Legislation
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Effective Date
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1332 Waiver
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Funding Source
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Program run by or to be run by (gov, insurers, others?)
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Markets
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Carrier participation - voluntary or mandatory?
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Provider Participation
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Provider reimbursement
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Are there regional exclusions on provider payments?
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Plans first available in 2023
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Authorized (premium reduction targets contingent on approval)
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Federal and state-funded subsidies via ACA PTCs and 1332 innovation waiver.
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Government (Division of Insurance)
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Individual, Small Group
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Mandatory. Any carrier in individual and small-group markets must offer public option plans in each county in which they operate
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Provider participation may be ordered following a public hearing, with penalties for noncompliant hospitals
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Payment floors apply if state is setting rates; floors vary by provider type and specific circumstances but generally set above Medicare reimbursement rates
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Unspecified
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