Revised HHS rules aim to shift more health plan control to states

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Photo: knitsteel via Flickr

Before the Affordable Care Act, health insurance regulation in the individual market largely was managed by the states. The ACA saw a shift to a greater federal role. Now under the Trump administration, some responsibilities are going back to the states.

In a new tip sheet for AHCJ, Louise Norris, whom many AHCJ members know as a contributor to healthinsurance.org, explains the new responsibilities. One significant area is network adequacy – whether a plan has enough doctors, hospitals and other providers to meet the needs of beneficiaries. The other area is drug formulary non-discrimination – did the plan design its drug formulary or marketing to discriminate against people with high-cost health needs?

In addition to being a frequent and respected writer on insurance, Norris brings a broker’s perspective to the healthcare reform discussion, as she and her husband in 2013 started Insurance Shoppers, Inc., a health insurance agency. In 2014, she wrote The Insider’s Guide to Obamacare’s Open Enrollment, a 38-page consumer guide updated for each open enrollment period.

Norris also compiles data about each state’s exchange and Medicaid program. You can find out more at @EyeOnInsurance on Twitter and healthinsurance.org on Facebook.

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