With an eye toward the imminent King v. Burwell ruling, Delaware submits a Supported State-based Marketplace blueprint to CMS and South Carolina’s governor says the State will not establish a State-based Marketplace. In Florida, Medicaid expansion fails after a House vote.
KING V. BURWELL AND SCOTUS UPDATES:
Delaware: Health Department Submits Supported State-Based Marketplace Blueprint
In advance of the King v. Burwell Supreme Court decision, the Delaware Department of Health and Social Services submitted a blueprint to CMS to transition from a State Partnership Marketplace to a Supported State-based Marketplace (SSBM). Under the proposed blueprint, the State would use the federal government’s information technology system to support application and enrollment functions for a State-based Marketplace. The State’s submission does not require it to establish an SSBM, but ensures the option to do so.
Maine: Supreme Court Declines to Hear State’s Medicaid Maintenance of Effort Case
The Supreme Court declined to hear Mayhew v. Burwell, putting to rest Maine’s proposal to drop Medicaid coverage for low-income 19- and 20-year-olds. CMS denied the proposal in 2012, arguing that it violated the ACA prohibition on states tightening Medicaid eligibility until 2019. CMS’ denial, which the State challenged as an unconstitutional coercion, was upheld by the U.S. Court of Appeals in 2014.
South Carolina: Governor Will Not Establish State-Based Marketplace
Governor Nikki Haley (R) affirmed that South Carolina would continue using HealthCare.gov even if the Supreme Court strikes down subsidies for states utilizing the Federally-facilitated Marketplace in its King v. Burwell ruling. According to a recent Kaiser Family Foundation study, over 154,000 South Carolinians, representing 90% of those who bought plans on the Marketplace, stand to lose their subsidies if the Supreme Court rules in favor of the plaintiff.
MEDICAID EXPANSION ANALYSIS & ACTIVITY:
4.3 Million Additional People Could Enroll if All States Expand Medicaid, Reports White House
After CMS announced that 71 million individuals were enrolled in Medicaid and CHIP through March 2015, the White House Council of Economic Advisers released a new report outlining the impact of not expanding Medicaid in the remaining 22 non-expansion states. If these states were to expand Medicaid in 2016, the report finds that an additional 4.3 million people could enroll, 1 million additional people would receive primary care through a clinician’s office, 572,000 more would report being in better health, and 611,000 fewer would having trouble paying other bills due to the burden of medical costs. Additionally, the report identifies the benefits of expansion for states’ economies, including greater productivity of their workforces.
Florida: Medicaid Expansion Fails after House Vote
The Florida House rejected the Senate’s Medicaid expansion bill, despite attempts to address opposition with multiple last-minute amendments, such as granting the Medicaid agency more flexibility to adjust premiums on the State's proposed private exchange and omitting an interim Medicaid managed care phase prior to enrollment in private coverage. The branches will now focus on negotiating a budget to present to Governor Rick Scott (R) ahead of the June 20 conclusion of the special session. Meanwhile, Governor Scott’s Health and Hospital Commission released its initial findings, which aim to make hospital financing more transparent.
New Hampshire: Legislative Branches Pass Budgets without Extended Medicaid Expansion Funds
The New Hampshire House and Senate both passed budgets for Fiscal Years 2016 and 2017 that do not include state funds to extend the State’s Medicaid expansion past its current sunset date at the end of 2016, after which time all expansion states must begin paying for a percentage of expansion-related costs. The Senate’s $11.3 billion budget, which was passed along party lines, is $170 million more than the House budget and includes funding for disabled and elderly individuals and higher education and cuts business tax rates beginning in 2017. Both budgets, however, are less than Governor Maggie Hassan’s (D) $11.5 billion plan, which includes additional funding for mental health and substance abuse programs and state funding for Medicaid expansion in 2017. The chambers must now send a compromise budget in advance of the June 30 deadline to Governor Hassan, who expressed her concern with both chambers' budgets.
MARKETPLACE UPDATES:
10.2 Million Consumers Effectuated Marketplace Coverage
CMS released new data indicating that of the 11.7 million consumers who selected a plan, 10.2 million have effectuated their enrollment by paying their premiums since the 2015 open enrollment period ended in February. Of the total effectuated enrollments, 7.3 million consumers receive coverage through the Federally-facilitated Marketplace, 6.4 million of whom receive a tax credit and are at risk of losing that financial assistance should the Supreme Court rule in the favor of the plaintiffs in King v. Burwell.
STATE STAFFING NEWS:
Idaho: Governor Appoints State Senator as Department of Insurance Director
Governor C.L. “Butch” Otter (R) announced State Senator Dean Cameron—an insurance salesman who has served in the Senate since 1991—as director of the State's Department of Insurance, effective June 15. Cameron, the chairman of the Senate Finance Committee, also currently co-chairs the Legislature's budget-setting committee and a Health Care Task Force. The appointment is subject to confirmation by the Senate in 2016.
Texas: Governor Appoints New Health and Human Services Executive Commissioner
Governor Greg Abbott (R) named Chris Traylor to the Texas Health and Human Services Commission’s top post. Traylor has served as Deputy Executive Commissioner since September 2012 and worked closely with prior Executive Commissioner Kyle Janek. Traylor was the Texas Medicaid director from 2007 to 2010.