Marketplace
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Fulfilling the ACA’s Promise
There is no doubt that families are much better off than they were before the Affordable Care Act (ACA) was enacted. Young adults, the most likely age group to be uninsured, can stay on their family’s health plan. Children with cancer will no longer exceed their annual limit on costs or max out their lifetime…
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Open Enrollment – Take 2
The next Marketplace open enrollment will be part sequel and part new production! With a mere 166 days until show time, there’s much to be done to get ready for the next curtain call on November 15, 2014. First, a look back is in order because there’s nothing like a full dress rehearsal to learn…
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Lessons Learned from CHIP Can Apply to Next Phase of ACA
By Gene Lewit The open enrollment period for Marketplace coverage under the Affordable Care Act (ACA) has ended and supporters of the legislation are finished celebrating the accomplishment of exceeding enrollment goals despite a rocky start. Nonetheless, this continues to be an important time for ACA outreach and enrollment efforts. Enrollment in Medicaid and the…
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New Survey by Enroll America Provides Insights into ACA Implementation
A new PerryUndem survey commissioned by Enroll America and funded by The Robert Wood Johnson Foundation contributes new information to the discussion about the Affordable Care Act. It’s a fairly extensive survey and I encourage you to read it in full if you have time. What I found most interesting was the positive response to…
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New Rules Protect Navigators and Certified Application Counselors from Over-Reaching State Laws but Also Impose New Requirements
Last week, CMS finalized rules that were proposed in March with a few modifications, some good and some not so good. The rules impact navigators, in-person assisters and certified application counselors (CACs) (collectively known as assisters) as summarized below. 1) Pre-empting certain aspects of state laws that restrict navigator and assisters. States are not precluded…
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Protecting Medicaid Kids at Renewal
By Martha Heberlein As my colleague, Tricia Brooks, noted a few weeks ago, MAGI-based renewals are upon us in many states (save those that have delayed them, which we talked more about in a separate blog). And buried within the ACA is a little-known provision that specifically protects children who were enrolled in Medicaid (but…
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How Are We Really Doing on Enrollment in California? Good Data Reporting Will Help Us Find Out
By Kristen Golden Testa, The Children’s Partnership California’s basic enrollment numbers coming out of the first open enrollment period under ACA are quite astounding: about 1.4 million Californians enrolled in Covered California, our state-based marketplace, and 1.9 million enrolled in Medi-Cal, for a whopping total of more than 3 million enrolled. But what’s going on…
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CHIP Enrollees Gain Same Mandate Accommodation as QHP Enrollees
By Joe Touschner Months ago, CMS clarified that those who signed up for a qualified health plan by the end of open enrollment would not face a tax penalty for lacking coverage in early 2014, even if their plans were not effective until May 1. This was necessary since the mandate exemption for a short…
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What Would Happen if CHIP Went Away? Our Research Suggests Kids (for now) Would be Significantly Worse Off
While the eyes of the world have been intently focused on the success or failure of the Affordable Care Act, an important question has recently surfaced in the policy debate by the Medicaid and CHIP Payment Access Commission (MACPAC, — the group legislatively tasked with making recommendations on Medicaid and CHIP to policymakers): Should the Children’s…
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What’s Missing in Monthly CMS Medicaid and CHIP Enrollment Report?
It’s really good to know we can count on the monthly reports from CMS to keep tabs on Medicaid and CHIP application and enrollment activity. Since CMS released the first data in January, we’ve seen improvements in the number of states reporting, and enrollment data was added to the initial report of application volume and…
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Illinois Keeps Its Eye on the Back Door: Medicaid Renewals
By Stephanie Altman, Sargent Shriver National Center on Poverty Law In Illinois, we’ve been busy enrolling more than 260,000 newly eligible adults through Medicaid’s front door. But we’ve also had our eye on Medicaid’s back door to make sure we don’t lose Medicaid-eligibles through the annual renewal process. The state has been working with us…
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Washington State’s Hard Work on Medicaid Renewals Pays Off
As part of my colleague’s blog series on renewals, I wanted to share how hard work is paying off on Medicaid renewals in Washington state. Washington is among the first states in the country to get started on MAGI-based renewals. What are MAGI-based renewals? Just like new applications, renewals in Medicaid will be based on…
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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…