Insurance Market Reform

The Labor Department released its survey to help HHS determine what is an "essential benefit" which will determine what insurers will have to cover in the state exchanges. The study mainly looked at large employer benefits.

Michigan is adding two more health insurance plans to its high risk insurance pool in an effort to cover more uninsured individuals with chronic illnesses. The new plans have lower premiums and higher deductibles compared to the plans currently offered, but all plans will offer the same coverage.

On November 17, State Coverage Initiatives hosted a webinar that explored the pros and cons of the Basic Health Program. This option under the Affordable Care Act lets states provide their low-income residents ineligible for Medicaid with coverage that may be more affordable than subsidized health plans in the exchange.

Value-Based Purchasing and Consumer Engagement Strategies in State Employee Health Plans, a SCI report written by Bailit Purchasing, LLC, is a purchaser guide that lays out concise descriptions of two principal means for improving the value that states can gain through administering State Employee Health Plans (SEHPs): value-based purchasing and consumer engagement. 

Rising insurance premiums and shortages of primary care physicians are two trends that have focused state policymakers’ attention on the functioning of their local health care marketplaces. In addition, many state officials have expressed concern over the unprecedented number of hospital mergers during the last decade.