Private Insurance State Policy Tracker

Use this interactive map to help you determine if your state has taken action to implement changes to private insurance provisions through state laws, regulations, or other policies. This map tracks state action in the following areas: 1332 waivers, individual mandates, short-term limited duration insurance protections, bans on transitional policies, extended Open Enrollment period, and Essential Health Benefits modifications.

NASTAD’s interactive Medicaid Waiver Map tool is available here.

This map was produced as part of a project supported by the Elton John AIDS Foundation.

Last Updated: May 2019

Color Coding

State has taken no action

State has taken at least one action

Alaska

State has taken at least one action

1332 waiver

  • Status: Approved
  • Allows federal pass through funding to partially finance the state's reinsurance program.
  • Federal Approval (July 2017)

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Alabama

State has taken no action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Arkansas

State has taken no action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

None

 

Transitional policies

Allowed through 2020, consistent with federal guidance. The state permits transitional plans to remain in force to the extent permitted by the U.S. Centers for Medicare and Medicaid Services. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Arizona

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 185 days. There are no limits on consecutive policies, but renewals may not exceed 180 days. ARS 20-1379 (2018).

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

California

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

Sale of short-term limited duration insurance policies is prohibited. S.B. 910, 2017-2018 Leg., Reg. Sess. (Ca. 2018).

Transitional policies

Not allowed. The California Health Benefit Exchange Board voted not to allow continuation of transitional individual market policies beyond December 31, 2013. California Health Benefit Exchange Board Meeting Minutes, November 21, 2013. Transitional policies in the small group market were required by law to terminate on December 31, 2015. CA Health & Safety § 1367.012 (2018); CA Ins. § 10112.300 (2018).

Extended Open Enrollment Period

Open Enrollment has been permanently extended, and will run from October 15 – January 15 beginning with the 2019 plan year. A.B. 156, 2017-2018 Leg., Reg. Sess. (Ca. 2017).

Essential Health Benefits modifications

None

Colorado

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. Consumers must wait 6 months to apply after enrollment in 2 short-term plans within a 12-month period, regardless of whether the consumer is enrolled in the same product or insurer. Colo. Rev. Stat. § 10-16-102 (2018).

Transitional policies

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. Consumers must wait 6 months to apply after enrollment in 2 short-term plans within a 12-month period, regardless of whether the consumer is enrolled in the same product or insurer. Colo. Rev. Stat. § 10-16-102 (2018).

 

Short-term plans must cover Essential Health Benefits. Short-term plans are subject to guaranteed issue requirements, and underwriting may only be used in determining pre-existing conditions that will be excluded under the policy. 3 CCR § 702-4-2-59.

 

Transitional policies

Not allowed. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

Open enrollment for the 2019 plan year is extended until January 15, 2019. Colorado Department of Health Care Policy and Financing.

 

Essential Health Benefits modifications

None

Connecticut

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. There are no limits on consecutive policies, but insurers must reduce the pre-existing condition exclusion period for subsequent policies. C.G.S. § 38a-476 (2017). Short-term limited duration insurance must cover Essential Health Benefits. C.G.S. § 38a-482c (2017).

Transitional policies

Not allowed. Office of the Governor.

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. There are no limits on consecutive policies, but insurers must reduce the pre-existing condition exclusion period for subsequent policies. C.G.S. § 38a-476 (2017). Short-term limited duration insurance must cover Essential Health Benefits. C.G.S. § 38a-482c (2017).

 

Transitional policies

Not allowed. Office of the Governor.

 

Extended Open Enrollment Period

Connecticut has not extended the Open Enrollment Period. Open Enrollment will run from November 1 – December 15. Access Health CT FAQs.

 

Essential Health Benefits modifications

None

District of Columbia

State has taken at least one action

1332 waiver

None

 

Individual mandate

Washington, D.C.’s individual mandate goes into effect January 1, 2019. B. 22-0753, 2018 Council Sess. (D.C. 2018).

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 3 months. After 3 months of coverage, a consumer must wait 9 months before enrolling in coverage with the same insurer. Pre-existing conditions for which an applicant sought treatment within the prior 12 months may not be excluded from coverage, and issuers may not deny coverage based on such a condition. D.C. Act 22-595 (Jan. 23, 2019).

 

Transitional policies

Not allowed. Department of Insurance Press Release.

 

Extended Open Enrollment Period

The Open Enrollment Period for the 2019 benefit year will run from November 1, 2018 through January 31, 2019. DC Health Benefit Exchange Resolution.

 

Essential Health Benefits modifications

None

Delaware

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 3 months. An issuer may not sell consecutive policies to the same policyholder or sell a short-term policy to the same policyholder more than once in any given year. 18 Del. Admin. Code § 1320.

 

Transitional policies

Not allowed.

 

State legislation requires all plans issued or renewed after January 1, 2014 to comply with ACA requirements. Del. Code Tit. 18 § 3303 et seq.; Department of Insurance Press Release.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Florida

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

There are no limits on initial contract duration or consecutive policies. However, plans offered for more than 6 months must follow the state’s pre-existing condition exclusion ban, which prohibits plans from having a pre-existing condition exclusion period of more than 24 months for consumers without continuous coverage. Fla. Stat. Ch. 627.6045 (2018).

 

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Georgia

State has taken no action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed. Kevin Lucia et al., State Regulation of Coverage Options Outside of the Affordable Care Act: Limiting the Risk to the Individual Market, The Commonwealth Fund (Mar. 29, 2018).

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Hawaii

State has taken at least one action

1332 waiver

  • Status: Approved
  • Waives SHOP requirements that conflict with the state’s Prepaid Health Care Act, which requires employers to provide more generous coverage than is required under the ACA.
  • Waives the requirements that small business tax credits are available only through SHOP. Instead, Hawaii receives federal funds and makes health care premium reimbursements available to small employers who provide coverage to employees.
  • Federal Approval (December 2016)

Individual mandate

None

Short-term limited duration insurance protections

Initial contract duration cannot exceed 90 days. A consumer may not enroll in short-term coverage if they were covered by a short-term policy at any time within the previous calendar year, regardless of whether the consumer is enrolled in the same product or insurer. Insurers may not issue short-term, limited duration insurance to individuals who were eligible to purchase Marketplace coverage during Open Enrollment or a Special Enrollment Period in the previous calendar year, effectively preventing most people from buying these plans. H.B. 1520, 29th Leg., Reg. Sess. (Haw. 2017).

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Iowa

State has taken no action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

None

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Idaho

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Short-term plans are renewable at the option of the insured. H. 0275, 2019 Reg. Leg. Sess. (Id. 2019).

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

Idaho has not extended the Open Enrollment Period. Open Enrollment will run from November 1 – December 15.

 

Essential Health Benefits modifications

None

Illinois

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 180 days. At the end of the initial contract, a consumer must wait 60 days before enrolling in coverage with the same issuer. S.B. 1737, 2018 Leg., Reg. Sess. (Il. 2018).

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

  • Status: Approved
  • Adds five additional covered benefits to the state’s benchmark plan, intended to address the opioid epidemic. Beginning in 2020, the Illinois benchmark plan will: cover alternative therapies for pain, limit opioid prescriptions for acute pain, remove barriers to obtaining Buprenorphine or brand equivalent products for MAT, cover prescriptions for at least one intranasal spray overdose reversal agent, and cover tele-psychiatry.
  • Federal Resources
  • Department of Insurance Press Release (August 2018)

Indiana

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. Ind. Code § 27-1-37.3-5. There are no limits on consecutive policies.

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Kansas

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

Short-term policies are limited to one renewal period, with or without a requirement of medical re-underwriting or medical requalification. Kan. Stat. 40-2, 193 (2017).

Transitional policies

Allowed. Kevin Lucia et al., State Regulation of Coverage Options Outside of the Affordable Care Act: Limiting the Risk to the Individual Market, The Commonwealth Fund (Mar. 29, 2018).

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Kentucky

State has taken no action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed through 2019, consistent with federal guidance. The Department of Insurance is also permitting limited changes to transitional plans to provide premium relief. The proposed changes must be submitted to the Department and are subject to prior approval requirements. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Louisiana

State has taken at least one action

1332 waiver

None

Individual mandate

None

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Short-term plans with contract duration of more than 6 months are subject to limits on pre-existing condition exclusions. La. R.S. § 22:1027 (2018). There are no limits on consecutive policies.

 

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Massachusetts

State has taken at least one action

1332 waiver

None

Individual mandate

Massachusetts has had an individual mandate in place since 2006. Mass. Gen. Laws Ch. 111M § 2 (2018); Department of Revenue.

Short-term limited duration insurance protections

State law prohibits medical underwriting and requires all plans to comply with guaranteed issue and rating requirements. Therefore, no short-term plans are available in the market. Mass. Gen. Laws Ch. 176M.

Transitional policies

Not allowed. Department of Insurance Bulletin.

Extended Open Enrollment Period

The Open Enrollment Period for the 2019 benefit year will run from November 1, 2018 through January 23, 2019. Department of Insurance Bulletin.

Essential Health Benefits modifications

None

Maryland

State has taken at least one action

Maryland

1332 waiver

  • Status: Approved
  • Allows federal pass through funding to partially finance the state's reinsurance program, beginning in 2019.
  • Federal Approval (August 2019)

 

Individual mandate

None.

 

Short-term limited duration insurance protections

Initial contract duration must be less than 3 months. H.B. 1782, 2018 Leg., Reg. Sess. (Md. 2018). There are no limits on consecutive policies.

 

Transitional policies

Not allowed. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

None

 

Essential Health Benefits modifications

None

Maine

State has taken at least one action

1332 waiver

  • Status: Approved
  • Allows federal pass through funding to partially finance the state's reinsurance program, beginning in 2019.
  • Federal Approval (July 2019)

Individual mandate

None

Short-term limited duration insurance protections

There are no limits on initial contract duration. A consumer may not enroll in short-term coverage for more than 24 consecutive months, regardless of whether the consumer is enrolled in the same product or insurer. ME Rev. Stat. Tit. 24-A Sec. 2849-B (2017).

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin. The policy applies only to small-group plans because there are no transitional policies still in force in Maine.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Michigan

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

Initial contract duration cannot exceed 185 days. A consumer may not enroll in short-term coverage with the same insurer for more than 185 days in a 365-day period. Mich. Comp. Laws § 500.2213b (2018).

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Minnesota

State has taken at least one action

1332 waiver

  • Status: Approved
  • Allows federal pass through funding to partially finance the state's reinsurance program, beginning in 2019.
  • Federal Approval (October 2017)

Individual mandate

None

Short-term limited duration insurance protections

Initial contract duration cannot exceed 185 days. A consumer may not enroll in short-term coverage with the same insurer for more than 365 days in a 555-day period. Minn. Stat. 62A.65 § 7 (2017).

Transitional policies

1332 waiver

  • Status: Approved
  • Allows federal pass through funding to partially finance the state's reinsurance program, beginning in 2019.
  • Federal Approval (October 2017)

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 185 days. A consumer may not enroll in short-term coverage for more than 365 days in a 555-day period, regardless of whether the consumer is enrolled in the same product or insurer. Minn. Stat. 62A.65 § 7 (2017).

 

Transitional policies

Not allowed. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

The Open Enrollment Period for the 2019 benefit year will run from November 1, 2018 through January 13, 2019. State Marketplace (MNSure).

 

Essential Health Benefits modifications

None

Missouri

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. Department of Insurance Filing Guidelines. There are no limits on consecutive policies.

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Mississippi

State has taken no action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Montana

State has taken no action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

North Carolina

State has taken no action

1332 waiver

None

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

None

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

North Dakota

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. S.B. 2118, 2019 Reg. Leg. Sess. (N.D. 2019) (to be codified at ND Cent. Code § 26.1-36.49). Short-term plans are renewable at the option of the insured, but may be renewed only once for a total coverage period not to exceed 12 months. Medical underwriting at renewal is prohibited. S.B. 2118, 2019 Reg. Leg. Sess. (N.D. 2019); Department of Insurance Bulletin.

 

Transitional policies

Allowed. Kevin Lucia et al., State Regulation of Coverage Options Outside of the Affordable Care Act: Limiting the Risk to the Individual Market, The Commonwealth Fund (Mar. 29, 2018).

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Nebraska

State has taken no action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

None

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

New Hampshire

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. A consumer may not enroll in short-term coverage for more than 540 days in a 24-month period, regardless of whether the consumer is enrolled in the same product or insurer. NH Stat. 415:5 (2018).

 

Transitional policies

Allowed through 2020. Plans can remain in force through December 2020, but only if they are renewed on or before January 1, 2020. Partial year renewals not permitted under state law. NH Stat. 420-G:4 (2018). All transitional policies must end in 2020, even if federal guidance allows for another extension beyond 2020. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

New Jersey

State has taken at least one action

1332 waiver

  • Status: Approved
  • Allows federal pass through funding to partially finance the state's reinsurance program, beginning in 2019.
  • Federal Approval (August 2018)

Individual mandate

New Jersey’s individual mandate goes into effect January 1, 2019. A.B. 3380, 218th Leg., Reg. Sess. (N.J. 2018).

Short-term limited duration insurance protections

Underwritten short-term plans are not permitted. All individual health plans must comply with guaranteed renewability and guaranteed issue requirements, provide coverage for a full year, provide comprehensive benefits that exceed ACA requirements, and comply with federal rating and medical loss ratio standards. N.J.S.A. 17B:27A-3 (2018); Department of Insurance Press Release.

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

New Mexico

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 3 months. A consumer may not enroll in short-term coverage if they have been enrolled in a short-term plan within the past 3 months, regardless of whether the consumer is enrolled in the same product or insurer. Short-term plans must cover most (but not all) Essential Health Benefits. H.B. 285, 2019 Leg. Reg. Sess. (N.M. 2019).

 

Transitional policies

Not allowed. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Nevada

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

Initial contract duration cannot exceed 185 days. A consumer may not enroll in short-term coverage with the same insurer for more than 185 days in a 365-day period. Nev. Admin. Code § 689A.434 (2018).

Transitional policies

Not allowed. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

New York

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Underwritten short-term plans are not permitted. All individual health insurance policies must comply with guaranteed renewability requirements and must provide comprehensive coverage, including Essential Health Benefits. NY Insurance Law §§ 3216, 3221, 4303, 4304, 4305, and 4328; 11 NYCRR § 52.71; Department of Insurance Bulletin.

 

Transitional policies

Not allowed. Department of Insurance.

 

Extended Open Enrollment Period

The Open Enrollment Period for the 2019 benefit year will run from November 1, 2018 through January 31, 2019. NY State of Health Press Release.

 

Essential Health Benefits modifications

None

Ohio

State has taken no action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

None

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Oklahoma

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. 36 O.S. § 6060.4; Department of Insurance Bulletin. There are no limits on consecutive policies.

 

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Oregon

State has taken at least one action

1332 waiver

  • Status: Approved
  • Allows federal pass through funding to partially finance the state's reinsurance program, beginning in 2019.
  • Federal Approval (October 2017)

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 3 months. After 3 months of coverage, a consumer must wait 60 days before enrolling in coverage with the same insurer. ORS § 743B.005 (2017).

 

Transitional policies

Not allowed. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Pennsylvania

State has taken no action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed. The Department of Insurance did not issue a bulletin officially allowing transitional policies in 2019 consistent with federal guidance, but 2019 rate filing guidelines include information about transitional plan filings. Department of Insurance 2019 Rate Filing Guidelines.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Rhode Island

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

State law prohibits pre-existing condition exclusions and requires all plans to comply with rating requirements. Therefore, no short-term plans are available in the market. RI Gen. Laws § 27-18.5-2 (2019).

 

Transitional policies

Not allowed. Department of Insurance and HealthSourceRI Joint Statement.

 

Extended Open Enrollment Period

None

 

Essential Health Benefits modifications

None

None

South Carolina

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration may not exceed 11 months. There are no limits on consecutive policies, but renewals may not exceed 33 months. Department of Insurance Bulletin.

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

South Dakota

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. S.D. Admin. R. 20:06:39:34.01 (2018). There are no limits on consecutive policies.

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Tennessee

State has taken no action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed. Kevin Lucia et al., State Regulation of Coverage Options Outside of the Affordable Care Act: Limiting the Risk to the Individual Market, The Commonwealth Fund (Mar. 29, 2018).

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Texas

State has taken no action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

None

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Utah

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Insurers must reduce the pre-existing condition exclusion period for subsequent policies. H.B. 55, 2019 Reg. Leg. Sess. (Ut. 2019).

 

Transitional policies

Allowed through 2020, consistent with federal guidance. State law permits transitional plans to remain in force to the extent permitted by the U.S. Centers for Medicare and Medicaid Services. Utah Code 31A-31-117 (2018).

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Virginia

State has taken at least one action

1332 waiver

None

 

Individual mandate

None

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 6 months. Department of Insurance.

 

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

Vermont

State has taken at least one action

1332 waiver

None

 

Individual mandate

Vermont’s individual mandate goes into effect January 1, 2020. H. 696, 2018 Leg., Reg. Sess. (Vt. 2018).

 

Short-term limited duration insurance protections

Initial contract duration cannot exceed 3 months. A consumer may not enroll in short-term coverage for more than 3 months in a 12-month period, regardless of whether the consumer is enrolled in the same product or insurer. H. 892, 2018 Leg., Reg. Sess. (Vt. 2018).

 

Short-term plans must cover Essential Health Benefits and comply with all state health insurance regulations. Short-term plans may not impose pre-existing condition exclusions, limitations, or waiting periods. Rule I-2018-03.

 

Transitional policies

Not allowed. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

Vermont has not extended the Open Enrollment Period. Open Enrollment will run from November 1 – December 15. Vermont Health Connect.

 

Essential Health Benefits modifications

None

Washington

State has taken at least one action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Not allowed. Department of Insurance Press Release.

Extended Open Enrollment Period

None

Essential Health Benefits modifications

None

Wisconsin

State has taken at least one action

1332 waiver

  • Status: Approved
  • Allows federal pass through funding to partially finance the state's reinsurance program, beginning in 2019.
  • Federal Approval (July 2018)

 

Individual mandate

None

 

Short-term limited duration insurance protections

A consumer may not enroll in short-term coverage with the same insurer for more than 18 consecutive months. Wis. Stat. § 632.7495 (2018).

 

Transitional policies

Allowed through 2020, consistent with federal guidance. Department of Insurance Bulletin.

 

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

 

Essential Health Benefits modifications

None

West Virginia

State has taken no action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed. Kevin Lucia et al., State Regulation of Coverage Options Outside of the Affordable Care Act: Limiting the Risk to the Individual Market, The Commonwealth Fund (Mar. 29, 2018).

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Wyoming

State has taken no action

1332 waiver

None

Individual mandate

None

Short-term limited duration insurance protections

None

Transitional policies

Allowed through 2019, consistent with federal guidance. Department of Insurance Bulletin.

Extended Open Enrollment Period

N/A – Only State-Based Marketplaces may choose to extend Open Enrollment.

Essential Health Benefits modifications

None

Guam

Northern Mariana Islands

American Samoa

Puerto Rico

Marshall Islands

Palau

Federated States of Micronesia

Virgin Islands

1332 Waiver

Yes
No

Individual Mandate

Yes
No

Ban on transitional policies

Yes
No

Short-term limited duration insurance protections

Yes
No

Extended Open Enrollment Period (2019 Plan Year)

Yes
No

Essential Health Benefits modifications

Yes
No

1332 Waivers: Section 1332 of the Affordable Care Act (ACA) permits state to apply for State Innovation Waivers to alter key ACA requirements in the individual and small group markets while preserving key consumer protections. States can use this flexibility to address issues unique to their insurance markets or experiment with alternative models for providing coverage to consumers.

Individual mandates: The ACA’s individual mandate—the requirement that everyone must have health coverage—was repealed by federal legislation, effective January 1, 2019. However, states may take action to implement an individual mandate through state law.

Short-term limited duration insurance protections: Federal regulations have expanded access to short-term limited duration insurance by allowing plans to have an initial contract term of up to 364 days, and to be renewed for up to 36 months. Some states have taken action to impose more stringent requirements by limiting initial contract duration and sale of consecutive policies.

Bans on transitional policies: Transitional policies are non-ACA compliant health plans that are still in force in many states. These plans were supposed to terminate in 2014, but they have been extended a number of times under federal policy. However, states make the final decision about whether to adopt the federal extension of transitional policies.

Extended Open Enrollment Period: Under federal regulations, Open Enrollment Period for states using the Federally-Facilitated Marketplace (FFM) is from November 1 through December 15. States operating State-Based Marketplaces may extend Open Enrollment.

Essential Health Benefits modifications: Federal regulations permit states to alter coverage standards for individual and small group market plans subject to Essential Health Benefits (EHB) requirements. States may use this flexibility to weaken EHBs or to expand access to services.