On February 20, 2018, the Government Accountability Office (GAO) released a report recommending changes in federal policies and procedures governing state-operated Medicaid demonstration waiver projects.  These projects represent the leading edge in state Medicaid innovation as well as over $109 billion in federal Medicaid spending annually. GAO found in its review of these projects that the Centers for Medicare and Medicaid Services (CMS) has not always demanded thorough, scientifically valid, and timely data evaluations as to whether the projects achieved state-specified, CMS-approved goals to improve care and to contain costs.  

On February 5, 2018, the Center for Consumer Information and Insurance Oversight (CCIIO) released a new Notice of Funding Opportunity to support states as they implement several of the market reforms and consumer protections under Title I of the Affordable Care Act (ACA). This grant program is a follow-up to the Health Insurance Enforcement and Consumer Protections Grants funded in 2016. Specifically, the new grant program – known as the State Flexibility to Stabilize the Market Grant Program (“State Flexibility Grant Program”) – is intended to provide states with the opportunity to ensure their laws, regulations, and procedures align with federal requirements.

The State Flexibility to Stabilize the Market Grant Program (“State Flexibility Grant Program”) was developed to support states as they implement several of the market reforms and consumer protections under Title I of the Affordable Care Act (ACA). This new funding opportunity builds upon many of the efforts currently underway in states related to the Consumer Protection grant funds, which were awarded in October 2016. PCG assisted many states with projects related to those consumer protections grant funds and our team has used that experience to compile the following insights and suggested activities to help states with their grant applications for this new federal funding opportunity.

The administration released its budget proposal on February 12, 2018. As expected, the proposal includes a number of changes related to health care. The budget plan revives the Affordable Care Act (ACA) repeal, with a proposal similar to the Graham Cassidy Heller Johnson bill. Specifically, the budget plan proposes a staged repeal and replace, with the replace being a block grant program for states.