As Congress debates comprehensive national health reform, the Kaiser Family Foundation has two reports and an updated fact sheet that examine state-level health reform in Massachusetts and the lessons it offers for policymakers in Washington. Consumers’ Experience in Massachusetts: Lessons For National Health Reform and In Pursuit of Affordable Health…
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Massachusetts and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared
This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and…
This report provides an early look at state efforts to prepare for health reform, examining the experiences to date in five states (Connecticut, Michigan, Massachusetts, North Carolina and Washington). The report finds that the state political environment and expected leadership transitions create uncertainties and are already factoring into state strategies…
Washington’s Managed FFS Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
Washington is the first state to sign a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test a managed fee-for-service (FFS) financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, beginning on April 1, 2013. Washington’s managed FFS demonstration uses…
Roads to Community Living: A Closer Look at Washington State’s Money Follows the Person Demonstration
This case study looks at Washington state’s Money Follows the Person demonstration program, Roads to Community Living. The program is responsible for assisting over 2,400 Medicaid beneficiaries with complex long-term services and supports (LTSS) needs in transitioning out of institutions back to community-based care settings. Washington State has been a…
This paper contains short profiles four Medicaid beneficiaries who have been helped by Money Follows the Person demonstration programs in Michigan and Washington state.
This state report explains how the ACA expands coverage in Washington, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Washington are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.
This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities across 15 states plus DC. Although premium changes vary across and within states, premium changes for 2015 in general are modest when looking at low-cost plans. On average, individuals will pay slightly less in premiums for the benchmark silver plan in 2015 than in 2014.
This brief provides an on-the-ground view of ACA implementation after completion of the second open enrollment period. It is based on 40 in-person interviews conducted in five states that have made different implementation choices, including three states (Colorado, Kentucky, and Washington) that have developed a State-based Marketplace and adopted the Medicaid expansion and two states (Utah and Virginia) that rely on the Federally-facilitated Marketplace (FFM) for enrollment of individuals into qualified health plans (QHPs) and that have not adopted the Medicaid expansion to date. The interviews were conducted by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and Perry Undem Research/Communication with a range of stakeholders in each state, including Medicaid and Marketplace officials, consumer advocates, assisters, and hospital and community health center representatives, during April and May 2015. The report presents key findings related to enrollment systems; enrollment and renewal; outreach, marketing, and enrollment assistance; and access to and utilization of care. It concludes with key priorities identified by stakeholders looking ahead.
Analysis of 2016 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces
This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities in 10 states plus DC. Premium changes for the benchmark silver plans vary significantly across the sample cities. The benchmark rates will increase 4.4 percent on average in 2016 without accounting for tax credits, a relatively modest amount but greater than the average increase for 2015.