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The Scoop: August 16, 2019 Edition

A round-up of recent state-level headlines regarding individual health insurance, group health insurance, and Medicaid

Arkansas resident Julie Rosamond discusses a new rule that would require "able-bodied" Medicaid recipients in Arkansas to work or volunteer for a minimum number of hours each month. | (May 2, 2018) REUTERS/Karen Pulfer Focht

Reviewed by our health policy panel.

This week, consumers in more than two dozen states can expect good news – either in the form codified consumer protections, through expanded insurer participation in state marketplaces and or through permanently extended open enrollment periods. Here’s the rundown:

Delaware codifies ACA consumer protections into state law

Delaware has enacted legislation to codify various ACA consumer protections into state law, ensuring they’ll remain in effect in Delaware regardless of changes at the federal level. Delaware’s new law includes provisions such as guaranteed-issue coverage, mandated essential health benefits, limits on out-of-pocket costs, rules pertaining to how insurers can set rates, and a ban on lifetime and annual benefit limits. Delaware also enacted separate legislation that adds adult dental coverage to the state’s Medicaid program.

Insurers enter marketplace or expand exchange participation in 15 states

For the second year in a row, insurer participation in the ACA’s individual market health insurance exchanges is growing for 2020:

  • Bright Health is joining the exchange in Florida, North Carolina, Nebraska, Oklahoma, and South Carolina.
  • Anthem is rejoining the exchange in Nevada.
  • Anthem, Blue Shield of California, and Chinese Community Health Plan are all expanding their coverage areas in California.
  • Celtic, Cigna, and Blue Cross Blue Shield of Tennessee are all expanding their coverage areas in Tennessee.
  • Centene plans to expand its coverage areas in Arizona, Florida, Georgia, Kansas, North Carolina, Ohio, South Carolina, Tennessee, Texas, and Washington (Centene already offers coverage in all of these states — generally under the name Celtic or Ambetter — but will have plans available in more areas in each state in 2020).

Montana accepts public comments on Medicaid work requirement

Montana plans to seek federal approval for a Medicaid work requirement, and is accepting public comments on the proposal until August 23. Read more about Montana’s Medicaid expansion program.

Four states enact new rules for short-term health plans

  • Indiana used to limit short-term health insurance plans to six months and prohibit renewals, but that changed last month. Indiana’s new rules allow short-term plans to have initial terms of up to 364 days, and plans can be renewed for up to a total of 36 months. But Indiana is also requiring all short-term plans to have benefit caps of at least $2 million.
  • Arizona and Oklahoma have also enacted legislation to allow short-term plans with longer durations to be sold in those states. Arizona’s new rules take effect in late August, while Oklahoma’s will take effect in November. Both states previously limited short-term plans to six months.
  • On the other end of the spectrum, Maine has enacted a law – which takes effect in January 2020 – that requires short-term plans to terminate no later than December 31 of the year in which they’re issued. Maine’s legislation also imposes a variety of other new restrictions on the marketing and sale of short-term plans.

Colorado offers SEP to residents with a terminating short-term plan

Colorado implemented strict new rules for short-term health plans in April 2019, and as a result, there are no longer any short-term insurers offering plans in the state. The state has finalized a new special enrollment period, effective September 1, 2019, that will allow people with a terminating short-term plan (or one that has terminated since April 2019) to purchase an ACA-compliant individual market plan.

Missouri task force will encourage insurers to expand coverage areas

Last month, Missouri’s governor created a task force designed to come up with innovative solutions for improving Missouri’s insurance market. The goal is to improve affordability and access to care, and to encourage insurers to expand their coverage areas, particularly into rural areas of the state. Depending on what the task force recommends, Missouri may submit a 1332 waiver proposal to CMS, seeking to bring innovative solutions to the state’s insurance market.

Colorado, Rhode Island join challenge to healthcare sharing ministries

  • Following suit with several other states, Colorado’s Division of Insurance has issued cease and desist orders for Aliera Healthcare and Trinity Healthshare. Regulators are concerned that these companies are marketing their healthcare sharing ministry products in a misleading way, allowing consumers to mistake them for ACA-compliant health coverage.
  • Rhode Island’s insurance commissioner is also investigating Aliera to see if the company has been misleading residents.

Two states and DC permanently extend open enrollment periods

Although open enrollment for ACA-compliant 2020 coverage runs from November 1 to December 15  in all states that use and some of the states that run their own exchanges, California, Colorado, and DC have permanently extended their open enrollment periods.

  • California: October 15 to January 15
  • Colorado: November 1 to January 15
  • DC: November 1 to January 31

Read our 2020 Guide to Open Enrollment.

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

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