Expert Perspectives

Jan 12, 2021 

The No Surprises Act: Implications for States

In the waning days of 2020, Congress enacted a $900 billion COVID-19 relief package and government funding bill (H.R. 133). Included in the measure is the “No Surprises Act”, which contains new protections for consumers from surprise medical bills from out-of-network providers. The new law establishes, for the first time, comprehensive protections in the states without their own balance billing laws and for the nearly 135 million people in self-insured plans beyond the reach of state regulators. This expert perspective summarizes provisions that have particular implications for state regulators.

Jan 7, 2021 

The State of Play: Public Option at the Federal and State Level and What to Expect in 2021

Faced with significant premium fluctuation and the risk of “bare counties”, many policy stakeholders have turned to the public option as a potential tool to promote stability and affordability in the individual insurance market. Since 2017, nearly a dozen states have considered or passed legislation to study or implement a state-based public option program. Additionally, the 2020 election and transition to a new federal administration marks a pivotal point for state policymakers with interest in fostering new coverage options. An incoming Biden Administration’s support for state innovation will create new state-based coverage opportunities, even as major federal legislation is unlikely under a divided Congress. This expert perspective provides a brief overview of selected states efforts to implement a public option and highlights what to expect in a federal policy environment.

Jan 4, 2021 

Advancing Health Equity in Oregon: Building a Foundation

As health inequities continue to be exacerbated by the COVID-19 pandemic, there is concerted energy to address this topic across states. Oregon has had a longstanding focus on health equity and employed two foundational strategies that can serve as examples for other states seeking to further their health equity efforts. Oregon first developed a common language and defined what “health equity” meant in the state. The state also engaged community partners to ensure that the community voice was apparent in policy decisions on the state level. When combined, these strategies have helped Oregon develop a foundation to build and implement subsequent health equity efforts in the state.

Dec 11, 2020 

CHART Model Community Transformation Track: Value Proposition for States

The Centers for Medicare and Medicaid Services announced its latest effort to strengthen rural health care across America: the Community Health Access and Rural Transformation (CHART) Model. The CHART model will be a voluntary opportunity for rural communities to test care transformation supported by payment reform. This expert perspective reviews the key features of the model and outlines considerations for states.

Dec 4, 2020 

Audio-Only Medicaid Telehealth Policies

In response to the COVID-19 crisis, many state Medicaid agencies implemented temporary telehealth service delivery and reimbursement policies that allow for both audio/visual and audio-only telehealth modalities. As states begin to consider their longer-term telehealth policies for the period following the COVID-19 public health emergency, many are looking to continue covering and paying for limited audio-only telehealth. This expert perspective discusses the legal authority that permits states to continue to authorize Medicaid reimbursement for audio-only telehealth after the public health emergency ends.