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ACAP Applauds Introduction of Medicaid and CHIP Continuous Quality Act in U.S. Senate

ACAP applauds the introduction of S. 1980, the Medicaid and CHIP Continuous Quality Act of 2014, which was introduced in the United States Senate by Senator Jay Rockefeller (D-W.V.) on the five-year anniversary of the Children's Health Insurance Program Reauthorization Act. The bill will provide twelve-month continuous enrollment for people eligible for Medicaid and CHIP and direct the Secretary of Health and Human Services to establish standardized quality measures of the care provided to Medicaid and CHIP beneficiaries. 

“ACAP applauds Senator Rockefeller for his efforts to provide Medicaid and CHIP beneficiaries with reliable health insurance coverage and establish uniform quality measures for the Medicaid and CHIP program,” said Murray. “This bill will lead to more efficient, effective use of scarce public health care resources... [p]roviding 12-month continuous enrollment in Medicaid and CHIP brings these critical programs in line with private health plans, Medicare and other health care programs. We call upon all Senators to join Senator Rockefeller and promptly pass the Medicaid and CHIP Continuous Quality Act.” 

More about the MCQA bill > | Press statement >

New ACAP Fact Sheet Looks at Preferred Drug Lists

A new ACAP Fact Sheet takes a look at state policies with respect to Preferred Drug Lists, or PDLs. For Medicaid managed care plans in states that "carve in" prescription drugs -- that is, include prescriptions under the purview of the Medicaid MCO -- PDLs are one way to promote use of relatively inexpensive, effective medications. Drugs on the PDL can be prescribed without health plan authorization.

PDLs are an especially important lever for Medicaid managed-care organizations: For Medicare and private health plans, patients are usually encouraged to select lower-cost drugs through co-pay design (for instance, generics typically come with lower copays than brand-name medications. However, for Medicaid managed care plans, copays are nominal or non-existent. This leaves PDLs as a means to managing the mix of prescription drugs, while assuring access to more expensive medications when medically necessary.

PDL policy across states is a continuum: on one end, some states set one statewide PDL, while on the other end some states allow plans freedom over PDL design. Other states allow limited plan choice.) The paper, which was developed by The Menges Group, explores the arguments for both ends of the spectrum -- state versus plan design of PDLs. Read the paper >

Dennis Heaphy Named Winner of 2014 Leadership in Advocacy Award

ACAP honored Dennis Heaphy, a health care analyst for the Disability Policy Consortium in Massachusetts and co-chair of Disability Advocates Advancing our Healthcare Rights with 2014Leadership in Advocacy Award. Mr. Heaphy was recognized for his efforts to assure key consumer protections for persons with disabilities as aspects of the Affordable Care Act were implemented, including demonstration projects designed to serve persons dually eligible for Medicare and Medicaid. 

Mr. Heaphy was cited for his leadership role in advocating for improvements to care for individuals living with disabilities through the design of the One Care “duals demonstration” program in Massachusetts. “Dennis exemplifies the kinds of partnerships that Safety Net Health Plans seek as we work to deliver top-quality care—especially for populations such as dual eligibles,” said ACAP CEO Margaret A. Murray. “We rely on input from advocates such as Dennis to make the transitions to the demonstrations as seamless as possible.” Read more >

ACAP Analysis: 4 in 10 Issuers Participating in Marketplaces Also Offer Coverage Through a Medicaid Managed Care Plan 

Note: Data updated December 13, 2013.
Issue Brief | List of Issuers (Excel)

A new ACAP analysis examines a comprehensive list of issuers offering Qualified Health Plans (QHP) in Marketplaces across the country and notes which issuers also offer health coverage through a Medicaid managed care plan in the same state.  The analysis counts 286 separate QHP issuers in the 50 states and the District of Columbia, counting issuers once for each state in which they participate in a Marketplace.  Of those 286 issuers, more than 4 in 10—117 overall—also offer coverage through a Medicaid MCO in the same state. This suggests that there is significant overlap between Marketplace plan offerings and Medicaid managed care in many states, which would help to limit the impact of “churn.” Read more >

Four of the 10 Top-Ranked Medicaid Health Plans in the U.S. Are ACAP-Member Safety Net Health Plans

New rankings of health insurance plans from the National Committee for Quality Assurance (NCQA) count four Safety Net Health Plans, all members of ACAP, among the top ten Medicaid insurance plans in the United States. The plans were ranked in NCQA’s Medicaid Health Insurance Plan Rankings 2013-2014 based upon their performance against metrics of clinical quality and member experience. Read More >

H.R. 1698 Would Bring Enrollment Stability to Medicaid, CHIP Programs

Representatives Gene Green (D-Texas) and Joe Barton (R-Texas) recently introduced H.R. 1698, the Stabilize Medicaid and CHIP Coverage Act of 2013, which would provide for 12-month continuous enrollment for Medicaid and CHIP. Every year millions of people enroll in the two programs, only to subsequently lose their coverage despite still being eligible. 

“ACAP applauds Representatives Green and Barton for their leadership in seeking to provide Medicaid and CHIP beneficiaries with a source of coverage they can count on,stabilizing health care services for those who need it most," said ACAP CEO Margaret A. Murray in a statement. “Providing 12 months of continuous enrollment in Medicaid and CHIP brings these critical programs in line with private health plans, Medicare and other health care programs.We call upon other Members of Congress to join Reps. Barton and Green and promptly pass the Stabilize Medicaid and CHIP Coverage Act."

ACAP has developed a Web site that provides a wide range of resources on "churn" and its ill effects, including maps detailing the variance in enrollment continuity rates among various subgroups and from state to state. For more details, visit coverageyoucancounton.org. 

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