Marketplace
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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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One Small Step Forward for Transparency & Regulatory Oversight
By Sabrina Corlette, Center on Health Insurance Reforms We at CHIR have been urging the federal agencies responsible for implementing the Affordable Care Act (the Departments of Health & Human Services, Labor and Treasury, often called the “tri-agencies”) to move forward with two key provisions designed to improve health plan transparency and regulatory oversight. The…
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How will Premium Rate Changes Affect Consumers’ Renewals into Marketplace Coverage?
By Sandy Ahn, Center on Health Insurance Reforms In a few weeks we’ll know just to what extent premium rates have changed for marketplace health plans in 2016 as states conclude their rate reviews by August 25. As we found in a recent report examining consumers’ renewal experiences in six state-based marketplaces, price is the…
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A Look at the Latest Controversy Brewing over the ACA: The Annual Limit on Out-of Pocket Costs
By JoAnn Volk, Center on Health Insurance Reforms The latest dust up in Washington is a fight between the Obama Administration and employer groups over the Affordable Care Act provision that limits consumers’ annual out-of-pocket costs. Employers are concerned that recent administration guidance “clarifying” the rules to implement this policy will increase their costs, particularly…
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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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Proposed Legislation Will Fix Medicaid Glitch for Former Foster Youth Who Move
I’ve written before about an unintended flaw in the Affordable Care Act that relates to Medicaid eligibility for former foster youth. The simple use of the words “the” versus “a” state has led to an interpretation of the law that allows states to deny coverage to young adults who were in foster care in a…
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King v Burwell: An Exercise in Sound and Fury Signifying Nothing
By Tim Westmoreland, Georgetown University O’Neill Institute for National and Global Health Everyone within reach of an electronic device already knows that the Supreme Court has upheld the Affordable Care Act (ACA) again today. Tax subsidies can continue to assist low-income people in States that do not establish their own insurance exchanges. The death spiral…
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Highest Court in the Land Upholds the Affordable Care Act (Twice)!
Just like most of you, I took a deep breath when I saw the Supreme Court decision in King v Burwell announced today. Here at CCF, we all high-fived but now I’m lamenting the fact that we had to waste all of this time and energy worrying about what would happen if the opponents of…
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First Peek at Health Coverage Rates Post-ACA: Uninsurance Drop in 2014
Hot off the press! Today we get our first look at annual insurance coverage data from the Centers for Disease Control (CDC) for 2014 and the results are in: fewer people were uninsured in 2014—the first year of full ACA implementation— than 2013. Children and adults in Medicaid expansion states had lower rates of uninsurance.…
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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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Waiting on King… what’s at stake?
It feels like déjà vu. The health policy world is waiting on pins and needles to see what the Supreme Court has to say about the viability of the Affordable Care Act. On possible decision days, all browsers are pointed to SCOTUSblog.com. But this time we are waiting for a decision in King v. Burwell…
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What, Exactly, is in that CHIP Extension?
It’s hard to believe it was just last month when Congress passed and President Obama signed the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, which extended CHIP funding for two additional years with no major structural or program changes. It funds the ACA’s 23%-point bump, extends CHIPRA’s child health quality provisions and outreach/enrollment…
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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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State-Based Marketplaces Looking for Financing Stability in Shifting Landscape
By Sean Miskell Over the last few months, state-based health insurance marketplaces have navigated a largely successful second open enrollment period and a mostly uneventful first tax season for marketplace consumers. Yet state-based marketplaces continue to face important decisions, such as determining the size of their operating budgets and how to finance them. Because marketplaces…
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States Need to Select Essential Health Benefit Benchmark Plans for 2017 Soon!
Did you know states need to select their Essential Health Benefits (EHB) benchmark plan for 2017 in just a few weeks? If not, you could be forgiven for missing this one. There’s plenty going on to capture your attention – the wait for the Supreme Court to weigh in on premium tax credits in federally…
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New and Improved! A Special Enrollment Period for Some Caught in Medicaid Coverage Gap
As part of our Robert Wood Johnson Foundation-funded Navigator Technical Assistance project, we’ve helped Navigators and assisters answer tough questions from consumers. Many questions focused on special enrollment periods (SEPs), including a new “tax season” SEP that applied to individuals who learned about the requirement to have coverage only when they found out they were…
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Healthcare.gov Fixes System Glitch in Counting Social Security Income for Certain Tax Dependents
Earlier this week, Health Affairs ran a lengthy blog I wrote about how Healthcare.gov incorrectly counts Social Security income for tax dependents who are not required to file taxes. Policy experts and enrollment assisters had suspected the system glitch existed for some time before CMS confirmed the error in early March. Thankfully, the problem is…
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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…