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Medicare & Medicaid

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The Scoop: October 16, 2019 Edition

A look at state-level headlines regarding individual health insurance

California has enacted several pieces of healthcare legislation, including measures that address nurse staffing levels in hospitals.

Welcome to this week’s round-up of state-level health reform news, including:

Open enrollment underway in California; window shopping available in several states

Open enrollment for 2020 health plans has begun in California. (It starts everywhere else on November 1.) Minnesota’s state-run exchange, MNsure, has now enabled window-shopping for 2020 health plans. Window shopping had already begun earlier in the month in California, Maryland, Idaho, Nevada, and New York.

Medicare open enrollment started October 15

For the 61 million Americans are covered by Medicare, open enrollment is now underway nationwide, and continues through December 7. Medicare beneficiaries can change their prescription drug plan, switch from Original Medicare to Medicare Advantage or vice versa, or switch from one Medicare Advantage plan to another. Coverage changes take effect January 1.

Enrollment in Idaho’s expanded Medicaid begins November 1 (coverage takes effect January 1)

Although Medicaid enrollment is available year-round for eligible individuals, Idaho is expanding Medicaid eligibility as of January, and people who are eligible under the new guidelines can begin to enroll as of November 1.

Enrollment now underway as North Carolina transitions to Medicaid managed care

Although North Carolina has not expanded Medicaid under the ACA, the state is in the process of implementing a long-planned transition to Medicaid managed care. Enrollment is now underway, and most Medicaid enrollees in the state need to select a managed care plan by mid-December. Coverage under the managed care program will begin in February 2020.

Judges express concerns about Medicaid work requirements

Earlier this year, a federal judge struck down Medicaid work requirements in Arkansas and Kentucky (and New Hampshire) over concerns that people would lose coverage. When the U.S. Court of Appeals for the District of Columbia heard oral arguments in the appeal last week, all three judges on the panel expressed concerns about coverage losses, casting doubt on the future of Medicaid work requirements.

Legal battle over ‘captive’ agents in Florida continues

Last month we told you about how Florida Blue prevents insurance agents from showing their clients plans from other insurers, and about Oscar Health’s lawsuit to try to change this, which was dismissed by a judge in September. But Oscar appealed this week, so there could still be a future ruling that prevents Florida Blue from requiring agents to only show clients plans offered by Florida Blue. But for now, consumers in Florida need to be aware of the current rules and be sure they’re seeing all of their available plan options before purchasing coverage.

California busy enacting healthcare legislation

California has enacted several pieces of legislation related to healthcare, including measures that address nurse staffing levels in hospitals, private insurance reimbursement for dialysis centers, and vaccine exemptions. Healthcare journalist Ana B. Ibarra has a thorough summary of the state’s newly enacted legislation.


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.

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