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May 2012 St@teside

Health Reform Resources

SCI keeps the Federal Reform Resources Web page ( up-to-date with the most recent information from the states, the federal government, and health policy organizations in an effort to guide our readers through the health reform implementation process. We know there are several places to go for the latest health reform resources, and we thank you for using SCI as one of your trusted sources. Here are some of the most recent resources that can be found on our Federal Reform page:

Insurance Market Reforms:

Plan Management: Issues for State, Partnership and Federally Facilitated Health Insurance Exchanges
National Academy of Social Insurance
This report reviews how state and federal regulators currently perform plan management activities and assess how those activities are likely to change as a result of the ACA.

Medical Loss Ratio Requirements under the ACA-Final Rule
U.S. Department of Health and Human Services
The U.S. Department of Health and Human Services has issued a final rule on how insurers must notify customers that they failed to meet the ACA’s medical loss ratio requirements.

Insurance Exchanges:

Alabama Health Insurance Exchange System RFP
Office of the Alabama Health Insurance Exchange
The Office of the Alabama Health Insurance Exchange issued an RFP to procure the Alabama Health Insurance Exchange System (System). The System should be a state-of-the-art automated 301 system that supports the Exchange in providing various functions including eligibility, enrollment, plan management, SHOP, financial management, a Web portal, and administration.

Detailed Analysis for Financing the Maryland Health Benefit Exchange
Maryland Health Benefit Exchange
The Maryland Health Benefit Exchange Board has released an RFP to hire a financial consultant to draw up a budget for the exchange and outline the funding options, specific fees to fund the exchange, and the possible impact those fees would have on health plan and premium affordability.

Michigan Essential Health Benefits Comparison
Michigan Office of Financial and Insurance Regulation
The Michigan Office of Financial and Insurance Regulation have identified the 10 possible health plans that could serve as the state’s essential health benefit package. It’s asking for public comment over the next month on the right approach.

Rhode Island RFP Unified Health Infrastructure Project
State of Rhode Island
Rhode Island has released an RFP to procure one or more vendors to design, implement, and operate a technology platform to support both new and existing health insurance initiatives under the Affordable Care Act (ACA), support existing human services programs, provide hosting services for the state’s health benefits exchange and integrated eligibility system (HIX/IES), and potentially provide contracted operations of key business functions of the HIX/IES.


Overview: Proposed Federal Rules for Increased Medicaid Payment for Primary Care Providers
Center for Health Care Strategies
The Center for Health Care Strategies (CHCS) published an analysis of HHS’ proposed regulatory language for implementing the Medicaid primary care rate increase under the Affordable Care Act.

Understanding Participation Rates in Medicaid: Implications for the Affordable Care Act
Office of the Assistant Secretary for Planning and Evaluation
This brief reviews current research on current Medicaid participation rates and participation rates after reform implementation, with discussion of methodological approaches, a review of published participation rate estimates prior to the Affordable Care Act (ACA), and enrollment projections upon ACA implementation.

Planning for Expansion Populations - Demographic Data Sources
State Health Access and Data Assistance Center
This SHADAC presentation discusses the numbers and characteristics of those who will be newly eligible for Medicaid under the Affordable Care Act and how this varies across states.

Strategic Planning and Timelines:

Developing an Evaluation Framework for the Affordable Care Act
State Health Reform Assistance Network
Selected presentations from a State Health Reform Assistance Network sponsored a Small Group Convening in Minneapolis from April 30- May 1, 2012. The State Health Access Data Assistance Center (SHADAC) and other technical experts led sessions to aid state officials in developing an effective evaluation framework in the context of the Affordable Care Act.

Delivery System Reform:

The Cost of Failure to Enact Health Reform: 2010 – 2020
The Urban Institute
This report from the Urban Institute, assesses the changes in coverage patterns and health care costs that will occur nationally if major reforms are not enacted. The authors find that by 2015, there could be 59.7 million people uninsured and 67.6 million by 2020.