Insurance Coverage and Medical Care

Three speakers provided a look at major health policy issues, with emphasis on state policy options available in 2017. Michael Williams discussed health equity and disparities and how they drive health care costs. Dania Palanker reviewed health insurance exchanges and provided data for the 2016 open enrollment period. She also looked at the major policy proposals being considered by the incoming Trump administration. Ameet Sarpatwari analyzed pharmaceutical drug pricing and state policy recommendations recently developed by a work...

The Medicaid Policy Academy provided attendees an opportunity to meet with federal government officials and other Medicaid experts to develop a deeper understanding of program rules and requirements. With the upcoming change of administration in Washington, D.C., speakers and attendees discussed how policy changes might impact states' Medicaid programs. 

Presentation slides and audios from the session are posted, as well as speaker biographies. 

In 2016, five states enacted legislation designed to mitigate a controversial health insurance procedure known as step therapy, which requires patients to try less expensive, often generic medications before being approved for costlier treatments. With the growing availability of generics step therapy, alongside prior authorization and benefit tiers, has emerged as a popular cost savings tool for private insurers, as well as Medicaid and Medicare programs.

Insurance companies and...

CSG Midwest
Starting in January, states that chose to expand their Medicaid programs under the Affordable Care Act will have to begin paying part of the associated costs, and three of the Midwest’s expansion states say they will rely at least in part on revenue from their taxes on health care providers.

Seema Verma, a health policy consultant from Indiana, has been picked by President-elect Donald J. Trump to direct the Centers for Medicare and Medicaid within the U.S. Department of Health and Human Services according to Politico.

Health policies and programs in the states face an uncertain future with the election of Donald J. Trump. During his campaign he vowed to repeal the Affordable Care Act.

Currently 73 million Americans are enrolled in the Medicaid program, a federal-state partnership program for which the federal government pays 62 percent of total expenditures. A Medicaid block grant, one proposal under discussion, might provide the states more flexibility but also might transfer more financial responsibility, especially in the long term, to the states. 

Today's Stateline article by Christine Vestal highlights three states--California, Maryland and New York--that are moving to use Medicaid reimbursement policies to facilitate more counseling for substance use addicts who are in medication-assisted treatment. 

An article in today's Kaiser Health News suggests that a President Trump could dismantle much of the Affordable Care Act without Congressional action. For instance, just a stroke of his presidential pen could eliminate subsidies to persons between 100 and 250 percent of the poverty level. On the other hand, Clinton's proposals to support and build on the ACA would seem to require Congressional action. 

Voters in Colorado will head to the polls this November not only to cast their ballots for the next president of the United States, but also to determine whether they will become the only state in the nation to adopt single-payer health care.

More than 20 legislators from 16 states--many of them in key leadership positions on health or budget committees that deal with Medicaid in their home states--attended a CSG policy academy in Washington D.C. on September 21-23, 2016, to learn how states are making reforms in their Medicaid program that pursue the health "triple aim": improving the quality of care for individuals, improving the health of populations, and reducing per capita costs of health care.

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