Marketplace
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“Stairstep” Children Moved from CHIP to Medicaid Receive Better, More Affordable Coverage
The Affordable Care Act (ACA) aligned coverage for more than half a million low-income, school-aged children in 22 states that were previously covered under different programs. Prior to 2014, state Medicaid programs were required to cover children of different age groups at different minimum income eligibility thresholds. Young children under age six with family incomes up…
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King v Burwell Could Undermine Coverage For Children: One More Reason Why We Need CHIP Funding Renewed Quickly
Most of the conversation about the King v Burwell case has focused on which states would be affected, what would happen to insurance markets, or how many people would become uninsured as a result. But there’s one thing almost no one is talking about: how the decision might affect children’s coverage and why it’s another…
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Many Qualify for Affordability Exemption to Tax Penalty
With funding from the Robert Wood Johnson Foundation, we at Georgetown’s Center on Health Insurance Reforms and the Center for Children and Families have been providing technical assistance to Navigators and assisters in a handful of states, helping answer the questions they receive from consumers. As the second open enrollment period (OE2) winds down and attention turns…
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Why Should Pregnancy Trigger an SEP? The Risks and Impact of going without Prenatal Care
As OE2 comes to a close, we are thinking more and more about the particulars when it comes to Special Enrollment Periods (SEP) and who may qualify in the upcoming months. SEPs provide an opportunity for individuals to enroll in health insurance after a major life-changing events such as getting married, moving, losing a job,…
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Critiquing the Performance as the Curtain Closes on OE2
A big round of applause as the curtain drops at the end of the second open enrollment period for the health insurance marketplaces with more than 11 million people signing up at the box office. OE2, as it’s affectionately called, was part sequel, part new production. Throughout its run, which was just over half the…
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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?
UPDATED VERSION HERE 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…
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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…