIM) grant Minnesota received for health care reform in February 2013, implemented new payment models that prioritize high-quality care and reward providers for achieving established goals. Preliminary results additionally demonstrate that this approach is producing a higher quality of care at a lower cost. The IHP has expanded this year to include three additional providers and now serves 145,000 Minnesotans through the state’s Medicaid program.
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