Coverage

Medicaid Managed Care Rule: Network Adequacy Standards

Recently the Obama administration released standards for the operation of Medicaid managed care plans. This is the final analysis in a series looking at what advocates should know about the new standa...

How the Supreme Court’s Decision Affects Medicaid and the Affordable Care Act

In June 2012, the Supreme Court's decision on the Affordable Care Act ruled that the penalty for states that don't expand Medicaid is unconstitutional. By removing the penalty, the court's decision ch...

Medicaid Managed Care Rule: What Advocates Should Know

Recently the Obama administration released new standards governing Medicaid managed care plans. These managed care rules haven’t been updated since 2002, and a lot has changed in the past 14 years. ...

The Trump Administration Marketplace Rule—and How States Can Respond

In April 2017, the Department of Health and Human Services (HHS) finalized a rule creating sweeping changes to health insurance marketplaces. Many of these changes could make it more difficult or more...

Worry No More: Americans with Pre-Existing Conditions Are Protected by the Health Care Law

The Affordable Care Act protects all Americans from being denied health insurance, charged more in premiums, or sold a policy that excludes coverage for necessary treatments based on pre-existing cond...

Per Capita Caps in Medicaid: Shifting Health Care Costs to the States

Changing Medicaid to a per capita cap payment system would radically change the way the program has been funded since 1965. It’s a change that would shift costs and risks to states and children, sen...

Being a Woman Just Got a Little Easier: How the Affordable Care Act Benefits Women

The Affordable Care Act guarantees that women will be able to get affordable health insurance that covers the health services they need. Thanks to the health care law, women cannot be denied coverage ...

Designing the Essential Health Benefits for Your State: An Advocate’s Guide

The Affordable Care Act requires all health plans to cover a minimum set of benefits, known as essential health benefits. Although the law establishes 10 broad categories of minimum services, each sta...

Creating Consumer-Friendly Wellness Programs to Promote Healthy Lifestyles

Wellness programs can be a powerful tool to help individuals improve their health and reduce their risk of developing chronic conditions. These programs encourage people to adopt healthy behaviors, li...

Lower-Income Families See Healthcare Costs Soar in House Repeal Bill

See also: Seniors' Premiums Skyrocket under House Repeal Bill