States Pick Up ACA Slack

With the political battle over the future of the Affordable Care Act (ACA) dragging on in Washington, a number of states have recently taken steps to protect their residents from potential instability in the health insurance market. New Jersey is setting up its own state health insurance exchange to replace the federally run healthcare.gov marketplace, as discussed here, and on July 2, Pennsylvania Gov. Tom Wolf signed legislation to allow his state to do the same. Both states will also have reinsurance funds to help insurers pay for care to their costliest patients. Nevada, New Mexico and Oregon are also considering shifting to state-based marketplaces.

In addition, several states are replacing the ACA’s individual health insurance mandate, which was eliminated beginning in 2019, with their own state requirements. The new state budget plan signed by California Gov. Gavin Newsom on June 27 includes an insurance mandate similar to the former ACA mandate, along with expanded premium subsidies for people who buy coverage through the state’s insurance exchange. A state individual mandate, along with a new state reinsurance fund, is also pending in Rhode Island, and Vermont’s individual mandate will become effective in 2020.