State policy experimentation likely to create uncertainty for providers in 2019

January 5, 2019, Modern Healthcare, Harris Meyer- The coming year will be one of state health policy experimentation that could lead to even wider healthcare disparities across the country. State initiatives could drive larger differences in insurance coverage rates, access to care and consumer protections. States already vary widely in their uninsured rates, ranging from 2.8% in Massachusetts to 17.3% in Texas in 2017, according to the U.S. Census Bureau. With Congress likely deadlocked for the next two years between the Democratic-controlled House and the Republican-controlled Senate, states will be where any major health policy action takes place. Providers, health plans and consumers could face sharply different fates in different states. In Republican-led states, the likely initiatives will feature Medicaid work mandates through Section 1115 waivers; alternative coverage systems to the Affordable Care Act through Section 1332 innovation waivers; and leaner, cheaper health plans allowed by new CMS rules that don’t require consumer protections mandated by the ACA.

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