As I noted last week, Washington State is the first in the nation to finally correct one of the dumbest provisions of the Affordable Care Act as it was originally passed:

(3) Access limited to lawful residents.--If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.

Again, this doesn't just mean that they can't get federal financial help; it means they can't enroll via ACA exchanges at all:

Undocumented immigrants aren’t eligible to buy Marketplace health coverage, or for premium tax credits and other savings on Marketplace plans. But they may apply for coverage on behalf of documented individuals.

Connecticut House Bill 6616 was introduced to the state House in February with a total of 13 cosponsors (all Democrats). Since then it's had a public hearing and has been reported favorably out of the legislative commissioners' office and to the House Appropriations Committee.

The bill seems to expand Medicaid and/or CHIP eligibility ("Husky A, B or D") to a significant number of undocumented children in the state, but it's rather densely worded, making it difficult for me to be certain just how far up the age range it applies. However, according to Louise Norris, it would extend it from the current 12-year old limit for undocumented children up to age 20 by January 2024 and age 25 by later that year, as long as their household income is still below the thresholds currently in place for those populations:

Section 17b-261 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2024):


I had heard that this was in the works, and with the recent trend of more & more states (most recently including Georgia) splitting off from the Federally Facilitated Marketplace (FFM) hosted via HealthCare.Gov, it's hardly surprising...but it's still a pretty big deal, especially given that Illinois is the 6th largest U.S. state by population. Via Amy Lotven of Inside Health Policy:

Illinois’ Department of Insurance would be authorized to operate a state-based exchange, starting in plan year 2026, under legislation introduced late Thursday by the Illinois Democratic House Majority Leader Robyn Gabel. Sources earlier this week told IHP they had heard state officials were working with lawmakers on exchange legislation and the bill could be unveiled by this week.


So, I've been combing through a mountain of healthcare & health insurance-related legislation which has been introduced by various state legislators around the country, and this one caught my eye:

OR HB3326

Relating to changing the name of the Oregon Health Authority; declaring an emergency.

The bill summary doesn't provide much more detail:

Changes name of Oregon Health Authority to Oregon Department of Health. Makes conforming changes. Becomes operative on January 1, 2024. Declares emergency, effective on passage.

OK, so it changes the name of the health department and...declares an emergency relating to that? Huh? What?

It was introduced about a month ago by GOP state representative Werner Reschke. It doesn't have any other cosponsors from either party so far.

I decided to take a look at the actual legislative text.


via the Michigan Dept. of Insurance & Financial Services (DIFS):

New DIFS Bulletin to Protect LGBTQ+ Michiganders from Discrimination in Insurance, Financial Markets

March 17, 2023

(LANSING, MICH) The Michigan Department of Insurance and Financial Services (DIFS) has issued a bulletin that reaffirms the department’s commitment to protecting Michiganders from discrimination based on sex, sexual orientation, and gender identity in the insurance or financial services industries. The bulletin ensures that the insurance and financial services industries, including health insurance, must comply with the newly-amended Elliott-Larsen Civil Rights Act as signed into law by Governor Gretchen Whitmer yesterday afternoon.

Hawaii House Bill 1179 was introduced in January by 16 Democratic state legislators.

The first section of the legislative text is about as frank and clear as I've ever seen:

The legislature finds that Hawaii has long been a leader in advancing reproductive rights and advocating for access to affordable and comprehensive sexual and reproductive health care without discrimination. However, gaps in coverage and care still exist, and Hawaii benefits and protections have been threatened for years by a hostile federal administration that has attempted to restrict and repeal the federal Patient Protection and Affordable Care Act and limit access to sexual and reproductive health care. The Trump administration made it increasingly difficult for insurers to cover abortion care and assembled a Supreme Court that restricted abortion access and that may eliminate the Patient Protection and Affordable Care Act in the near future.

via the Iowa Health & Human Services Dept.:

The Children’s Health Insurance Program (CHIP) is offered through the Healthy and Well Kids in Iowa program, also known as Hawki. Iowa offers Hawki health coverage for uninsured children of working families.

No family pays more than $40 a month. Some families pay nothing at all. A child who qualifies for Hawki health insurance will get their health coverage through a Managed Care Organization (MCO).

Currently, only children up to 19 years old in families earning up to 302% of the Federal Poverty Level (FPL) are eligible for Iowa's CHIP program (Hawk-I). That's roughly $60K/year for a single parent with one child, or around $91K/yr for a family of four. Again, only the children are eligible, not the parents or guardians.

Mazel Tov to Audrey Morse Gasteier, who I know via online discussions & have met a couple of times in person at the annual Families USA conference. I'm sure she'll continue to do a great job:

BOSTON — Audrey Morse Gasteier, who has served as a policy leader at the Massachusetts Health Connector for more than a decade, was named executive director of the state-based Marketplace today by Secretary of Health and Human Services and Health Connector Board Chair Kate Walsh.

Morse Gasteier had been serving as acting executive director since January. 

 “Since its establishment in 2006, the Health Connector has been where Massachusetts residents can find affordable health care,” said Secretary Walsh. “Audrey has been a key part of that important work for many years, and I look forward to working with her as we continue to make health care coverage accessible to everyone in Massachusetts.”

I first wrote about this back in May 2022, but had lost track of the waivers' status since then. As I wrote at the time:

One of the most inane restrictions of the ACA in my view, as I noted in my "If I Ran the Zoo" wish list back in 2017, is that it doesn't allow undocumented immigrants to enroll in ACA marketplace health plans ("Qualified Health Plans" or QHPs).

I don't just mean that they aren't eligible for federal financial subsidies--that's a prohibition which I can at least understand, even if I don't agree with it. I mean that they aren't allowed to enroll in ACA exchange-based QHPs even at full price, as noted in Section 1312(f)(3):

As I noted last month, as we've reached the 3rd anniversary of the COVID-19 pandemic hitting U.S. shores and with the Public Health Emergency winding down, it's become more & more difficult for data analysts and researchers to acquire comprehensive, county-level data about cases, hospitalizations, deaths, vaccinations and so forth.

In particular, at least three major sources of this data have either announced that they're shutting down their data tracking projects or have already done so, including Johns Hopkins University, the White House COVID-19 Community Profile Report and the New York Times.

With two of these already discontinued and the third set to do so within the next few weeks, this story is somehow even more depressing to me (via Robert King at Fierce Healthcare; h/t Katherine Hempstead for the heads up):