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Headlines in this edition of The Scoop: Open enrollment ends tonight in Colorado and Connecticut; Medicaid expansion might be a reality in Kansas by 2021; Maine considers a state-run exchange, merged risk pool, standardized plans; Short-term plan rules now in effect in Maine; California extends Medi-Cal for young adults; Virginia lawmakers considering legislation to sharply limit short-term plans; Delaware considers legislation to limit insulin costs; New Hampshire is working on a reinsurance program.
There are currently short-term plans available in Virginia with initial terms of up to 364 days. But lawmakers in Virginia's newly-blue legislature are considering bills that would sharply limit short-term plans as of mid-2020.
There was a slight overall average rate decrease in New Hampshire's individual market for 2020, on the heels of a double-digit rate decrease in 2019. And a planned reinsurance program could drive rates even lower in 2021. New Hampshire switched from PAP to Medicaid managed care in 2019 (with a work requirement that was subsequently overturned by a judge), so Medicaid expansion enrollees no longer receive coverage under qualified health plans in the exchange.
Maine defines a short-term health insurance plan as a policy that lasts less than 12 months, although the rules are changing in 2020. At that point, Maine will require short-term plans to terminate no later than December 31 of the year in which they're issued.
Vermont's individual mandate will take effect in 2020, but there will not be a penalty for non-compliance. Average rate increases are much larger than the national average for 2020.
So what are your options if you’re not eligible to enroll in an ACA-compliant plan and short-term plans are not for sale in your area?
The Kansas Medicaid program — which is called KanCare — has not been expanded under the ACA, but the state is poised to expand coverage as of 2021. Bipartisan legislation has been introduced in the 2020 legislative session that would expand Medicaid as of January 2021.
Medi-Cal, California's Medicaid program, covers more people than any other Medicaid program. Nearly13 million people are covered under the program. Starting in 2016, California began covering undocumented immigrant children with eligible household income. And as of 2020, Medi-Cal is available to undocumented immigrants through age 25.
Headlines in this week's edition of The Scoop: Open enrollment continues in DC and five states; Legislation filed in Virginia to create a state-run exchange; Individual mandates now in effect in California and Rhode Island; 53,000 people have gained coverage under Idaho’s Medicaid expansion; Medicaid fully expanded in Utah; Medicaid work requirement in effect in Michigan; Legislation filed in New Mexico to expand exchange board’s authority; Surprise balance billing protections now in effect in Texas; West Virginia AG works to overturn ACA while simultaneously backing legislation to protect state's residents from that possibility; California and 19 Democratic led states ask SCOTUS to hear Texas v. Azar this year
2020, average rates decreased slightly. Maine lawmakers are considering a bill that would create a state-run exchange, extend and expand the existing reinsurance program to cover the small group market, create standardized health plans, add pre-deductible primary care visits to state-regulated health plans, and possibly merge the individual and small group risk pools.