Final update made on October 25, 2013 (no further updates will be made)

Establishing the Marketplace

On March 28, 2013, Governor Susana Martinez (R) signed legislation creating the New Mexico Health Insurance Exchange (NMHIX). Governor Martinez had vetoed previous legislation that would have established a Marketplacein 2011; however, the state had moved forward with a plan to create the New Mexico Health Insurance Exchange within the New Mexico Health Insurance Alliance.¹  The Alliance was created in 1994 to provide small employer groups and qualifying individuals with access to health insurance.²  The new legislation creates a Board of Directors for the Marketplace,  requires the establishment of strong conflict of interest policies, and allows the creation of a Native American Service Center to help with outreach to Native American populations.^3 ,4  The Board of Directors of the Marketplace will also oversee the Alliance until all the individuals and employers currently receiving coverage through the Alliance, along with enrollees in the New Mexico medical insurance pool, the state’s high risk pool, are transitioned into the Marketplace. On October 1, 2013, NMHIX launched its consumer-facing web portal, “Be Well New Mexico.” The website is available in English and Spanish. New Mexico is running its Small Business Health Options Program (SHOP) Marketplace, but will work with the federal government to run the individual Marketplace until October 2014. Under this arrangement, the state will maintain plan management and consumer assistance functions, while the federal government will operate the IT system.

Prior to enactment of Marketplace authorizing legislation, a 15-member Health Insurance Exchange Advisory Task Force was created by the Human Services Department to advise the state regarding development of a Marketplace. The Task Force consisted of eight workgroups focused on specific topics: Essential Health Benefits; outreach, education, adoption, and enrollment; legislation; market regulation; Native Americans; program integration; financial sustainability; and employer participation.⁵  Based in part on the insight collected by these workgroups, the Task Force released final recommendations on April 9, 2013.⁶ 

Structure: ExchangeBe Well New Mexico is a quasi-governmental organization, specifically a non-profit public corporation.

Governance: ExchangeBe Well New Mexico is governed by a Board of Directors consisting of thirteen voting members. These members include: the state Superintendent of Insurance; six members appointed by the Governor, including the Secretary of Human Services, a health insurance issuer, and a consumer advocate; and six members appointed by the state Legislature, including one health care provider and one health insurance issuer.⁷ 

In April 2013 the board members were selected and include:⁸ 

• Dr. James R. Damron (Chair), University of New Mexico School of Medicine
• Jason Sandel (Vice Chair), New Mexico Medical Insurance Pool
• Terriane Everhart, Property Consultants
• John Franchini, New Mexico Superintendent of Insurance
• Teresa Gomez, Futures for Children
• Dr. Martin Hickey, New Mexico Health Connections
• Dr. Larry Leaming, Roosevelt General Hospital
• Gabriel Parra, Presbyterian Healthcare Services
• Patsy Romero, Easter Seals El Mirador
• David Shaw, Nor-Lea General Hospital
• Ben Slocum, Lovelace Health Plan
• Sidonie Squier, Secretary, New Mexico Human Services Department
• Dr. J. Deane Waldman, University of New Mexico Health Sciences Center

The board named Mike Nunez, Executive Director of the New Mexico Health Insurance Alliance, to be the interim CEO of Be Well New Mexico at least through the first quarter of 2014, when the board hopes to hire a long-term CEO.

Contracting with Plans: The New Mexico Division of Insurance (DOI) has the regulatory responsibility for licensing Qualified Health Plan (QHP) issuers and reviewing and approving QHP policies. On April 15, 2013, DOI released its submission guidelines for qualified health plans (QHPs).⁹   Carriers are required to offer Silver and Gold levels of coverage, and must offer at least one statewide plan at each metal level for which the carrier submits a plan. (For example, if Carrier A has submitted a plan available at all the metal levels, then it needs to provide at least one statewide plan at all the metal levels. If Carrier A has only submitted plans at the Silver and Gold levels, then it only needs to provide statewide plans at the Silver and Gold Levels.) A carrier must offer three silver plan variations for each silver QHP to reflect the cost-sharing subsidies, and one zero cost sharing plan variation and one limited cost sharing plan variation for each metal level QHP. Benefits, networks, non-essential health benefits (EHB) cost sharing, and premiums must be the same across the silver plan variations. Carriers can offer plans in either the individual Marketplace or SHOP, and will not be required to offer the same plan in both Marketplaces. Plans that do not participate in the Marketplace initially will not be able to participate until the 2016 plan year.¹⁰ 

Be Well New Mexico will use geographic and tobacco rating. It is defining the number of geographic rating areas in New Mexico as four Metropolitan Service Areas (MSAs) plus one. The cap on a maximum differential between the highest and lowest rated area is 40%. The maximum ratio for tobacco rating will be 1:1.5.

Health insurance rates for individuals have now been approved and plan summaries and premiums can be viewed online.¹¹  Five insurers are participating in the Marketplace statewide.

In addition to ACA requirements, carriers offering QHPs will be required to report New Mexico-specific quality information to Be Well New Mexico and DOI. Quality reporting will not be required for dental carriers; however dental-specific quality measures may be created by DOI for future plan years.¹² 

Dental and Vision Benefits: DOI will allow either embedded pediatric dental benefits at a minimum actuarial value level of 70% or the health plan can opt out of embedding.  DOI has adopted the reasonable limit of annual cost sharing for stand-alone pediatric dental plans to be at or below $700 for a single child enrollee plan, and $1400 for two or more children enrolled in a plan. Plans sold through the SHOP Marketplace are not required to embed pediatric dental benefits, but stand-alone pediatric policies will be available on the SHOP Marketplace.¹³ 

Risk adjustment, Reinsurance, and Risk corridors: Governor Martinez stated in her letter to Secretary Sebelius that New Mexico intends to administer a risk adjustment and reinsurance program during the first year of the Marketplace, but noted that the State would not be able to come to a final determination until it has an opportunity to examine the federal risk adjustment methodology.  Governor Martinez also noted New Mexico’s intention to use the federal service for Advance Premium Tax Credit/Cost-Sharing Reduction eligibility determinations.¹⁴ 

Consumer Assistance and Outreach: On July 9, 2013 the New Mexico Human Services Department received a Level One Establishment grant of $18.6 million. This award will be used to support comprehensive outreach, education, and marketing activities, as well as the state’s “Healthcare Guide” program (Navigators and In-person Assisters). The state will partner with nonprofit organizations, counties, schools and universities, faith communities, providers, and business organizations to provide extensive outreach at local events.  The State will also provide targeted outreach and education to tribal sovereign Nations at health fairs and events, and create an educational website and hotlinks for Native Americans.¹⁵ 

On June 18, 2013, Be Well New Mexico issued an RFP for advertising and marketing assistance, educational content, and public relations services, to be funded by the state’s Level One grant award. In August, the Marketplace awarded a $6-$7 million contract,¹⁶  and on September 17^th launched its “Be Well New Mexico” marketing and outreach campaign. The campaign features radio, print and TV ads, billboards, a website and social media. It also features an original “Be Well New Mexico” song, performed by six Albuquerque-area musicians. However, due to issues that individuals have faced with using healthcare.gov, Be Well New Mexico decided to postpone its advertising campaign, including television commercials and other paid advertising, until the federal website is working better and it is easier for individuals to enroll.¹⁷ 

On June 28, 2013 Be Well New Mexico released a Request for Information (RFI) for “Healthcare Guides,” which is how the Marketplace will refer to Navigators and Assisters.¹⁸  The Marketplace is contracting with two umbrella entities to develop Navigator/Assister programs and implement comprehensive outreach, education, and enrollment strategies. In August, the Marketplace selected these two umbrella entities: New Mexico Primary Care Association and Native American Professional Parenting Resources. These umbrella entities have subcontracted with community organizations throughout the state to provide Healthcare Guide services. Individual Healthcare Guides must complete a training and certification program, as well as a criminal background check. Healthcare Guides will deliver education, outreach, and in-person assistance to result in enrollment in the Marketplace, and connect customers to the Customer Service Center, Be Well New Mexico website, or certified and licensed brokers if additional support is needed. Targeted Native American assistance programs will also be developed to serve New Mexico’s Native American population.¹⁹ 

Be Well New Mexico is using the federal call center for its individual Marketplace and creating its own call center for the SHOP Marketplace. There is one phone number that all customers can call to receive assistance (1-855-99-NMHIX). That call center will connect customers to either: 1) the state Medicaid program’s call center for Medicaid-related calls; 2) contracted Healthcare Guide entities and/or certified Healthcare Guides; 3) the federal call center for customers seeking health insurance on the individual market; 4) New Mexico’s SHOP Marketplace; or 5) referrals to agents and brokers as requested.

Agents and brokers who wish to sell Marketplace products will be required to meet licensing requirements and take additional training on Be Well New Mexico protocols. They will be required to register with the Marketplace, receive training on QHP options and other publicly subsidized insurance programs and comply with Marketplace privacy and security standards. Web brokers will be delayed until the 2015 operational year.²⁰ 

Small Business Health Options Program (SHOP) Marketplace: In New Mexico’s SHOP Marketplace, employers must cover a minimum of 50% of their employees’ health care costs. If a business has less than 25 full-time employees, offers coverage to all full-time employees, has an average annual salary for all employees of less than $50,000, and contributes at least 50% of premium costs for employee plans, the business may be eligible to receive a tax credit. Employers select a health plan metal level (bronze, silver, gold, or platinum) to offer employees, and select a reference plan on which to base their contribution for each employee. Employees can select any plan within the metal level offered by their employer, although they may have to pay more or less, based on the plan they choose compared to the reference plan.²¹ 

Financing: The Exchange Advisory Task Force made several recommendations related to the financing of the Marketplace.  It recommended that an assessment be placed on insurers both inside and outside of the Marketplace to remove the potential disincentive for Marketplace participation, and that an assessment be placed on self-insured plans to contribute to financing the Marketplace’s administrative costs. In addition, the Task Force recommended that if/when the High Risk Pool and the Health Insurance Alliance are absorbed into the Marketplace, the assessments currently placed on plans for their administrative support be transferred to support the Marketplace.²² 

Basic Health Program (BHP): New Mexico has explored establishing an optional coverage program available through the Affordable Care Act (ACA) which allows states to use federal funding to offer subsidized health insurance to adults with incomes between 139 and 200% of the federal poverty level (FPL) who would otherwise be eligible to purchase subsidized coverage through a Marketplace. The state selected a subcontractor to create a health care reform fiscal model, which includes the estimated impact of a BHP.²³  In its final recommendations, the Advisory Task Force recommended that the BHP continue to be studied as the Marketplace moves forward. Workgroup members believe the BHP is necessary to mitigate the effects of churn and avoid possible loss of coverage.²⁴ 

Essential Health Benefits (EHB): The ACA requires that all non-grandfathered individual and small-group plans sold in a state, including those offered through the Marketplace, cover certain defined health benefits.  On October 17, 2012, the Public Regulation Commission’s Insurance Division recommended that New Mexico’s EHB benchmark be the Lovelace Classic Preferred Provider Organization, a small group plan.²⁵ 

Marketplace Funding

The New Mexico Department of Human Services received a federal Exchange Planning grant of $1 million in 2010.  The Office of Health Care Reform requested and was granted a 12-month budget extension on the Planning grant funds for a new project end date of September 29, 2012.²⁶  On November 29, 2011, the New Mexico Human Services Department received a federal Level One Establishment grant of almost $35 million.²⁷  The grant funding will be used to refine the vision and objectives of the Marketplace, continue stakeholder engagement, develop a multi-year business and operational plan, and examine the information technology infrastructure and functionality necessary to operate the Marketplace by 2014. In October 2012, New Mexico requested an extension of the Level One grant. On July 9, 2013 the New Mexico Human Services Department received an additional Level One Establishment grant of $18.6 million. This award will be used to support comprehensive outreach, education, and marketing activities, establishing the state’s Navigator program, and supporting the state’s in-person assistance personnel.²⁸ 

In addition, New Mexico, along with nine other states, is receiving technical assistance from the Robert Wood Johnson Foundation through the State Health Reform Assistance Network; this assistance includes help with setting up health insurance Marketplaces, expanding Medicaid to newly eligible populations, streamlining eligibility and enrollment systems, instituting insurance market reforms and using data to drive decisions.²⁹ 

Next Steps

On January 3, 2013, New Mexico received conditional approval from the U.S. Department of Health and Human Services (HHS) to establish a state-based Marketplace.³⁰  However, due to time constraints in implementing an IT system, on May 17, the Board of Directors voted to work with the federal government to run the individual Marketplace until October 2014. Under this arrangement, the state will maintain plan management and consumer assistance functions, while the federal government will operate the IT system. The state will also run the SHOP Marketplace.^{31  32}  The Be Well New Mexico Marketplace portal opened on October 1, 2013. The state’s SHOP Marketplace has begun to sign up small businesses to buy coverage and help them select plans for their businesses. Employees will be able to sign up for plans starting November 1. Be Well New Mexico directs individuals to HealthCare.gov, the federal health insurance Marketplace portal to apply for and enroll in coverage.

Additional information about Be Well New Mexico can be found at the state’s back office Marketplace website (NMHIX) and its customer portal (Be Well New Mexico). You can also obtain information from Be Well New Mexico’s Facebook page, Twitter feed, and You Tube site.

1. New Mexico Level I Health Insurance Exchange Establishment Grant. September 2011.  ↩︎
2. Title 13, Chapter 10, Part 11. Health Insurance Alliance Plan of Operation and Eligibility.  ↩︎
3. SB 221. New Mexico Health Insurance Exchange Act.  ↩︎
4. “Governor Susana Martinez Signs Bipartisan Legislation to Establish State-Based Health Insurance Exchange By New Mexicans, For New Mexicans.” State of New Mexico, Office of the Governor. March 28, 2013.  ↩︎
5. Presentation to the New Mexico Insurance Exchange Advisory Task Force. August 22, 2012.  ↩︎
6. New Mexico Health Insurance Exchange Advisory Task Force Recommendations. New Mexico Human Services Department. April 9, 2013.  ↩︎
7. SB 221. New Mexico Health Insurance Exchange Act.  ↩︎
8. First Board Members Named for New Mexico Health Insurance Exchange. Albuquerque Business First, and Governor Susana Martinez Announces Appointments to the New Mexico Health Insurance Exchange Board. State of New Mexico Office of the Governor. ↩︎
9. New Mexico Qualified Health Plan Submission Guidelines. 4/15/13.  ↩︎
10. New Mexico Public Regulation Commission. FAQ about QHP submissions in New Mexico.  ↩︎
11. New Mexico Health Insurance Rate Review. Individual Exchange Rates.  ↩︎
12. New Mexico Qualified Health Plan Submission Guidelines. 4/15/13.  ↩︎
13. New Mexico Public Regulation Commission. FAQ s for Qualified Dental Plan Submission.  ↩︎
14. Letter from Governor Martinez to Secretary Sebelius. December 13, 2012.  ↩︎
15. Center for Consumer Information and Insurance Oversight. New Mexico Health Insurance Marketplace Grants Awards List.  ↩︎
16. NMHIX Board Meeting Minutes, August 7, 2013.  Albuquerque Business First. “Health Insurance Exchange Board Awards PR Contract.”  ↩︎
17. Albuquerque Journal. NM Health Exchange Advertising is on Hold. Oct. 17, 2013.  ↩︎
18. New Mexico Health Insurance Exchange. Assister/Navigator (“Healthcare Guides”) Request for Information. June 28, 3013.  ↩︎
19. New Mexico Health Insurance Exchange. RFI: Assister/Navigator.  ↩︎
20. New Mexico Health Insurance Exchange. Board Meeting Agenda: June 7, 2013.  ↩︎
21. New Mexico Health Insurance Exchange: SHOP Employer Management.  ↩︎
22. New Mexico Health Insurance Exchange Advisory Task Force Recommendations. New Mexico Human Services Department. April 9, 2013.  ↩︎
23. The Hilltop Institute. “New Mexico Health Care Reform Fiscal Model: Detailed Analysis and Methodology.” March 2012.  ↩︎
24. New Mexico Health Insurance Exchange Advisory Task Force Recommendations. New Mexico Human Services Department. April 9, 2013.  ↩︎
25. Press Release by the New Mexico Public Regulation Commission. October 17, 2012.  ↩︎
26. New Mexico Office of Health Care Reform. 4th Quarterly Report Project Summary for CCIIO. ↩︎
27. New Mexico Level I Health Insurance Exchange Establishment Grant. September 2011.  ↩︎
28. Center for Consumer Informaiton and Insurance Oversight. New Mexico Health Insurance Marketplace Grants Awards List.  ↩︎
29. Robert Wood Johnson Foundation. “RWJF Seeks Coverage of 95 Percent of All Americans by 2020.” May 6, 2011.   ↩︎
30. Letter from Secretary Sebelius to Governor Martinez. January 3, 2013.  ↩︎
31. “NM Changing its Plans for Health Exchange.” Associated Press.  ↩︎
32. New Mexico Health Insurance Exchange Board Meeting Minutes. May 17, 2013.  ↩︎

Final update made on October 24, 2013 (no further updates will be made)

Establishing the Marketplace

On February 15, 2013, Governor Earl Ray Tomblin (D) submitted a blueprint to Secretary Sebelius for West Virginia to establish a Partnership Marketplace with plan management responsibilities.¹  In the previous year, Governor Tomblin had signed SB 408 into law to establish the West Virginia Health Benefits Exchange and the state had begun exploring implementation options for a state-based marketplace. ²  However, concerns over the sustainability of a state-run marketplace led the Governor to pursue a Partnership Marketplace instead.

Prior to the decision to pursue a Partnership Marketplace, the Health Policy Division within the Office of the Insurance Commissioner (OIC) led the marketplace planning initiative. In January 2012, the OIC released a business plan which documented an approach to implementing the Marketplace.³  In addition, the OIC held a series of public engagement meetings throughout the state and met regularly with stakeholder groups to focus on marketplace implementation issues related to carriers, consumers, producers, and providers.

Contracting with Plans: In April 2013, the West Virginia Offices of the Insurance Commissioner (OIC) released a Qualified Health Plan Submission Guide to provide guidance to health insurance issuers regarding the certification standards for individual and SHOP Qualified Health Plans (QHPs) offered through the Marketplace. Two plans applied and were chosen as QHPs in West Virginia: Highmark Blue Cross Blue Shield and Carelink/Coventry Health Care.⁴  However, Carelink/Coventry Health Care withdrew from the Marketplace in September 2013, leaving Highmark Blue Cross Blue Shield as the only insurer. Highmark offers eleven plans in the individual Marketplace and four plans in the SHOP. Rates were released through Healthcare.gov.⁵ 

Rates vary based on tobacco use, family composition, age, and geography. West Virginia has established eleven geographic rating areas. Issuers must submit rate information to the Marketplace on an annual basis, and the OIC will review rates for compliance with rating standards.⁶  Acting as a clearinghouse, OIC will accept plans that meet federal and state certification criteria. The State has partnered with the West Virginia School of Osteopathic Medicine to develop a strategy to maximize and report on provider quality in the Marketplace, such as through measurement and reporting, purchasing, and engaging consumers through better information.

Risk Adjustment, Reinsurance, and Risk Corridors: In 2011, the West Virginia legislature passed HB 2745 to develop an all-payer claims database and the state expects to begin collecting data in 2013.⁷  This database will provide the baseline information to create a risk adjustment program, as well as to provide outcome quality data and enable analyses of Marketplace policy initiatives. Governor Tomblin noted in his letter of intent to establish a Partnership Marketplace that West Virginia does not intend to operate a reinsurance program in 2014.⁸ 

Consumer Assistance and Outreach:  The federal government will administer the state’s Navigator program, while the West Virginia OIC will oversee an In-Person-Assister (IPA) program.⁹  Navigator entity applications were due on June 7, 2013 and grantees were notified by the federal government on August 15.¹⁰  CMS awarded two organizations approximately $600,000 for the Navigator program in West Virginia.¹¹  However, in September 2013, one of the organizations, West Virginia Parent Training and Information Inc., declined the $365,000 federal grant to be a navigator organization after receiving an inquiry from the State Attorney General.¹²  WVPTI did not explicitly cite the inquiry, which directed the nonprofit to answer 26 questions about their personnel and hiring practices, as the reason the group declined the grant.

The state selected an In-Person Technical Assistance contractor in July 2013 to help select IPA entities that will operate around the state. ¹³  IPAs will focus on assisting vulnerable and underserved populations in the individual private and public markets. The state requires that IPAs meet the same training, privacy and security, and conflict of interest standards as outlined in federal guidance on Navigators. The state estimated a need of 270 IPAs during open enrollment, and approximately 30 IPAs during non-peak periods. IPAs are available in 46 of 55 counties and an available list of IPAs in West Virginia is available through the state’s health insurance Marketplace website.¹⁴  West Virginia will rely on the federal government for mass marketing and branding of the Marketplace. The IPA vendor may perform some marketing at the local level.¹⁵ 

Organizations can apply to be Certified Application Counselors through CMS and assist consumers in the application and enrollment process. Additionally, 27 Health Centers have been awarded outreach and enrollment assistance grants from HRSA to assist eligible consumers to enroll in coverage.¹⁶  More than 800 local assisters have been trained as of September 30, 2013.¹⁷ 

Coordination with Medicaid: West Virginia is expanding its Medicaid program to individuals with incomes below 138% of the federal poverty level. Eligibility will be determined through the federal healthcare.gov and those who qualify for Medicaid will be directed to the state Medicaid website.¹⁸  West Virginia has sent letters to more than 170,000 people who were signed up for the Supplemental Nutrition Assistance Program (SNAP) and qualified for Medicaid.¹⁹  For those who respond to these letters, they will be automatically enrolled in Medicaid in November.

Essential Health Benefits: The ACA requires that all non-grandfathered individual and small-group plans sold in a state, including those offered through the Marketplace, cover certain defined health benefits. Since West Virginia did not put forward a recommendation, the state’s benchmark EHB plan will default to the largest small-group plan in the state, Highmark (Blue Cross Blue Shield of West Virginia) – Super Blue Plus 2000 PPO.

Marketplace Funding

The West Virginia Office of the Insurance Commissioner received a federal Exchange Planning grant of $1 million in September 2010 and a federal Level One Establishment grant of $9.7 million in August 2011. The Establishment grant will be used to study consumer quality and effectiveness, complete economic modeling, and investigate risk adjustment strategies and policy integration with state agencies. In July 2013, West Virginia received a second Level One Establishment grant for $10.2 million to support the IPA program and plan management activities. ²⁰  The state requested and received a No Cost Extension for the Establishment grant, in part due to the delay of the release of an RFP for an actuarial assessment and economic model of the Marketplace.²¹ 

Next Steps

On March 5, 2013, West Virginia received conditional approval from the U.S. Department of Health and Human Services (HHS) to establish a Partnership Marketplace.²²  On October 1, West Virginia launched a consumer website that provides information on Navigators and In-person Assisters by county and links to healthcare.gov where consumers can apply for and enroll in coverage.

Additional information about the West Virginia Marketplace can be found at: http://bewv.wvinsurance.gov/ and www.healthcare.gov

1. State of West Virginia, Offices of the Insurance Commissioner, Health Policy Division. “Blueprint Section 4: Plan Management.”  ↩︎
2. SB 408/HB 3018 (Chapter 100). West Virginia Health Benefit Exchange Act.  ↩︎
3. West Virginia, Offices of the Insurance Commissioner, Health Benefits Exchange. “Business Plan, Version 1.2.” January 19, 2012.  ↩︎
4. Nelson, C. September 11, 2013. “Highmark Now State’s Only Marketplace Option.” Charleston Daily Mail.  ↩︎
5. Healthcare.gov. Health Plan Information for Individuals and Families.  ↩︎
6. West Virginia Offices of the Insurance Commissioner. Qualified Health Plan Submission Guide. Aparil 2013.  ↩︎
7. HB 2745. West Virginia 2011 Legislation.  ↩︎
8. Letter from Governor Tomblin to Secretary Sebelius, February 15, 2013.  ↩︎
9. State of West Virginia, Offices of the Insurance Commissioner, Health Policy Division. “Blueprint Section 4: Plan Management.” ↩︎
10. WV Health Benefit Exchange. Stakeholder Meeting Summary. May 28, 2013.  ↩︎
11. WV Health Benefit Exchange. Stakeholder Meeting Summary. May 16, 2013.  ↩︎
12. Eyre, E. “Rockefeller: Morrisey Intimidated Health Group Over ACA.” WV Gazette. September 7, 2013.  ↩︎
13. WV Health Benefit Exchange. Stakeholder Meeting Summary. July 9, 2013.  ↩︎
14. West Virginia Health Insurance Marketplace.  ↩︎
15. WV Health Benefit Exchange. Stakeholder Meeting Summary. May 16, 2013.  ↩︎
16. HRSA. West Virginia: Health Center Outreach & Enrollment Assistance.  ↩︎
17. Johnson, S. September 30, 2013. “Health Insurance Marketplace Opens Tuesday.” Metro News.  ↩︎
18. Medicaid.gov. West Virginia Moving Forward in 2014.  ↩︎
19. Terrarosa, T. October 17, 2013. “Health Insurance Marketplace Faces Difficulties.” The Dominion Post.  ↩︎
20.  West Virginia Health Insurance Marketplace Grants Awards List.  ↩︎
21. West Virginia Establishment Grant Quarterly Report, 4/1/12-6/30/2012. ↩︎
22. Letter from Secretary Sebelius to Governor Tomblin. March 5, 2013.  ↩︎

The Department of Defense (DoD) puts significant resources into understanding, preventing, and treating infectious diseases related to global health. Its efforts help to protect the health and well-being of U.S. military personnel, but also contribute to the health of civilians at home and abroad. DoD’s infectious disease efforts range from advancing medical research pertaining to infectious diseases; to innovating new tools and strategies for their control and prevention; to tracking, preparing for, and responding to outbreaks around the world. DoD’s work also helps strengthen other countries’ efforts to address these diseases.

This report provides an overview of DoD’s work pertaining to infectious diseases, looking at how activities are organized internally and ways they are coordinated with other U.S. government (USG) agencies and external partners. It focuses on the force health protection areas of medical research and development, health surveillance, and personnel education and training programs in infectious diseases, as well as to support the growing area of partnership engagement activities with partner countries. It identifies the various DoD funding streams for infectious disease efforts and spotlights DoD’s work to address two of global health’s key infectious disease challenges, HIV/AIDS and malaria, and DoD and USG funding supporting these efforts.

This report builds on The U.S. Department of Defense and Global Health, a Kaiser Family Foundation report released last fall that provided the first comprehensive look at the department’s role in global health.

Source

A. Houser, W. Fox-Grage, and K. Ujvari. Across the States 2013: Profiles of Long-Term Services and Supports, AARP Public Policy Institute, September 2012, available at: http://www.aarp.org/content/dam/aarp/research/public_policy_institute/ltc/2012/across-the-states-2012-full-report-AARP-ppi-ltc.pdf. 

Source

M. O’Malley Watts, M. Musumeci, and E. Reaves, How is the Affordable Care Act Leading to Changes in Medicaid Long-Term Services and Supports (LTSS) Today? State Adoption of Six LTSS Options, The Henry J. Kaiser Family Foundation, April 2013, available at: http://www.kff.org/medicaid/issue-brief/how-is-the-affordable-care-act-leading-to-changes-in-medicaid-long-term-services-and-supports-ltss-today-state-adoption-of-six-ltss-options/;  updates available at: http://www.kff.org/state-category/health-reform/.

Source

U.S. Census Bureau, 2012 American Community Survey 1-Year Estimates, available at: http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_12_1YR_S1810&prodType=table

Source

KCMU and Urban Institute estimates based on FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 data. Because 2010 data were unavailable, 2009 MSIS data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.

Source

KCMU and Urban Institute estimates based on data from FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 reports. Because the 2010 data were unavailable, 2009 data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.

Source

KCMU estimates based on FY 2011 Centers for Medicare & Medicaid Services (CMS) National Health Expenditure Accounts data.

Source

KCMU and Urban Institute estimates based on data from FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 reports. Because 2010 data were unavailable, 2009 MSIS data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.