Health Insurance Exchanges Centers for Medicare & Medicaid Services

Health Insurance Exchanges are government-regulated private health insurance markets where individuals can purchase standardized health insurance plans.
News & Analysis as of

Medicaid managed care proposed rule expands program integrity obligations

On June 1, 2015, the US Centers for Medicare & Medicaid Services (“CMS”) published its proposed rule on Medicaid managed care (CMS-2390-P). As noted in our two earlier advisories, which provided an overview of the proposed...more

Manatt on Health Reform: Weekly Highlights - June 2015 #3

With the King v. Burwell ruling expected by the end of the month, Congressional Republicans continue to offer contingency plans in the event of a ruling for the plaintiffs; and the Mississippi Insurance Commissioner proposes...more

Manatt on Health Reform: Weekly Highlights - June 2015 #2

With an eye toward the imminent King v. Burwell ruling, Delaware submits a Supported State-based Marketplace blueprint to CMS and South Carolina’s governor says the State will not establish a State-based Marketplace. In...more

Manatt on Health Reform: Weekly Highlights - April 2015 #4

CMS releases new redetermination regulations and links uncompensated care funds to expanding Medicaid, and New York becomes the second state to launch the Basic Health Program. ...more

Federal Trade Commission and Department of Justice Hold Joint Workshop on Payment Models and Competition Within the Health Care...

On February 24-25, 2015, the Federal Trade Commission (“FTC”) and Antitrust Division of the Department of Justice (“DOJ”) co-hosted a second public workshop as part of the “Examining Health Care Competition” series to study...more

Manatt on Health Reform: Weekly Highlights - March 2015 #4

This week, Alaska’s Governor introduced Medicaid expansion bills in both the House and Senate after failing to get approval in his budget. Colorado determined that non-ACA-compliant plans cannot be sold in 2016, a year ahead...more

Manatt on Health Reform: Weekly Highlights - March 2015 #2

King v. Burwell speculation has been rampant since the Supreme Court heard oral testimony on Wednesday. All eyes are on Justices Kennedy and Roberts, who are likely to wield the deciding votes. In other news, CMS approved a...more

Health Care Update - March 2015

In This Issue: - King v. Burwell before the Supreme Court and the Potential Congressional Response - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional...more

Manatt on Health Reform: Weekly Highlights - February 2015 #4

Wrapping up the 2015 enrollment period, Healthcare.gov and State-based Marketplaces in seven states have announced special enrollment periods (SEPs) for people who were uninsured in 2014 and discover they owe a “shared...more

Administration Issues Proposed Rules on ACA Summary of Benefits and Coverage, Excepted Benefits/Wraparound Coverage

On December 30, 2014, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA), and the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise Affordable...more

Manatt on Health Reform: Weekly Highlights: January 2015 #3

This week, leadership changes at CMS continue, Montana’s Governor introduces Medicaid expansion legislation, and the California Marketplace allows new health plan entrants into the individual and SHOP Marketplaces for the...more

A Quick Look at Healthcare Issues Expected to Make News in 2015

As we look into our crystal balls, we do not expect a lot of new issues in 2015. Rather, we believe that most of the significant issues will be a continuation of issues that arose in 2014 or earlier. ...more

Manatt on Health Reform: Weekly Highlights: January 2015

Enrollment and coverage expansion tops the new this week. Federal officials announced 6.5 million people have enrolled through the Federally-facilitated Marketplace and released the first in a monthly series of detailed...more

Manatt on Health Reform: Weekly Highlights: December 2014 #4

With the holiday season underway, this week the Federal government awarded $110 million in exchange establishment grants, released proposed rules to permit employees to receive employer-sponsored insurance and tax credits,...more

States Doubling Down on Delivery and Payment Reform Efforts

Although health care reform implementation via the Affordable Care Act (ACA) has focused mostly on federal changes to the health care marketplace, individual States are getting some much needed help to design and implement...more

Health Care Reform Implementation Update

We are now more than two weeks into the Affordable Care Act (ACA’s) second open enrollment period, and 765,000 individuals have obtained coverage through HealthCare.gov. On Capitol Hill, House lawmakers filed a lawsuit...more

Monthly Benefits Update - November 2014

U.S. Supreme Court Grants Review of ACA Case Involving Premium Subsidies Offered Through Federally Facilitated Exchanges - The Supreme Court granted review in King v. Burwell, a Fourth Circuit case that upheld an IRS...more

Manatt on Health Reform: Weekly Highlights: December 2014

This week, a federal Issuer Bulletin describes how issuers in the Federally Facilitated Marketplace will identify their existing enrollees who are switching plans for 2015 coverage. The Exchange Board in New Mexico proposes a...more

Health Care Update - December 2014

In This Issue: - FDA Releases Menu Labeling Rule - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Upcoming Congressional Hearings - Excerpt from FDA...more

Manatt on Health Reform: Weekly Highlights: November 2014 #4

In this week’s highlights, new proposed guidance from the feds would allow default renewals to lower cost plans and bring enhanced transparency to Qualified Health Plan rate increases; open Enrollment hits its stride –...more

Manatt on Health Reform: Weekly Highlights: November 2014 #2

With the conclusion of the midterm elections last week and open enrollment just around the corner, this week’s news highlights both renewed pledges from the opposition and a flurry of implementation activity in the states....more

Health Care Reform Implementation Update

Over the past several days, the second open enrollment period through the Affordable Care Act’s (ACA’s) health insurance exchanges began; Republican lawmakers, now with majorities in both the House and the Senate, explored...more

Manatt on Health Reform: Weekly Highlights: October 2014

This week, states’ Marketplaces are busy preparing for the 2015 Open Enrollment Period. Marketplaces are reviewing projected enrollment and renewal figures and releasing searchable databases for 2015 health plan rates, among...more

Manatt on Health Reform: Weekly Highlights

Welcome to the first publication of the “Manatt on Health Reform: Weekly Highlights” newsletter. Many of you are familiar with the healthcare reform tracking efforts and weekly newsletters we produced for the KidsWell...more

CMS Issues Final Rule on Marketplace Auto-Enrollment

On September 5, 2014, the Centers for Medicare and Medicaid Services (CMS) published a final rule, effective October 6, 2014, that, among other things, specifies the auto-enrollment process for consumers who receive health...more

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