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ACA Public Health Insurance Exchanges/Medicaid



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Public Option Coming to Washington State by 2021
Last week, Washington's legislature passed a bill (SB 5526) that Governor Jay Inslee (D) is expected to sign that would require the WA Health Care Authority to contract with one or more insurers to offer a public plan on the exchange by 2021.
May 9, 2019
Health Insurance Exchanges Year 6 Results, Medicaid Expansion and Looking Ahead to 2020 – What Employers Should Know
This webinar focuses on the year 6 enrollment results of the health insurance exchanges and changes in Medicaid expansion. Additionally, we will look ahead to what employers should expect for the 2020 exchange plan year.
Apr 30, 2019
Exchange Enrollment Dips 3%, Democrats Pivot to Bolstering ACA
In late March, CMS reported that the number of people selecting plans for the 2019 exchange open enrollment period was down 3% from last year (11.4 vs. 11.8 million).
Apr 5, 2019
Working for You in Washington – March 6, 2019
The Business Group's recent policy initiatives include meeting with the CMS Administrator to advance alternative payment and delivery models for health care, advocating employers' views on surprise billing legislation on the hill and at the White House pushing again to repeal the ACA excise tax on employer plans, meeting with the Department of Labor on Mental Health Parity requirements and sending a letter to HELP Committee Chair on legislation and administration action to control health care costs.
Mar 6, 2019
CMS Promotes More State Flexibility to Reform Individual/Small Group Market under ACA
Late last month, CMS unveiled a fact sheet and a discussion paper that provides waiver concepts to the states, giving them more federal flexibility under ACA Innovation Waivers.
Dec 13, 2018
Health Insurance Exchanges Year 6 Details and Medicaid Expansion Update – What Employers Should Know
During this webinar, Business Group staff provides the latest details on the health insurance exchanges in year 6 including: overall trends in premiums and plan competition, a closer look at 5 key states, comparisons between exchange coverage and employer-sponsored coverage and more. Additionally, we will cover the latest developments in Medicaid expansion and its potential impacts on employer plans.
Nov 30, 2018
2019 Public Exchanges Chart with State-Level Premium and Insurer Information
A continuously updated chart with the latest details on the public health insurance exchanges for 2019 including insurers and premiums.
Nov 29, 2018
Spreadsheet of 2019 State and County Level Health Insurance Exchange Carriers and Premiums
This spreadsheet includes 2019 details of health insurance exchange carriers, premiums, cost-sharing information and more for 39 states.
Nov 29, 2018
Medicaid Expansion Ballot Measures Pass in Idaho, Nebraska and Utah
On November 6th, voters in Idaho (60%), Nebraska (53%) and Utah (53%) passed measures to expand Medicaid to more people as permitted under the ACA.
Nov 20, 2018
House Win for Democrats Impacts Health Policy Agenda in Washington
As the results of the 2018 election are finalized, Democrats have regained control of the House, while the Senate will stay in Republican hands. Democrats highlighted health care as an issue in the election and will likely make it a priority on their agenda
Nov 8, 2018
Administration Gives States More Flexibility for Individual/Small Group Market Reform Waivers under ACA
Recently, HHS and Treasury issued guidance that gives states more flexibility in benefit design and loosens the affordability requirement for Innovation Waivers, which permit alternatives to the state exchange requirements in the individual & small group markets under the ACA.
Oct 31, 2018
Medicaid Expansion on the Ballot in Idaho, Montana, Nebraska and Utah
On November 6th, voters in Idaho, Montana, Nebraska and Utah will cast ballots on whether to expand Medicaid to more people as permitted under the ACA.
Oct 31, 2018
CMS Approves More States' Plans to Stabilize Exchanges; 2 Add Taxes Impacting Employers
Recently, CMS approved 4 states' plans to create reinsurance programs to stabilize their exchanges and reduce premium hikes by offsetting insurer costs for people with high claims.
Sep 7, 2018
CMS Takes Positive Step toward Stabilizing the State Exchanges
Last week, CMS issued a final rule reinstating $10.4 billion of insurer-funded risk-adjustment payments for 2017, which were suspended in early July due to a February court decision.
Aug 3, 2018
Signs of More Instability Ahead for State Exchanges in 2019
Last week, CMS announced that it would halt collecting and distributing $10.4 billion of insurer-funded risk-adjustment payments for 2017, which had been expected to be allocated to plans in the fall of 2018.
Jul 13, 2018
Virginia Becomes 33rd State to Expand Medicaid under the ACA
Yesterday, Virginia Gov. Ralph Northam signed a budget resolution that will expand Medicaid to individuals earning up to 138% of the federal poverty level (FPL) by no later than January 1, 2019.
Jun 8, 2018
Approved and Pending State ACA Innovation Waivers with Employer Impacts
This chart tracks state actions on ACA innovation waivers that impact employer-sponsored coverage.
May 11, 2018
Louisiana Explores Taxing TPAs and Insurers to Fund Exchange Reinsurance Program
Louisiana's Department of Insurance is seeking to establish a reinsurance program in 2019 to stabilize exchange premiums funded by taxes on third party administrators (TPAs) and insured plans.
May 11, 2018
Health Insurance Exchanges Year 5 Results, Medicaid Expansion and Looking Ahead to 2019 – What Employers Should Know
This webinar builds upon our November 2017 exchanges webinar, with a particular focus on year 5 exchange enrollment results and changes in Medicaid expansion. Additionally, we will look ahead to what employers should expect for the 2019 exchange plan year.
Apr 27, 2018
Chart - 2018 Public Exchanges with State-Level Premium and Insurer
A continuously updated chart with the 2018 latest available details on the public health insurance exchanges including insurers and premiums.
Apr 26, 2018
Exchange Enrollment Relatively Stable Despite Large Premium Increases; CMS Grants Increased State Flexibility
Earlier this month, CMS reported that exchange enrollment for 2018 remained stable with only a 3% reduction from 2017 to 2018 (12.2 to 11.8 million enrollees), despite average premium increases of 37% for silver plans (70% AV plans).
Apr 13, 2018
Senators Again Push for Bill to Stabilize Exchanges
Senators Again Push for Bill to Stabilize Exchanges
Mar 20, 2018
2018 State Exchange Enrollment Down 3.7% from 2017
As we await official tallies from the federal government, the National Academy for State Health Policy indicated that 11.8 million people selected a plan in 2018 vs. 12.2 million in 2017, a 3.7% reduction.
Feb 14, 2018
Congress Weighs Reinsurance Programs to Help Stabilize Exchange Premiums
Senator Susan Collins (R-ME) and Representative Ryan Costello (R-PA) are pushing for federal funding for reinsurance programs to help stabilize exchange premiums.
Feb 1, 2018
More States Could Expand Medicaid after Administration Permits Work and Community Service Requirements
Earlier last month, CMS issued guidance allowing states to apply for Medicaid waivers to encourage working-age, non-pregnant and non-disabled beneficiaries to meet work or community engagement requirements (skills training, education, job search, volunteering or caregiving) in order to maintain benefits.
Feb 1, 2018
What's Next? 2018 Health Policy Outlook
This webinar will cover the outlook for the future of the excise tax on employer plans, other ACA taxes, the employer mandate, stabilization of the individual market, drug policy, and other areas. We will examine the alternatives and prospects for action on these and other health care issues by Congress and the Administration and the potential impacts.
Jan 26, 2018
Health Insurance Exchanges Year 5 Details: What Employers Should Know
During this webinar, Business Group staff provides the latest details on the health insurance exchanges in year 5 including: overall trends in premiums and plan competition, a closer look at 5 key states, comparisons between exchange coverage and employer-sponsored coverage and more.
Nov 17, 2017
Spreadsheet of 2018 State and County Level Health Insurance Exchange Carriers and Premiums
This spreadsheet includes 2018 details of health insurance exchange carriers, premiums, cost-sharing information and more for 39 states.
Nov 9, 2017
Senate HELP Committee Leaders Reach Deal on Stabilizing Exchanges; Bill's Future Uncertain
Earlier this month, Senate HELP Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA), along with 22 other Republican and Democrat Senators, introduced a bill that could help stabilize the exchanges by assuring federal cost-sharing reduction payments for 2 years.
Oct 31, 2017
Senate HELP Committee Holds 4 Hearings on Stabilizing Public Exchanges; Seeks to Pass Legislation
Since returning from August recess, the Senate HELP Committee has held 4 hearings on stabilizing the exchanges featuring state insurance commissioners, governors, insurers, providers, actuaries, and current and former government officials seeking legislative consensus.
Sep 15, 2017
Governors John Kasich (R-OH) and John Hickenlooper (D-CO) Release Proposal Calling for Exchange Stabilization
Yesterday, Governors John Kasich (R-OH) and John Hickenlooper (D-CO) joined by governors from Alaska, Louisiana, Montana, Nevada, Pennsylvania and Virginia sent a proposal to House and Senate leadership with recommendations to stabilize the exchanges.
Sep 1, 2017
Congress to Consider Moves to Stabilize the Exchanges in Wake of Senate Failure to Pass ACA Changes
Following the collapse of Senate attempts to change the ACA, Senators plan on holding hearings on stabilizing the exchanges and may still consider changes to the ACA.
Aug 9, 2017
CMS Makes Changes Aimed at Shoring Up Exchanges as More Insurers Plan to Leave
Last Thursday, CMS issued a final rule aimed at stabilizing the exchanges. Meanwhile, in a sign of continuing instability on the exchanges, more insurers indicated that they will not participate in the exchanges in 2018.
Apr 19, 2017
Latest Details of Private Exchanges
This chart tracks the latest details on the private exchanges, including: names and websites of private exchanges, target market, number of participating employers and total number of covered lives, participating carriers, other products offered and structure.
Feb 17, 2017
What Your CEO is Reading - Trump and ACA
This newsletter highlights a Washington Post article about the future of the Affordable Health Care Act (ACA) under the Trump administration.
Nov 11, 2016
What Your CEO is Reading - State Exchange Premiums
This newsletter highlights a New York Times article about the cost of state exchange premiums versus that of employer-sponsored coverage.
Oct 27, 2016
Declining Number of Carriers Participating in Public Exchanges
This Numbers You Need highlights the findings of an analysis of carrier participation in the public exchanges.
Oct 11, 2016
Consumer Groups Want CA to Scrutinize Exchange Premium Increases
Recently Consumers Union complained to the CA Department of Managed Healthcare that two insurers on the state’s exchange were unjustly raising premiums and using prescription drug prices as an excuse.
Sep 22, 2016
More Large Insurers Pull Back from Public Exchanges Due to Losses
After losing $200 million during the second quarter of 2016 and expecting it to grow to $300 million by year’s end, Aetna recently announced that it will reduce its 2017 public exchange footprint.
Aug 25, 2016
CMS Proposes Changes to Strengthen Public Exchanges
In the midst of higher than expected health care utilization, increased premiums, fewer insurers (especially in rural markets) and poor risk profiles of public exchange enrollees, CMS recently announced new policies aimed at stabilizing the exchanges’ risk pools.
Jun 17, 2016
More Guidance on Exchange Employer Appeals Process
Recently, federal agencies issued guidance on the Federally-Facilitated Marketplaces’ (also known as Exchanges) appeals process for employers that receive notices of employees being eligible for premium tax credits to subsidize Exchange coverage.
Apr 11, 2016
California Exchange Board May Require Insurers to Remove Poor Performing Providers by 2019
California’s exchange (second largest exchange by enrollment) is considering a number of new requirements for insurers in 2017 and beyond.
Mar 30, 2016
Status of the Public Exchanges
This Numbers You Need chart details the number of people in the public exchanges, the types of plans they are selecting, and common cost-sharing provisions.
Mar 30, 2016
Chart: State Actions Implementing Federal Health Reform
A chart tracking state efforts implementing federal health reform including creating Health Insurance Exchanges, expanding Medicaid and establishing the Basic Health Program.
Jan 20, 2016
ACA Key Plan Effective Dates for 2013-2018
This chart summarizes Affordable Care Act compliance deadlines applicable to group health plans for 2013-2018.
Aug 21, 2015
Private Health Exchange Case Study: Hallmark Cards
This webinar presentation covers: • An update on the private health exchange marketplace and how models are evolving; • Why Hallmark decided to adopt a private health exchange strategy; • How to determine and evaluate if an exchange strategy is right for your organization; and • Best practices for a successful transition to a private health exchange
Jul 27, 2015
U.S. Supreme Court Upholds ACA Premium Tax Credits on Federal Exchanges
The U.S. Supreme Court found that individuals who purchase health insurance through federally-facilitated exchanges can continue to receive premium tax credits to subsidize that coverage.
Jun 25, 2015
California’s Exchange Caps Specialty Drug Cost Sharing
Last week, the California state exchange approved caps on out-of-pocket expenses for specialty pharmacy medications beginning in 2016.
Jun 2, 2015
Employers’ Interest in the Public Exchanges for Active Employees
This Numbers You Need chart contains the latest information on employers’ interest in public exchanges.
Apr 16, 2015
Making the Move to a Private Exchange: The Mercer Marketplace and VCA Inc. Case Study
This webinar focuses on VCA's move to a private exchange and the early benefits of VCA's move. It includes: • How private exchanges became a mainstream solution for employers of all types and sizes. • How the Mercer Marketplace has helped employers bend the trend on benefit costs. • Why VCA chose the Mercer Marketplace. • Lessons learned in year one, with a focus on early results, employee reaction and engagement.
Mar 11, 2015
CA’s Network Requirements Could Spread to Other States
California’s Insurance Commissioner issued “emergency” network adequacy requirements for (non-managed care) individual and small group plans in 2016.
Feb 5, 2015
Large Employers' 2015 Health Plan Design Survey
This year’s survey looks at the benefit offerings of 136 large employer members of the Business Group, and the changes they are making for 2015. Areas of focus include: changes due to ACA provisions, health care costs, consumerism, transparency and health improvement.
Aug 11, 2014
Large Employers' 2015 Health Plan Design Survey Chart Pack
This chart pack provides a summary of the benefit offerings of 136 large employers and the changes they are making for 2015. Areas of focus include: changes due to ACA provisions, health care costs, consumerism, transparency and health improvement.
Aug 11, 2014
Questions to Consider When Requesting Information from Private Exchanges
This document provides our members with specific questions to consider when evaluating a private exchange including company overview, profile, transition/technology/implementation, administrative profile, revenue/fees, structure/products, employee exchange experience and financial aspects.
Jul 17, 2014
Agencies Update COBRA Guidance
Recently, the Department of Labor, Department of Health and Human Services , and Department of the Treasury issued guidance (1) detailing individuals’ special enrollment rights for Exchange coverage, in reference to COBRA, and (2) providing updated COBRA and CHIPRA notices.
May 8, 2014
Narrow Networks in Today’s Health Care Climate
Looks at narrow networks in the context of today’s health care environment, and provides examples of companies using them in unique ways as part of their overall health benefits strategy.
Nov 1, 2013
Cost-Sharing Arrangements for ACA-Related Fees
The purpose of the survey was to determine how employers would share the cost of the transitional reinsurance program contributions and other ACA-related fees with health plan participants. In addition, respondents were asked if they have or will be sending out communications specific to these ACA-related fees. Fifty employers participated in this survey.
Mar 25, 2013
OPM Issues Final Regulations on Multi-State Plans for Exchanges
Recently, the Office of Personnel Management (OPM) issued final regulations implementing the Multi-State Plan Program (MSPP). These regulations provide a framework for multi-State plans (MSPs), which will become available beginning in 2014 for individuals and certain small employers through state insurance Exchanges.
Mar 12, 2013
More on HHS's Exchange Regulations under the Affordable Care Act
This Public Policy Alert focuses on HHS's final exchange regulations that set forth minimum standards for establishing and participating in Exchanges and basic standards that employers must meet to participate in the Small Business Health Options Program (SHOP).
Mar 22, 2012
HHS Issues Final Regulations Implementing Exchanges under Affordable Care Act
The Department of Health and Human Services (HHS) recently released final regulations implementing Exchanges under the Patient Protection and Affordable Care Act.
Mar 13, 2012
HHS Guidance Proposes to Let Each State Define Essential Health Benefits
The Department of Health and Human Services (HHS) issued a Bulletin outlining a proposed regulatory approach to defining "essential health benefits" under the Affordable Care Act.
Dec 19, 2011
Comments to the Director of the HHS Center for Consumer Information and Insurance Oversight Recommending HHS Require Transparency of Provider-Specific Price and Quality Information from Exchange Plans
The National Business Group on Health sent a letter to the Department of Health and Human Services to ensure the capability of the exchanges and exchange boards to meet the growing consumer demand for provider and facility-specific price and quality information.
Nov 21, 2011
Department of Health and Human Services (HHS) Releases Initial Rules Giving States Flexibility to Establish Insurance Exchanges
The Department of Health and Human Services (HHS) released initial rules which offer the states flexibility in establishing insurance exchanges that includes some important details for employers; however, other details await future guidance.
Jul 21, 2011

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