Drew Altman, Kaiser Family Foundation Jan
6, 2020
With
legislation in Congress likely to be blocked by partisan division and interest
group opposition, much of the real action in health care this year will be in
the states.
The big
picture: States don’t have the money or purchasing power the
federal government does, but their decisions nevertheless affect millions of
people, and they could signal the future of federal reform.
What to watch: Colorado
and Washington are implementing public insurance options that could be a model
for Democrats at the federal level.
·
Both plans would be privately administered, and would pay
providers 160% of Medicare rates, or more.
·
It’s not yet clear whether they’d be open to very many people
with employer-based coverage, or how many providers will accept this coverage.
·
Pennsylvania and New Jersey are taking over their Affordable
Care Act marketplaces from the federal government.
·
California is embarking on an ambitious state-financed coverage
expansion.
State interest in
Massachusetts-like cost controls may grow, as could interest in using Medicaid
to pay for non-medical services for high cost patients, as North Carolina is
doing.
The other side: Idaho and
other red states are promoting short-term insurance plans as an alternative to
the Affordable Care Act.
·
Georgia is seeking ACA waiver plan to ditch the state’s
marketplace, with consumers enrolling through insurers and web brokers, and a
subsidy scheme allowing healthier consumers to choose skimpier plans that do
not meet all ACA standards.
·
Tennessee is seeking a form of per capita cap within Medicaid,
with broad flexibility and favorable terms for the state.
·
Red states’ efforts to implement work requirements for Medicaid
appear to be faltering in the face of adverse court decisions and opposition.
But the Trump administration is still approving them.
https://www.axios.com/health-care-2020-states-california-utah-tennessee-trump-d57a6a5b-a3b6-45b8-87b8-53060c217aaf.html?utm_content=111674688&utm_medium=social&utm_source=linkedin&hss_channel=lcp-47978
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