State Resources

Advanced Premium Tax Credits (APTCs) are part of a financial assistance program established by the Affordable Care Act that can be used to help lower the costs of premiums for individuals with incomes between 100-400 percent of the federal poverty level. Outreach and education on this complex benefit will be crucial to the success of the program. The following are a collection of resources that states have released to inform consumers about APTCs.

This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information.  The 2013 survey included almost three thousand interviews with non-federal public and private firms. It found that annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, with workers on average paying $4,565 towards the cost of their coverage.

The need to readmit a patient to the hospital soon after discharge can be an indicator of poor care coordination. Hospital readmissions are also extremely costly to the health system overall. Commonwealth Fund–supported researchers identified several strategies that hospitals could use to lower their 30-day readmission rates, among them: partnering with community physicians or physician groups, making nurses responsible for medication reconciliation, and arranging follow-up appointments before leaving the hospital.

New York's Department of Financial Services (DFS) released its approved premium rates for the insurers planning to offer coverage in the state’s state-based marketplace.

This module’s primary purpose is to act as a pre-requisite training to the enrollment assistance trainings required for Community Partner Employees to become certified Application Assisters by Cover Oregon.

 Access Health CT released a draft of its navigator and in-person assistor training course syllabus.

State health insurance exchanges have unique strategies for certifying health plans for people to purchase through the exchange beginning on October 1, 2013. Some exchanges plan to selectively contract and negotiate prices with plans; others plan to add standards for plans beyond the federal requirements; and others are accepting all plans that meet the federal requirements. This chart highlights information about state approaches to qualified health plan certification, providing key insights about state exchanges’ approach to certification in the first few years of exchange operations.

Policy experts predict that small employers, especially those with younger and healthier employees, will increasingly establish “self-funded” health plans, leaving the traditional fully-insured market to obtain lower premiums and avoid market reforms under the Affordable Care Act. Through interviews with stakeholders in 10 study states, this paper describes factors that may influence whether and how extensively this change will occur. It also shows that states have minimal data on this potentially growing market, but they would be well served to improve their monitoring efforts so they can identify any increases in small group self-funding and resulting adverse selection, and respond appropriately.

The State of West Virginia issued this Request for Proposal for those interested in providing in-person assistance services and oversight for the federally administered West Virginia Health Benefit Marketplace.