In this edition:
- Six states extend their ACA 2020 open enrollment periods
- Tennessee unveils proposed modified block grant model for Medicaid
- Kaiser Permanente workers prepare to strike in five states and DC
- Some Montana residents misled by short-term insurers could receive restitution
- Anthem partners with Georgia Farm Bureau to offer medically underwritten plans
Welcome to this week’s edition of The Scoop. We’ll be publishing The Scoop on Wednesdays going forward.
Here’s the latest state-level health insurance-related news.
Six states extend their ACA 2020 open enrollment periods
Open enrollment for 2020 individual market health insurance is scheduled to run from November 1 to December 15, 2019. But state-run health insurance exchanges can extend that window, and most have done so in prior years. For the upcoming open enrollment period, six state-run exchanges have announced extensions. The extensions are permanent in DC, California, and Colorado, and apply to the Fall 2019 open enrollment period in Massachusetts, Minnesota, and New York.
Tennessee unveils proposed modified block grant model for Medicaid
Tennessee may become the first state in the country to receive federal Medicaid funding as a block grant, rather than an open-ended match. State officials unveiled the block grant proposal this week, opening a 30-day public comment period that runs through October 18. Tennessee’s proposal is considered a modified block grant approach, as it includes a provision that calls for federal funding to increase if the state experiences Medicaid enrollment growth in the future.
Kaiser Permanente workers prepare to strike in five states and DC
People who use Kaiser Permanente facilities in California, Colorado, DC, Oregon, Virginia, and Washington should be prepared for a potential strike in October. Negotiations between Kaiser and the unions are ongoing and the situation could still be resolved without a strike. But the unions have voted to authorize a strike if an agreement is not reached, and up to 80,000 workers could participate.
Montana residents misled by short-term insurers could receive restitution
Montana’s insurance commissioner has sent letters to more than 3,600 state residents who may be eligible to claim restitution if they were misled when they purchased short-term coverage between 2012 and 2016. Most of the policies were sold by Health Insurance Innovations, but several other companies were also using dishonest sales tactics and/or unlicensed salespeople, and have contributed to the restitution fund.
Anthem partners with Georgia Farm Bureau to offer medically underwritten plans
As of October, sole proprietors and small groups involved in agriculture in Georgia can have coverage under Georgia FARM plans as long as they’re members of the Georgia Farm Bureau. These plans are established as part of a multiple welfare arrangement and are self-insured, although Anthem is providing stop-loss coverage and administration services. Premiums are based on medical underwriting, but the plans are guaranteed issue and do cover pre-existing conditions. It’s not entirely clear how Georgia FARM plans are getting around the ACA’s individual and small-group requirements and the current federal rules for association health plans, but Georgia’s Department of Insurance has indicated that the plan is compliant with existing regulations.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.