2013
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Updates on Consumer Assistance: Navigator Grants and Training
By Sabrina Corlette, Georgetown University Center on Health Insurance Reforms This has been a busy month for those of us eager for robust consumer assistance to help people enroll in the new health insurance marketplaces, which launch on October 1, 2013. First, the Administration released a set of on-line training materials for certified application counselors (CACs) and in-person assisters.…
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Blending In-Person Assistance and Self-Service Online Applications for Health Insurance
By Gene Lewit, Stanford University Health Policy Center for Primary Care and Outcomes Research The countdown to October 1 has begun, when millions will begin to enroll in health insurance under the Affordable Care Act (ACA). The ACA seeks to make enrollment easier by asking states to provide online enrollment systems. These new portals are…
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CMS Issues More Guidance on Stairstep Kids
By Wesley Prater As Tricia Brooks highlighted in her previous blog, CMS recently released a set of FAQs to provide more guidance on telephonic applications, MAGI-based eligibility, Medicaid and CHIP eligibility, and the 75/25 Federal matching rate. The FAQs included more guidance about the transition of children ages 6-18 up to 133% of the FPL…
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While Premium Growth has Slowed, Annual Employer Survey Shows a Mixed Bag for Lower-Wage Workers
By Martha Heberlein The good news: Premium growth in 2012 was a modest 4% by historical standards, according to the annual Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey. But there’s much room for progress, especially for lower-income families. Over the last decade, the average premium for family coverage has increased 80%.…
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Nevada and West Virginia Latest to Remove CHIP Waiting Periods
As we have blogged before we were hoping that CMS was going to prohibit states operating separate state CHIP program from imposing waiting periods for children. But they didn’t, and the choice continues to fall squarely in the state’s purview. Last week we learned that two more states, Nevada and West Virginia, are now moving…
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Tech Tuesday: HHS Provides Guiding Principles for Telephone Applications
“No wrong door,” a phrase coined to explain access to all the insurance affordability programs (Medicaid, CHIP and subsidized coverage through a Health Insurance Marketplace) through a single application process, is also often used to describe the different paths to enrollment. Beginning October 1, 2013, states are expected to allow individuals to apply online, over…
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Hospitals Should Exercise the Option to Enroll Kids in Medicaid through Presumptive Eligibility
Among many other provisions, the Affordable Care Act (ACA) gives hospitals the prerogative to make Medicaid presumptive eligibility (PE) decisions, regardless of whether the state has previously implemented PE. Presumptive eligibility allows states to train specific “qualified entities,” such as health care providers, schools, government agencies and community-based organizations, to screen for eligibility and temporarily…
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How Will Aligning Eligibility for Children in Medicaid Make Better Sense for Families and States?
By Wesley Prater The Affordable Care Act is most widely recognized for its expansion of affordable coverage to low-income parents and adults; however, a lesser-known feature of the ACA also helps children by aligning Medicaid coverage across families at 133% of the federal poverty level (FPL). Today, states must cover children under the age of…
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Aligning Eligibility for Children: Moving the Stairstep Kids to Medicaid
A feature of the Affordable Care Act (ACA) that has not received a lot of attention requires that Medicaid cover children with incomes up to 133 percent FPL as of January 2014. Today, there are “stairstep” eligibility rules for children. States must cover children under the age of six in families with income of at…
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HHS Announces Navigator Awards
As October 1 fast approaches, we continue to learn more about resources available in states to help guide families through the enrollment process. Today, HHS announced recipients of $67 million in grants to fund navigators in the 33 states where the federal government will operate the insurance marketplaces. (We outlined the funding opportunity on Say Ahh!…
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Response to Sticker Shock: More Expensive Than What?
Whenever I read stories about the sticker shock that may hit some consumers when the Affordable Care Act takes effect, it reminds me that buying insurance can be more mystifying than buying a new car. There have been so many jalopies being sold in “mint condition” in the wild west of the insurance market for…
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Clearing Up Confusion About Health Reforms Out-of-Pocket Protections
By Sarah Lueck, Center on Budget and Policy Priorities Recent media coverage may have sown confusion about health reform’s requirement that health insurance plans cap how much consumers can pay out-of-pocket each year for medical care. The bottom line: for many plans, the protections will take effect as scheduled in 2014. Some plans will be able…
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When One Young Person’s Life Took a Detour, the ACA Provided Help Along the Way
By JoAnn Volk, Georgetown University Center on Health Insurance Reforms In the spring of 2011, the University of California Santa Cruz senior was sure he was so tired because he wasn’t taking care of himself – not unusual for a busy student organizer winding up his final year in college. But when his neck started swelling,…
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Tech Tuesday: Two States Get Smart and Team Up on Medicaid Management Information System
Most of the attention on IT development has been focused on eligibility and enrollment systems, those customer-facing websites and online applications that collect data from the applicant and other electronic sources to determine eligibility. But behind the scenes, Medicaid Management Information Systems (MMIS) support the “backend” administrative functions such as provider enrollment, prior authorization, medical…
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There’s a Hole in Our Bucket: Addressing Children’s Health Insurance Churn
By Ashley Storms, New England Alliance for Children’s Health Pursuing health coverage for all children can sometimes feel like pouring water into a leaky bucket. Even when outreach and enrollment efforts are strong, a substantial portion of children will lose their insurance at least once. Unstable insurance coverage, known as “churn,” is inefficient and keeps…
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2013 Annual Conference
OPPORTUNITY KNOCKS: OPENING THE DOOR TO COVERAGE July 30 – August 1, 2013 Conference Materials Agenda Participant List Session Slides Medicaid/CHIP 101 Welcome A Look at Key Issues in the New Marketplaces Messaging to Keep Kids Coverage on the Agenda Understanding Premium Tax Credits and Cost-Sharing Reductions Best Strategies for Organizing
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CHIP Lock Outs May Leave Kids Without Premium Tax Credits, Too
By Joe Touschner As Tricia Brooks wrote last week, new rules set limits on how states handle lock out periods for children enrolled in CHIP. Several states impose a lock out period—a length of time when a child may not receive CHIP coverage—when families fail to pay CHIP premiums. The new rules limit lock out…
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I Support Arkansas’ Effort to Move Forward (But Am Holding My Nose)
So I just skimmed through the Arkansas Section 1115 Medicaid waiver application,which was submitted to the federal government a few days ago. This proposal is unique and uses Medicaid funding to buy coverage in the new marketplace through a premium assistance arrangement. I AM happy that Arkansas legislators and the Governor were sensible enough to…
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Tech Tuesday: How Kids Coverage Has Innovated Technology-Based Solutions to Maximize Enrollment
Over the past several years, I have had the pleasure of participating as a technical assistance faculty member for Maximizing Enrollment, a national program of the Robert Wood Johnson Foundation with technical assistance and direction provided by the National Academy of State Health Policy. The program works intensively with eight states to (as the name…
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New Rules Set Limits on Locking Kids Out of Coverage for Nonpayment of Premiums
Thirty-three (33) states charge premiums or enrollment fees for children enrolled in Medicaid or CHIP, starting as low as 101% of the federal poverty level in CHIP. In the past, federal guidelines for dealing with premium grace periods and nonpayment of premiums were minimal, particularly in CHIP. It was not until CHIP was reauthorized in…