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This Week in Managed Care: June 20, 2015


This week 3 states received approval to set up their own state exchanges in the even the Supreme Court removes subsidies in the federally facilitated marketplace, and the deadline passed for stakeholders to respond to CMS' proposed rules for mental health parity in Medicaid managed care.

This week 3 states began to prepare for the potential that the Supreme Court may rule in favor of the plaintiffs in King v. Burwell, which would make millions of Americans in states using the federal insurance marketplace ineligible for subsidies. Arkansas, Delaware, and Pennsylvania have all received tentative approval from HHS to set up their own health insurance exchanges in the event that the Supreme Court rules for King.

Kaiser Family Foundation found that the majority of Americans (73%) find drug prices unreasonable, even though only half of them actually take prescription medications. A quarter of those surveyed said they had a friend or family member who could not fill a prescription because of cost, and 76% blame drug manufacturers for the high prices.

And this week was the deadline to respond to CMS' proposed rules for mental health parity in Medicaid managed care. Insurers and states asked for more time to make changes than the 18 months allotted in the rules, but mental health advocates say Medicaid patients have waited long enough since the federal parity law was passed 7 years ago.

A decision from the Supreme Court in King v. Burwell is due soon. Some think that no matter what the ruling, Congress will have to protect premium subsidies because Americans who have gained health coverage won't accept losing it. Do you:

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