Enrollment Assistance
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What to know about the Census Bureau’s new ACS and CPS data on health coverage
On September 16, 2015 the Census Bureau will release data from the Current Population Survey (CPS) and American Community Survey (ACS), providing updated income, poverty, and health insurance coverage rates for 2014. These reports should give the best picture of the effects of the Affordable Care Act’s (ACA) major coverage expansions on the uninsured rate.…
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CMS Awards $67 Million to Assist Consumers with Accessing Coverage OE3 and Beyond
Let’s face it. Health insurance is complex, even for those of us who have worked in the field for years. Combine that with applying for means-tested financial assistance (through systems that are still being debugged), and there is no doubt that it can be a frustrating experience for consumers. Numerous studies have illustrated the critical…
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Consumer Assistance and Tools Needed to Ensure that All Eligible Marketplace Enrollees Get Cost-Sharing Reductions
Many of us have been asking this question for months: How many people who purchased coverage through the Marketplaces missed out on lower cost sharing because they did not enroll in a Silver plan? Now we have an estimate thanks to a new analysis by Avalere Health. Avalere’s headline – “More than 2 Million Exchange Enrollees…
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Getting Ready for OE3 – New Kaiser Family Foundation Survey Provides Helpful Lessons
By Hannah Ellison and Sabrina Corlette, Georgetown University Center on Health Insurance Reforms It’s the dog days of August and many of us are in beach mode, but we at CHIR are getting geared up. We’re just 12 weeks away from the start of the third open enrollment period (OE3) for the Affordable Care Act’s health…
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Changes to the Affordable Care Act’s Health Plan Summaries – and More to Come
One of the early reforms in the Affordable Care Act (ACA) – and the most popular, by some polls – is the requirement that plans and insurers provide easy-to-read summaries of plan benefits, cost sharing and rules. The Summary of Benefits and Coverage (SBC) is a standardized, 8-page form that allows consumers to make apples-to-apples…
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Celebrate or Condemn Enrollment Success? Affordable Care Act Critics Can’t Decide
Health care policy debates can often be confusing but the rapidly shifting positions in the latest tempest on Medicaid and the Affordable Care Act are harder to follow than a ping-pong ball. For background one has to travel back to 2013 as major glitches in the healthcare.gov website were adversely affecting initial enrollment in the…
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Navigator Grants for OE3 Announced
Today, CMS released the funding opportunity announcement (FOA) for a new round of navigator grants. As noted in my blog earlier this week, these grants will be awarded for a period of three years unlike annual awards in the prior two grant rounds. A total of $67 million will be awarded in the first year,…
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3-Year Navigator Grants Will Provide Stability to Enrollment Assistance
A recent posting of a Paperwork Reduction Act (PRA) notice in the federal register details plans by CMS to tweak navigator entity reporting requirements, which I’ll say more about in a few minutes. But what really excited me about the notice – drumroll please – is that, in the supporting statement, CMS signaled its intent…
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Confused about What Happens at Tax Time? FAQs on Penalties, Exemptions, Reconciliation, and SEPs:
By Tricia Brooks, Sandy Ahn, Sabrina Corlette, and JoAnn Volk As part of our Robert Wood Johnson Foundation funded work in providing technical assistance to consumer assisters in five states, we are getting a lot of questions about issues related to tax time and health coverage. Here are some of the common questions and answers.…
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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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OE2: A Round Up of Questions from Consumer Assisters During the Second Year of the Affordable Care Act
As part of a Robert Wood Johnson Foundation funded project providing technical assistance to navigators and assisters in five states with federally run marketplaces, a joint team of experts from Georgetown University’s Center on Health Insurance Reforms and the Center for Children and Families have received a broad range of questions since open enrollment began…
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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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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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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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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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Are People in Immigrant Families Gaining Coverage Under Health Reform?
I tried to answer this question for a presentation at an immigration conference right before the holidays. Unfortunately, although we are in our second open enrollment season under health reform, we can’t fully answer this question yet. What we do know indicates that we are making some progress but have a lot more work to…