Marketplace
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Medicaid & CHIP Participation Rates Show Continued Success of Efforts to Connect Kids with Coverage
Recently, CMS released 2012 rates of participation for children in Medicaid and CHIP. For the last few years, our friends at the Urban Institute have been calculating them. The new participation rates show the continued success in covering children. Since 2008, the national rate of participation has increased from 81.7% to 88.1%. Other highlights include:…
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For DACA Grantees, Health Insurance is (Only) a Dream
By Dinah Wiley [Update: In August 2022, the Biden administration codified the DACA program in regulation. The regulation did not change health insurance for DACA grantees. For current information on DACA, visit the National Immigration Law Center.] We receive a lot of questions about the health insurance eligibility of non-citizens with a special Deferred Action status…
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Recommendations to Strengthen Navigator and Assister Programs
Hats off to navigators and certified application counselors (CACs) across the country who persevered through the rocky rollout of the marketplaces and helped create the late surge that put enrollment over the top. There is much yet to be learned as we reflect back on open enrollment, but we already know there is much that…
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Who Gets Extra Time “In Line” and Beyond to Enroll in Health Coverage?
Time for a victory lap over the announcement that marketplace enrollment whizzed past the revised target (that was lowered after the rocky launch) and exceeded the original projection of 7 million people? Not for navigators and certified application counselors who deserve much of the credit. They are still helping people swept up in the enrollment…
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Understanding Special Enrollment Periods: A Look at Some Who Will be Out of Luck
As part of our Robert Wood Johnson Foundation-funded Navigator Technical Assistance project, we’ve had the opportunity to hear the range of questions navigators and assisters are fielding from consumers trying to understand their coverage options. Many of these questions have helped fill out our Navigator Resource Guide, which has 270 FAQs ranging from “what is the individual…
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Florida’s Obamacare Alternative: After Six Years is This the Best They CanDo?
An insurance exchange opened last month in Florida, and it’s called “Florida Health Choices,” but it doesn’t offer consumers or small businesses actual health insurance. Instead, the only products consumers can buy on the site are called “supplemental” insurance products, designed to supplement, but not replace, traditional health insurance. These products don’t meet any of…
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Two States On the Path to the Basic Health Program
Both Minnesota and New York are on the path to setting up a Basic Health Program (BHP) that will provide more affordable coverage for low-income families than they may find on the marketplace. Minnesota passed BHP legislation that was signed into law in May 2013. In New York, BHP was included in the Governor’s budget…
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Express Lane Stays Open for Another Year (and other extensions)
It’s been a while since we checked in on efforts to extend some expiring CHIPRA provisions and other important programs for children. The most viable legislative vehicle for these “extenders” in recent years has been the Medicare payment fix (i.e. Sustainable Growth Rate, or so-called “Doc Fix” ). Say Ahhh! readers may remember that the…
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Enrollment in Healthcare.Gov Exceeds Expectations
Today the Obama Administration announced that more than 7 million people had signed up for health insurance through healthcare.gov. This exceeds projections made by the nonpartisan Congressional Budget Office made before the famously troubled website rolled out last fall. I hope this good news will get as much coverage as the saturation coverage the website’s…
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A Limited Extension for Insurance Enrollment: Precedents from Medicare Part D
On March 25, the Administration created a grace period that will extend the March 31 Marketplace enrollment deadline for Americans who have run into roadblocks in their attempts to sign up for insurance coverage under the Affordable Care Act (ACA). Various reporters and commenters have pointed to parallels with decisions made in 2006 around the first enrollment period for Medicare Part…
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New Tools to Help Consumers Compare Health Plans
By Christine Monahan Over the last several months, faculty and staff at CHIR and their sister Center, Georgetown’s Center for Children and Families (CCF), have been providing support and technical assistance to navigators and others assisting consumers with enrollment in the new health insurance Marketplaces.* While the enrollment process can be tricky at multiple steps,…
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People Who Have Tried to Enroll through HealthCare.Gov Get Extension Beyond March 31st
With the deadline for the initial open enrollment on March 31 looming, consumers, advocates, and assisters have been stressing over what happens to people who, for no fault of their own, have not been able to complete their enrollment on HealthCare.Gov or through the federal call center. Late yesterday, federal officials announced that through mid-April,…
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Proposed Rule Offers Relief from Over-Reaching State Navigator Laws that Restrict Consumer Assistance
Last week, CMS issued a proposed rule that describes some of the circumstances in which state laws have overstepped their bounds and interfere with the important work of navigators, non-navigator assisters and certified application counselors (collectively known as assisters). The proposed rule, coupled with the recent court ruling in Missouri that federal law preempts state…
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Individual Responsibility—What are the Rules?
By Joe Touschner With the end of open enrollment approaching, it’s a good time to review some of the rules surrounding the ACA’s individual responsibility requirement, or individual mandate. Overall, the individual mandate is intended to impose a tax penalty on those who have access to affordable health coverage yet choose to go uninsured for…
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Time for a Dental Check-up
By Joe Touschner As families have signed up for new marketplace coverage over the past several months, many questions have come up around dental benefits. I wanted to pass along some useful resources for understanding 2014 plans as well as the latest news on how marketplace dental plans will change for 2015. First, just in…
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Covering Former Foster Youth Should Be Easy But …
Sometimes, it’s the simplest provision of a law that works the best – like the Affordable Care Act (ACA) provision that allows young adults to stay on their parents’ health plan until 26. But youth leaving the foster care system as they transition to adulthood don’t have families to fall back on, so the ACA…
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Help for Consumers Who Faced Marketplace Glitches
The Centers for Medicare and Medicaid Services (CMS) released guidance on February 27th for Marketplaces that have had technical difficulties getting consumers enrolled. The CMS guidance clarifies that if a consumer has had technical trouble trying to enroll, it could constitute an “exceptional circumstance,” and qualify the consumer for coverage (and financial help) on a…
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Last Call for State-Based Health Insurance Marketplaces
Arkansas Governor Beebe recently noted that some Republican Governors are warming to the idea of running their own health insurance marketplace. I hope that they know that their time is running out! Setting up a state-based health insurance marketplace is no small task, and unlike the Medicaid expansion decision, states that want to do it…
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Consumer Advocates Have Important Role to Play in Monitoring Provider Networks
The Affordable Care Act has helped level the playing field among insurers in terms of their ability to compete on cost in the individual and small group markets. Many insurers are turning to limited network products as a way to leverage more favorable pricing from providers, drive down unit cost, and lower premiums. Our colleagues…
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Women are Finally Receiving More Equitable Treatment When Shopping for Health Insurance
By Sarah Dash, Georgetown University Center on Health Insurance Reforms On a recent frosty morning, an article caught my eye. Like the never-ending snowstorms in the movie Frozen, it was another in a series of news stories chronicling worries about whether certain groups of people – in this case, women – are going to destabilize the risk pool…