Forefront: Georgia's Waiver Fight
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Monday, April 11, 2022 | The Latest Research, Commentary, And News From Health Affairs
Dear John,

Tomorrow at 3:00 PM Eastern, join Health Affairs for our April Journal Club meeting with Evan Lemire, focused on his article, “Unequal Housing Conditions And Code Enforcement Contribute To Asthma Disparities In Boston, Massachusetts.”

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Health Reform Updates
In an ahead-of-print article, Katie Keith writes that enrollment in Marketplace coverage remains high as we await new rules from the Biden administration and track No Surprises Act litigation.

Keith reports that 14.5 million people enrolled in the Affordable Care Act (ACA) Marketplace during the 2022 open enrollment period, including nearly 3.1 million new consumers. Overall, enrollment increased by 21 percent relative to 2021.

In her breakdown of litigation over the No Surprises Act, Keith explains the act, a related interim final, and legal challenges facing the measure.

Several of the lawsuits are currently on hold, and the Biden administration has indicated that it will issue a final arbitration rule by next month.

“This final rule could rescind, replace, or readopt the provisions set aside by the court. The final rule will likely affect the timeline of current litigation and could trigger future lawsuits,” Keith reports.

For more updates about the ACA and health reform, sign up for the Health Reform newsletter.

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Elsewhere At Health Affairs
Today in Health Affairs Forefront, authors write about the "Georgia Pathways" waiver, which would extend Medicaid coverage to people earning up to 100 percent of the federal poverty level provided they pay premiums and fulfill work requirements.

Nicole Huberfeld examines the tension between state and federal power in Medicaid, as the Georgia Pathways waiver does not fulfill the terms of the Affordable Care Act (ACA) Medicaid expansion.

Sara Rosenbaum and coauthors write about the section 1115 powers of the Department of Health and Human Services (HHS).

Section 1115 of the Social Security Act gives the HHS secretary the power to allow a state to deviate from provisions of federal Medicaid law. Rosenbaum and authors inquire about when 1115 Medicaid expansion experiments should be approved.

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