Blog
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Answers to Tough Q’s from Navigators, Assisters, Brokers, Tax Advisors About ACA Coverage
[Editor’s Note: Open Enrollment is officially closed but HHS announced that those trying to enroll on February 15 may be eligible for an extension until February 22. ] By JoAnn Volk, Tricia Brooks, Sabrina Corlette and Sandy Ahn As open enrollment (often called “OE2”) for health insurance under the Affordable Care Act draws to a…
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New Children’s Health Insurance Program Bills Introduced
Senate and House Democrats celebrated Valentine’s Day by introducing bills to extend CHIP funding through 2019. Senate Democrats, led by Senator Sherrod Brown, have co-sponsored S.522, “Protecting & Retaining Our Children’s Health Insurance Program Act of 2015 (PRO-CHIP)”. On the House Side, Representative Gene Green introduced companion bill H.R.919. The Senate bill would extend the…
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Cuts to Medicaid Pregnancy Coverage: Penny Wise and Pound Foolish
By Tricia Brooks and Sophia Duong, Maryland and Ohio are considering rolling back Medicaid coverage for pregnant women. Currently, Maryland’s eligibility level is at 259% FPL, and Ohio’s eligibility threshold rests at 200% FPL (not including the standard 5 percentage point disregard). Governors Hogan and Kasich’s proposed budgets cut these eligible income levels, but how…
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Arkansas Approves Private Option Improving Security for Families, Hospitals & State Budget
By Marquita Little, Arkansas Advocates for Children and Families Arkansas’s unique approach to Medicaid expansion, known as the Private Option, has been a success during its short lifespan. However, some state policy makers want to see the program end. Within just a couple weeks of being sworn in as the new Governor, Asa Hutchinson spoke…
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Getting MAGI Right: Current Monthly Income vs. Projected Annual Income
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes but to further complicate things, there are some differences that apply…
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Arkansas Finds Collecting Medicaid Premiums + Copays from People in Poverty Not Cost Effective
Buried in the nearly enacted move in Arkansas right now to reauthorize the state’s unique “private option” Medicaid expansion while looking at broader Medicaid reforms was a welcome change to the current Medicaid program. You can read about it in detail thanks to Arkansas Times reporter David Ramsey here. The bottom line is it became…
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Lessons in the Defeat of Tennessee Governor Haslam’s Medicaid Expansion Plan
In a disappointing committee vote yesterday Tennessee Governor Bill Haslam’s carefully crafted state-specific plan for using federal Medicaid expansion dollars was rejected. A state budget cost-neutral financing mechanism through hospital fees and multiple other provisions that would have made the plan a significant showcase of conservative health policy ideas were not enough to obtain legislative…
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Getting MAGI Right: Changes to Income Counting Rules in Medicaid and CHIP
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but to further complicate things, there are…
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How Do Updated 2015 Federal Poverty Level Thresholds Impact Medicaid, CHIP & Premium Tax Credit Eligibility?
Over the weekend, Healthcare.gov uploaded the new 2015 federal poverty levels (FPL) to use in assessing eligibility for Medicaid and CHIP. What does this mean to consumers applying for coverage? Let’s start with eligibility for Marketplace subsidies. For 2015 calendar year coverage, regardless of when someone applies or enrolls, eligibility is based on the 2014…
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Getting MAGI Right: When Does Social Security Income Count?
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but to further complicate things, there are…
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Millions Gain Coverage Through Affordable Care Act – What’s Medicaid Got to Do With It?
Last week, the Centers for Medicare and Medicaid Services (CMS) released Medicaid enrollment data that sheds light into how many people have gained Medicaid coverage though the Affordable Care Act. According to CMS, more than 3.2 million Medicaid beneficiaries were able to sign up for Medicaid in 22 expansion states because they fell into the…
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Do Workplace Wellness Programs Actually Improve Healthy Behaviors?
If you’re like most people, you started 2015 with a list of New Year’s resolutions. And if you have, chances are the list of resolutions includes something along the lines of lose weight, get fit, or maybe even quit smoking. It’s also likely few of those resolutions will be met or even still be around…
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Need Help Learning Eligibility Rules and Application Process for Families with Immigrants?
With less than two weeks left until the end of Open Enrollment two, assisters are racing to get everyone covered, including families with immigrants, often among the most difficult cases. I recently had a chance to help train more than 800 consumer assisters about how to overcome barriers to eligibility and enrollment for health coverage programs…
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Getting MAGI Right: An Assisters Worksheet for Determining Household Size in Medicaid and CHIP
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes, but to further complicate things, there are some differences that apply…
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President’s Proposed Budget: Four More Years of CHIP
It would be great this Groundhog’s Day if Pensetucky Pete’s shadow also allowed us to forecast additional years of CHIP. But today we did get an important signal from the Administration that CHIP must remain a strong player in the system of children’s coverage for the foreseeable future. President Obama’s proposed budget included four additional…
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Getting MAGI Right: Exceptions for Who Counts in the Household for Medicaid and CHIP
Last week, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP have been aligned with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but to further complicate things, there are…
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Study: Charging Medicaid Patients Co-Pays for Unnecessary Use of ER Does Not Decrease ER Visits
This was the interesting conclusion last week from a comprehensive study in the Journal of the American Medical Association. Researchers compared emergency department use by Medicaid patients from 2001-2010 in eight states that impose copayments for nonurgent use of the emergency department with ten states having zero emergency department copayments. The study involved over 10,000…
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Getting MAGI Right: Differences in Medicaid and CHIP Add Complexity
Next to the fact that millions of people are gaining health insurance, one of my favorite aspects of the ACA is its transformation of Medicaid – moving Medicaid into a modern era by harnessing technology and tapping trusted sources of electronic data to determine eligibility in real time. Launching a new high-performing eligibility system is…
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“Budget Neutral” Funding for State Share of Medicaid Expansion: Hospital Fees and Taxes?
As new plans to expand Medicaid are proposed, one issue increasingly coming up is the idea of “cost neutrality” to state budgets when creating the framework for a state expansion. The Affordable Care Act provided 100% federal funding for state expansions through 2016 but after that date states must pay a small graduated share of…
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Anticipated Cuts to Uncompensated Care Funds Increase Pressure on Florida to Expand Medicaid
Today I had the pleasure of joining the League of Women Voters of Florida and Florida Legal Services on a conference call to discuss a topic of utmost importance – the decision facing Florida’s policy makers as to whether or not to expand Medicaid – especially in light of the scheduled expiration of Florida’s Low…