Marketplace
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Blending In-Person Assistance and Self-Service Online Applications for Health Insurance
By Gene Lewit, Stanford University Health Policy Center for Primary Care and Outcomes Research The countdown to October 1 has begun, when millions will begin to enroll in health insurance under the Affordable Care Act (ACA). The ACA seeks to make enrollment easier by asking states to provide online enrollment systems. These new portals are…
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While Premium Growth has Slowed, Annual Employer Survey Shows a Mixed Bag for Lower-Wage Workers
By Martha Heberlein The good news: Premium growth in 2012 was a modest 4% by historical standards, according to the annual Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey. But there’s much room for progress, especially for lower-income families. Over the last decade, the average premium for family coverage has increased 80%.…
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Nevada and West Virginia Latest to Remove CHIP Waiting Periods
As we have blogged before we were hoping that CMS was going to prohibit states operating separate state CHIP program from imposing waiting periods for children. But they didn’t, and the choice continues to fall squarely in the state’s purview. Last week we learned that two more states, Nevada and West Virginia, are now moving…
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Tech Tuesday: HHS Provides Guiding Principles for Telephone Applications
“No wrong door,” a phrase coined to explain access to all the insurance affordability programs (Medicaid, CHIP and subsidized coverage through a Health Insurance Marketplace) through a single application process, is also often used to describe the different paths to enrollment. Beginning October 1, 2013, states are expected to allow individuals to apply online, over…
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HHS Announces Navigator Awards
As October 1 fast approaches, we continue to learn more about resources available in states to help guide families through the enrollment process. Today, HHS announced recipients of $67 million in grants to fund navigators in the 33 states where the federal government will operate the insurance marketplaces. (We outlined the funding opportunity on Say Ahh!…
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Response to Sticker Shock: More Expensive Than What?
Whenever I read stories about the sticker shock that may hit some consumers when the Affordable Care Act takes effect, it reminds me that buying insurance can be more mystifying than buying a new car. There have been so many jalopies being sold in “mint condition” in the wild west of the insurance market for…
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Clearing Up Confusion About Health Reforms Out-of-Pocket Protections
By Sarah Lueck, Center on Budget and Policy Priorities Recent media coverage may have sown confusion about health reform’s requirement that health insurance plans cap how much consumers can pay out-of-pocket each year for medical care. The bottom line: for many plans, the protections will take effect as scheduled in 2014. Some plans will be able…
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When One Young Person’s Life Took a Detour, the ACA Provided Help Along the Way
By JoAnn Volk, Georgetown University Center on Health Insurance Reforms In the spring of 2011, the University of California Santa Cruz senior was sure he was so tired because he wasn’t taking care of himself – not unusual for a busy student organizer winding up his final year in college. But when his neck started swelling,…
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Tech Tuesday: Two States Get Smart and Team Up on Medicaid Management Information System
Most of the attention on IT development has been focused on eligibility and enrollment systems, those customer-facing websites and online applications that collect data from the applicant and other electronic sources to determine eligibility. But behind the scenes, Medicaid Management Information Systems (MMIS) support the “backend” administrative functions such as provider enrollment, prior authorization, medical…
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There’s a Hole in Our Bucket: Addressing Children’s Health Insurance Churn
By Ashley Storms, New England Alliance for Children’s Health Pursuing health coverage for all children can sometimes feel like pouring water into a leaky bucket. Even when outreach and enrollment efforts are strong, a substantial portion of children will lose their insurance at least once. Unstable insurance coverage, known as “churn,” is inefficient and keeps…
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CHIP Lock Outs May Leave Kids Without Premium Tax Credits, Too
By Joe Touschner As Tricia Brooks wrote last week, new rules set limits on how states handle lock out periods for children enrolled in CHIP. Several states impose a lock out period—a length of time when a child may not receive CHIP coverage—when families fail to pay CHIP premiums. The new rules limit lock out…
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Tech Tuesday: How Kids Coverage Has Innovated Technology-Based Solutions to Maximize Enrollment
Over the past several years, I have had the pleasure of participating as a technical assistance faculty member for Maximizing Enrollment, a national program of the Robert Wood Johnson Foundation with technical assistance and direction provided by the National Academy of State Health Policy. The program works intensively with eight states to (as the name…
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New Rules Set Limits on Locking Kids Out of Coverage for Nonpayment of Premiums
Thirty-three (33) states charge premiums or enrollment fees for children enrolled in Medicaid or CHIP, starting as low as 101% of the federal poverty level in CHIP. In the past, federal guidelines for dealing with premium grace periods and nonpayment of premiums were minimal, particularly in CHIP. It was not until CHIP was reauthorized in…
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Certified Application Counselors
Trusted community-based organizations and health care providers have been a key part of our nation’s success in bringing the rate of uninsured children down to an historic low. These community partners will also be an important resource in connecting consumers to new coverage options under the Affordable Care Act. In particular, certified application counselors (CACs)…
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Tech Tuesday: Visit “Healthcare.Gov” or YouTube to Get a Taste of What’s Around the Corner
Working in the weeds of health policy, it’s easy to get bogged down in the minutiae of the health care law. And in the media, we are constantly bombarded with the aspects of the law that are most controversial or problematic. So sometimes we lose perspective (I know I do) as we seek perfection in…
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New Kaiser/Urban Report Highlights the Costs of NOT Extending Medicaid
By Martha Heberlein As many states are nearing or have reached the end of their legislative sessions, it’s a good time to take stock of who will implement the Medicaid expansion and the far-reaching implications of these decisions. Twenty-four states have decided to move forward with the expansion, 21 will not, and 6 continue to…
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Health Reform at Work – Lower Rates in New York
By Christine Monahan, Georgetown University Center on Health Insurance Reforms New Yorkers currently or considering purchasing coverage in the individual market woke up to exciting news today: premiums in 2014 are expected to be cut by more than half. And that’s for the most generous coverage on the market. New Yorkers will also be able to purchase…
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More Info on Individual Mandate Exemptions
By Joe Touschner The Affordable Care Act’s employer responsibility and individual responsibility requirements have been much discussed since the Administration announced its decision to delay reporting and penalties for the employer requirement for a year. The individual responsibility requirement, however, is still on track to go into effect in January and recent rules and guidance…
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Consumer Group Creates Set of Customer Service Standards for Marketplace Call Centers
By Betsy Imholz, Special Projects Director, Consumers Union Think of the last time you called your cable company to respond to the latest promotion or to ask a billing question. Recall the ache in the pit of your stomach, the cringing expectation you’d be put on hold, shuffled from person to person, denied the promised…
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Final Regulations on Navigators, In-Person Assisters and Certified Application Counselors
It was another hot summer Friday for regulations with the release of the final rule on navigator and non-navigator assisters (aka in-person assisters) and Exchange-based certified application counselors (CAC). (Don’t our friends at CMS know that we like to take weekends off?) All in all, the proposed rules for navigators were finalized with minimal changes…