Eligibility & Enrollment
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One More Chance to Comment on SBC Changes
Originally posted on the CHIRblog. Last week, the Departments of Health and Human Services, Treasury and Labor released a proposed revised template for the Summary of Benefits and Coverage (SBC), giving the public 30 days to comment before these long-coming changes are finalized. The process for implementing changes to the SBC template began in December…
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Healthcare.gov Changing Approach to Special Enrollment Periods, May be Bumpy Road for Consumers
This was originally posted on the CHIRblog. Lost your job? Moving to a new area? Having a baby? Make sure you have documentation of these life events if you want health insurance through healthcare.gov. Recently announced, the administration will now require verifying documents from consumers who enroll or change their plans using a special enrollment…
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Getting Enrollment Right for Immigrant Families
The Affordable Care Act (ACA) has yielded impressive progress in reducing the ranks of the uninsured, with more than 12 million people covered by the health insurance marketplaces alone. However, meeting the goal of enrolling the remaining seven million people who are eligible for marketplace coverage but are still uninsured— even after the third open…
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GAO Report Raises Concerns About Waiving Medicaid Transportation Benefits
By Sean Miskell As states debating whether to expand Medicaid (and some that already have) consider changes to their Medicaid programs via 1115 waivers, one proposal that keeps popping up is the elimination of non-emergency medical transportation benefits (NEMT). This week, the Government Accountability Office (GAO) released a report on state efforts to waive NEMT…
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SHADAC Report Echoes Good News on Uninsured Rate for Children
The State Health Access Data Assistance Center (SHADAC) published its annual report “State Level Trends in Children’s Health Insurance Coverage” and it is an excellent state resource on children’s health coverage rates. Similar to Georgetown’s annual report on children’s health insurance, SHADAC reports on state-by-state coverage rates for children and provides additional data on children’s…
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Commonwealth Fund Tool Demonstrates Effects of State Efforts to Expand Coverage and Improve Enrollment
By Sean Miskell Comparing outcomes across states provides an opportunity to consider how state-specific approaches to administering their health programs provide coverage to their residents and help them stay enrolled. Say Ahhh! readers certainly know that we like our 50-state tables here at CCF. The Commonwealth Fund has updated its interactive tool that allows users…
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CCF Research Helps Inform Debate over Reinstating Arizona KidsCare
Last week, I was in Phoenix, Arizona to testify at a hearing in the House of Representatives Health Committee on KidsCare. As Say Ahhh! readers know, the changes to KidsCare in the last several years created a unique research opportunity because Arizona is the only state without a functioning Children’s Health Insurance Program. My colleagues…
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Administration’s Budget Proposal Would Make Medicaid Expansion an Even Better Deal for Wisconsin and Other States
By Jon Peacock and Sashi Gregory, Wisconsin Council on Children and Families The proposed budget released this week by President Obama would make the expansion of Medicaid an even better deal for states like Wisconsin that have not yet taken up the option. If Wisconsin expanded BadgerCare (Wisconsin’s Medicaid program) eligibility in January 2017, the…
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2016 Federal Poverty Levels Are Out; What Does This Mean for the Marketplace and Medicaid?
Last week, the 2016 federal poverty levels (FPL) were published in the federal register. How does this impact consumers applying for coverage through the Marketplace, Medicaid or CHIP? Let’s start with eligibility for Marketplace subsidies. For 2016 calendar year coverage, regardless of when someone applies or enrolls, eligibility is based on the 2015 FPL levels.…
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“Healthy Students” Initiative Seeks to Help Children Achieve Better Health & Academic Success
Health care coverage helps children show up for school ready to learn and provides parents with the peace of mind of knowing they can afford to get their children the care they need to succeed. Sadly, many of America’s children are going without affordable coverage even though they are eligible for Medicaid or CHIP but…
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Little Known Provision Keeps Kids From Slipping Through Cracks Due to Differences in Eligibility Rules
For the most part, the Affordable Care Act aligns the way that Medicaid determines eligibility based on the same Modified Adjusted Gross Income (MAGI) rules used to determine eligibility for financial assistance in the Marketplace. But there are exceptions in Medicaid as I outlined in this blog. The differences can mean that an individual is…
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Survey Shows States Made Significant Progress Implementing Data-Driven Eligibility in Medicaid
Eligibility decisions made in real-time or overnight when someone submits a Medicaid application? Automated determinations of ongoing eligibility at renewal without requiring enrollees to fill out forms or send in paperwork? It wasn’t too long ago that many Medicaid stakeholders would have thought those were pie-in-the sky notions. Yet, thanks to new high-performing eligibility systems…
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NEACH Summit Highlights Continuous Battle for Health Care Access and Coverage for Children
By Ben Koller, Community Catalyst Last month, children’s health advocates and experts from around New England gathered for the New England Alliance for Children’s Health’s (NEACH) annual Children’s Health Care Summit. NEACH, an initiative of Community Catalyst, is a broad-based coalition of health advocates, providers, and legal experts dedicated to improving children’s access to high-quality,…
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Permanent 90/10 Rule Will Help States Continue Efforts to Modernize IT Systems
Although final publication of the 90/10 rule – providing generous, enhanced federal funding for Medicaid eligibility and enrollment systems – doesn’t quite bring the surprise of opening an unexpected holiday gift, it is still gives us many reasons to celebrate. If CMS had allowed the enhanced funding to expire as initially planned, states would have…
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Premium Assistance and Wrapped Benefits Part 2: A Startling Discovery
As I blogged about last week, our recent report with co-authors at the Kaiser Commission on Medicaid and the Uninsured looked at wrapped benefits and how they are working in selected Section 1906 premium assistance programs. The most startling discovery to me was the finding that families have no cost-sharing protections in the programs we…
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No QHPs Comparable to CHIP, Says (Delayed) HHS Certification
Like many others that watch child health policy closely, we have been anxiously awaiting release of the months-overdue Congressionally-mandated study comparing CHIP with coverage children receive through qualified health plans (QHPs) in the marketplaces. Released just before Thanksgiving, the HHS certification summary reinforces what growing evidence has indicated: No QHPs were found comparable to CHIP. Not…
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Children’s Health Coverage: On the road to 100 percent?
by Ben Kerman, Atlantic Philanthropies The 2015 open enrollment period offers an opportunity to build on tremendous progress in bringing health coverage to more children and their families. An analysis of recent census data by Georgetown Center on Children and Families confirms that many states are making headway. Twenty five states achieved statistically significant decreases…
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More Evidence that Medicaid Expansion Helps State Budgets
Recently, Kaiser Family Foundation released a report on Medicaid Enrollment & Spending Growth for FY 2015 and 2016. There is a lot of interesting data in the report, but the stand out finding confirms what we already know: Medicaid expansion is good for state budgets and leads to increases in coverage. Medicaid Enrollment is up…
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Healthcare.Gov Promises a Snazzier Production for OE3
Yesterday marked the debut of the third open enrollment period for the Health Insurance Marketplaces, including Healthcare.gov, which is the storefront to the Marketplace in 37 states. Has the performance improved? What new bells and whistles will delight the audience? Faster lines at the box office. Although it looks the same to consumers, new account…
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Child Uninsured Rate Hits Historic Low – Thanks Goes Mainly to ACA, Medicaid & CHIP
Like many of you I was super excited to see the first round of data from the Census Bureau looking at health insurance rates in 2014 when it came out in late September. Needless to say, 2014 was a big year for health policy changes! Today we are releasing our annual report focused specifically on…