Greetings! I'm posting a report we published with the Commonwealth Fund, out this morning:

Based on a 50-state study, we find that:

• 49 states and the District of Columbia have already taken action supporting the law’s implementation, such as passing legislation, issuing regulations or other guidance, or actively reviewing insurer filings.
• The reforms studied include: expanding dependent coverage for young adults up to age 26, prohibiting lifetime limits on health benefits, phasing out annual dollar limits on health benefits, prohibiting preexisting condition exclusions for children under age 19, prohibiting rescissions (cancelling insurance, except in cases of fraud or intentional misrepresentation), covering preventive services without cost-sharing, expanding coverage of emergency services, allowing choice of primary care provider, allowing choice of pediatrician, and allowing access to obstetricians and gynecologists without a referral.
• Of those the 49 states:
o Twelve states—Connecticut, Hawaii, Iowa, Maine, Maryland, Nebraska, New York, North Carolina, North Dakota, South Dakota, Vermont, and Virginia—passed new legislation or issued new regulations that addressed all 10 of the reforms.
o The District of Columbia and 11 states—California, Delaware, Indiana, Louisiana, Michigan, New Hampshire, New Jersey, Oregon, Utah, Washington, and Wisconsin—passed a new law or issued a new regulation on at least one early market reform.
o Fifteen states—Alabama, Arkansas, Colorado, Florida, Georgia, Illinois, Kentucky, Massachusetts, Minnesota, Missouri, Montana, New Mexico, Pennsylvania, South Carolina, and Texas—issued new subregulatory guidance, such as a bulletin to advise insurers of the reforms.
o Eleven states—Alaska, Idaho, Kansas, Mississippi, Nevada, Ohio, Oklahoma, Rhode Island, Tennessee, West Virginia, and Wyoming—reported that regulators were actively reviewing insurer filings for compliance with the reforms even though the state had not otherwise passed a new law or issued new regulations or other guidance.
o Only Arizona had taken no official action.

The report concludes that the ACA’s reforms are being “baked in” to state insurance law and practice, and that states have taken advantage of the considerable flexibility available to them to implement and enforce the law. However, on a more cautionary note, we find that states may need to be more aggressive in their approach to implementing the 2014 reforms, such as the guaranteed issue requirement and rating restrictions. Most state laws are inconsistent with the 2014 reforms, and implementing them will likely require states to make legislative or regulatory changes.

My blog post, "States Make Strides on Commercial Insurance Legislation," highlights recent state legislation posted to the site. See states in blue on left to jump to the legislation or see the links in the blog post:

http://www.statereforum.org/blog/aca-compliance-state-commercial-insuran...

What has your state done to align its commercial insurance laws with the ACA?

We encourage you to share progress and post proposed and enacted laws at State Refor(u)m. Choose "join a state discussion about this milestone" above in green to get to yor state page.

In the Maine Legislature, the new Majority is poised to pass Legislation that expands community rating beyond 3-1 in plan years after 2014. Further, guaranteed issue language is repealed and replaced with a reinsurance pool. A per member per month fee will fund the pool but the figure was chosen without actuarial study or input from the Bureau of Insurance. There is grave concern about the policy implications and non-compliance with the ACA. A compromise amendment to expand community rating within ACA, require study and hearing on any pool funding mechanism, and the effective date of some ACA provisions as a trigger for market reforms was defeated.

This bill requires transparency in insurance rate filing. The bill creates a permanent, public record of proceedings, hearings and investigations of the commissioner, requires insurers to submit comprehensive documentation, and bars use of certain types of credit history in the determination of insurance premiums. Access the bill here: http://www.statereforum.org/sites/default/files/wa_hb_1220.pdf