Marketplace
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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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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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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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Getting MAGI Right: A Primer on Differences that Apply to Medicaid and CHIP
Although Medicaid, CHIP, and tax subsidies in the marketplaces share a common method for determining eligibility – known as MAGI – there are several exceptions that apply only to specific circumstances in Medicaid and CHIP. These exceptions, along with significant changes in Medicaid/CHIP eligibility, pre- and post-ACA, add complexity to the implementation of MAGI, both…
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CCF to MACPAC: CHIP Should Continue While Policymakers Work to Improve Marketplace Coverage for Kids
By Sean Miskell As the expiration of funding for the Children’s Health Insurance Program (CHIP) approaches and policy makers consider its role in the new health coverage landscape, it’s a good time to take stock of CHIP coverage and whether or not comparable and affordable coverage is available to families through the new health insurance…
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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…
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49 National Groups to MACPAC: Keep CHIP While Improving Exchanges for Kids
Compared to what?! – This line is a favorite of my four-year-old from the popular Marcel the Shell with Shoes On web series. If you haven’t had the pleasure of seeing as I have many times, Marcel makes funny observations about his role and size in the world. The full quote (which you can see…
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Tennessee Proposal Highlights Importance of Medicaid Expansion for Residents and Providers
By Sean Miskell This week, Governor Haslam announced his plan to expand Medicaid via a two-year pilot program called Insure Tennessee. Like other formerly recalcitrant states that are now embracing expansion, Tennessee is pursuing a state-specific approach that differs from ‘traditional’ Medicaid expansion. One element of this plan – in which the Tennessee Hospital Association…
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How Do Minimum Essential Coverage and Minimum Value Tests Impact Consumers with Employer-Offered Coverage
By JoAnn Volk and Sandy Ahn, Center on Health Insurance Reforms Open enrollment in the Health Insurance Marketplaces overlaps this year with many employer plan open enrollment periods, which has prompted some employees to ask questions about how their offer of employer coverage may affect their eligibility for premium tax credits for a marketplace plan.…
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A Step Forward For Lawfully Present Immigrants Living in Poverty
It’s no secret that during last year’s open enrollment many applicants for health coverage in immigrant families faced major barriers to enrolling in marketplace coverage. One big problem was that lawfully present immigrants with income under 100 percent FPL—who are ineligible for Medicaid based on their immigration status but are eligible for premium tax credits…
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State-Based Marketplaces Offer More Health Plan Options for 2015
By Sean Miskell The Affordable Care Act (ACA) was designed to make quality health coverage more affordable and accessible, in part by promoting competition among insurers in the law’s new marketplaces. By providing consumers with a portal through which to compare plans and obtain financial assistance with the cost of coverage, policymakers hoped the marketplaces…
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New Policy Brief Outlines Strategies to Improve Children’s Oral Health
By Colin Reusch, Children’s Dental Health Project Despite evidence that access to dental care in Medicaid and CHIP is on the rise, tooth decay remains the most common chronic condition among children. And while tooth decay is especially prevalent among children of low-income families, less than half of all children enrolled in Medicaid see a…
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HHS Proposes EHB Rule Changes
By Joe Touschner Though the Institute of Medicine, the administration, and many states spent more than a year developing the essential health benefits, the resulting approach was intended to be temporary. The “benchmark plan” method for choosing the EHBs initially applied to plan years 2014 and 2015, with a review of the approach promised for…
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The President’s Immigration Announcement: What Do Health Policy Wonks Need to Know?
Last Thursday, President Obama announced immigration reforms that will provide up to five million people with relief from deportation and work authorization. While the reforms will do much to alleviate the constant fear of separation that many immigrant families face, most people included in the reforms will not be eligible for federal health coverage affordability…
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How Could Executive Action on Parents Reduce the Number of Uninsured Citizen Kids?
Here’s something that most news stories on President Obama’s Executive Order probably are not touching on — protecting several million parents from deportation is likely to reduce the number of uninsured kids – the vast majority of them citizens. As child health experts, we have pointed out for years that reducing the number of uninsured…
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House Companion Bill Introduced to Extend Primary Care Rate Bump
By Sophia Duong Earlier this week, Representative Kathy Castor (D-Fla.) introduced the Ensuring Access to Primary Care for Women & Children Act (H.R. 5723), a bill aimed at continuing the Medicaid primary care increase for 2015 and 2016. The primary care bump is set to expire at the end of this year. H.R. 5723 also…
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New Report on States’ Oversight of Health Plan Network Adequacy
At yesterday’s National Association of Insurance Commissioner’s (NAIC) national meeting, the consumer representatives to the NAIC released a report on state approaches to regulating and monitoring the adequacy of health plan provider networks. The report, made possible thanks to a generous grant from the Robert Wood Johnson Foundation, summarizes the results of a survey sent…