Health Plan Weekly

Nonprofit Medicaid Plans Ask Feds to Step In to Fix ‘Inadequate’ Pay Rates

  • Oct 25

    Oct 25, 2024

    With the Medicaid unwinding process winding down, two health insurer trade groups are sounding the alarm about how the resulting changes in the Medicaid risk pool are putting financial stress on nonprofit and regional health plans. To address the situation, both the Alliance of Community Health Plans (ACHP) and Association for Community Affiliated Plans (ACAP) say they want the federal government to push states to raise the payment rates to private Medicaid plans. 

    “This is an issue that is impacting much of managed care across the country,” says Jennifer McGuigan Babcock, senior vice president for Medicaid policy at ACAP. “We have heard…anecdotally from our plans that should changes not be made for 2025, and potentially for 2026 rates, there will be significant problems.” 

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    • Leslie Small

    Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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