Across the Country in ACA World - Aug No. 2

1. State rankings: 
   1. At $29, CT ranks 29th in state public health funding per person. DC ranks 1st at $139 per person.  Missouri ranks 51st at $6 per person.  Is more spending necessarily better?
   2. Maybe not, because CT ranked 5th overall and 1st in Healthy Lives in the Commonwealth Fund’s 2019 Scorecard on State Health System Performance.  CT ranked 27th in Avoidable Hospital Use and Cost, and we fell in 6 indicators.  CT's performance dropped the most in Hospital 30-day readmission rate ages 18-64; Drug poisoning deaths; and Preventable hospitalizations ages 18-64. 
2. Covered California issued a report on its Efforts to Lower Costs While Ensuring Consumers Get the Right Care at the Right Time.   Covered CA uses contracted requirements of its QHP issuers to:  1) Identify the race or ethnicity of all enrollees through self-identification or imputed methodologies;  2) Collect data on disease control and management measures for diabetes, hypertension, asthma, and depression;  3) Conduct population health improvement activities and interventions to narrow observed disparities in care; and   4) Promote community health initiatives that foster better health, healthier environments, and healthy behaviors. 
3. MNSure awarded over $4.2 million in 24 navigator grants to 43 organizations. MNSure enrolled about 129,000 in QHPs at the end of 2019 OE.  The MNSure navigator page does a nice job of communicating navigator info.
4. Rhode Island’s new reinsurance pool, approved through the §1332 Innovation Waiver process, is expected to lower premiums by 5.9% and increase the individual market by 1% in 2020.  Of the 13 waivers approved so far, 12 of them focus on reinsurance programs like Rhode Island's.  And the head of HealthSource RI is moving to a similar position in Pennsylvania, with the recently established Pennsylvania Health Insurance Exchange Authority.
5. State Health and Value Strategies is tracking state activity on 1332 waivers and has resources, including a template, for states interested in pursuing a Section 1332 waiver.
6. As of June, 17 states were working toward some kind of public-option health plan.  Washington already adopted public option legislation.
7. Tufts Health Plan is merging with Harvard Pilgrim.  Tufts Health Plan recently entered the CT Medicare market in a partnership with Hartford HealthCare.   The Tufts Health Plan Foundation invests in healthy aging programs in the states where it does business.
8. On  Sept 3 at 1pm, the RWJF’s State Health and Value Strategies program will host a webinar on the public charge final rule. The public charge rule will change how US Department of Homeland Security determines whether immigrants—when seeking admission to the U.S., an extension of their stay, or status change to become a legal permanent resident—are “likely at any time to become a public charge” (i.e., dependent on the government for financial support).  The new public charge rule takes effect October 15.
9. On Sept 10 at 10 am the US Census Bureau will discuss its report on US Health Insurance Coverage for 2018 at an online news conference  The health insurance report will include state-level coverage for 2017 and 2018.   Two other reports on Income and Poverty for 2018 will also be discussed. 
10. AHCT’s Community Conference takes place Wed Oct 16.
11. Doctors Don't Always Know What Patients Will Owe for Meds.  Under a new Medicare rule, companies with prescription drug plans for older adults must offer real-time pricing information for meds by 2021. “Surveys show Americans are interested in health care savings but are also very intimidated by terms of insurance coverage.  They don't really understand things like copays, coinsurance, deductibles…”