Marketplace
-
Navigator Assister Training Outline
This comprehensive outline for navigators and other types of assisters was developed to inform the scope of training that is being developed at both the federal and state level to prepare navigators and other assisters to connect consumers to existing and expanded coverage options un the Affordable Care Act.
-
Tech Tuesday: CMS Option Provides States with a Powerful Outreach Tool
By Shelby Gonzales, Center on Budget and Policy Priorities Connecting families to health coverage and other benefits requires comprehensive and strategic outreach. Getting people to sign up is hard work, and it often takes time to make measurable gains in enrollment. One strategy has been extremely effective in enrolling eligible children. Using information available from…
-
CMS Releases Guidance on Alternative Application
By Martha Heberlein The ACA requires states to use a single, streamlined application to determine eligibility for all health insurance affordability programs. Back in April, CMS released the model application that they will use in the federally-facilitated marketplaces (FFM). States can either adopt this for their own use or can use an alternative application that…
-
100 Days to “Launch”: What a Formerly Controversial Health Program Can Teach Us
By Sabrina Corlette, Georgetown University Center on Health Insurance Reforms People, stop wringing your hands and roll up your sleeves. On Sunday, we’ll be just 100 days from the first day of open enrollment in new, high quality and affordable health insurance coverage options. As we barrel towards the finish line, pundits and policymakers have been quick…
-
Tech Tuesday: Survey of State CIOs Provides Insight on State Medicaid Eligibility and Enrollment Systems
This weekend, the final 100-day countdown to open enrollment begins. Will state Medicaid eligibility and enrollment systems be ready? Results from a recent survey published by the National Association of State Chief Information Officers (NASCIO) and the Healthcare Information and Management Systems Society (HIMSS) indicate that 72% of the 26 states and/or territories that responded…
-
Figuring Out Premium Tax Credits
By Joe Touschner [For more up-to-date information on figuring out premium tax credits, visit Consumer Reports health tax credit tool or state specific brochures. Kaiser Family Foundation has also updated its subsidy calculator.] Insurers have been filing small group and non-group rates in several states recently, leading to claims and counter-claims about whether the ACA…
-
Tech Tuesday: Technology and Website Design Matter When It Comes to Selecting a Health Plan
By Julie Silas, Consumers Union Over the past two years, like many of you, I have been expending my energy on fine tuning important policy positions that will impact millions of people (hello, please, no more proposed regulations!). While I have tried to wade into the practical, concrete functionality that will be essential for those…
-
Navigator and Assister Training Is Not a One Shot Deal
Now that both state-based and the federally-facilitated marketplaces are well on their way to recruiting and selecting navigators, attention turns to training and support. Effective training is critical to ensuring that the needs of consumers, particularly low-income, hard-to-reach and vulnerable populations, are met. But training is only one element of creating and supporting a high-functioning…
-
Final Rule on Workplace Wellness Programs: A Look at the Implications for Consumers
By JoAnn Volk, Georgetown University Center on Health Insurance Reforms The ACA’s ban on using health status to set health insurance premiums is a key consumer protection in the new law and will bring relief to tens of millions of Americans who face discrimination in today’s health insurance market. Proponents argued the ban would make…
-
Tech Tuesday: An Advocate’s Role in Medicaid Eligibility and Enrollment System Development
Even as states across the country continue to evaluate their options for implementing the Affordable Care Act (ACA), almost all states are moving to take advantage of significant federal funding to modernize their Medicaid information technology (IT) infrastructures in response to the new law. The decisions being made now and in the months ahead will…
-
Five Strategies to Make it Easier to Enroll in Medicaid and CHIP Coverage
By Martha Heberlein In case you missed it, it was a beautiful day in Washington on Friday and some exciting news from CMS made the day all the brighter – a State Health Official letter they released provides states with some tools to enroll eligible folks more efficiently. Understanding that states will be facing the…
-
Assister Types Abound: But Will Navigators and Assisters Be Plentiful Enough?
I was ready to wrap up this blog series last week when HHS announced an additional $150 million in funding for “Outreach and Enrollment Assisters” in community health centers to help connect consumers to coverage. There seems to be a wealth of assisters: navigators, in-person assisters, certified application counselors and now health center assisters. And…
-
Tech Tuesday – Technology Takes Over to Verify Medicaid Eligibility Electronically
With new high-performing IT systems, states will be able to use cost-effective, trusted and secure electronic data sources to verify eligibility including income, citizenship, immigration status, and other criteria. States have some discretion in how they verify eligibility (i.e. what data sources they use) but they cannot require individuals to provide documentation or more information…
-
How Many Calls Does it Take to Sign Up for CHIP in Pennsylvania?
Eighty-six phone calls! That’s how many calls it took new parents Ari Friedman and Tara Mendola of Philadelphia, Pennsylvania to finally obtain Children’s Health Insurance Program (CHIP) coverage for their son. (And we all know new parents have nothing better to do than sit on hold!) Ari and Tara are both graduate students who were…
-
Tech Tuesday – A New Blog Series Highlighting Technology and its Potential to Transform Eligibility and Enrollment
I frequently marvel at the deep Medicaid and CHIP policy expertise of so many of our state and national partners. And when someone’s knowledge doesn’t run as deep, they often make up for it in their passion for expanding health care coverage. Whether you’re a seasoned advocate or new to public health coverage, it doesn’t…
-
Proposed Navigator Standards Comments Due Today
Last call for comments on the HHS proposed navigator standards released last month. Comments are due by 5:00pm ET today, May 6th. The rules outline the conflict of interest and training standards that will apply to federally-funded navigators in 34 states and in-person assisters in states with state-based or consumer partnership exchanges. In addition to…
-
HHS’s New Model Application – A Major Step Forward
By Jocelyn Guyer HHS released a new version of its model applications for health care coverage this morning. The new models represent a major step forward – they are much shorter, crisper and easier to fill out than the draft versions that were released in January of this year. The new model applications also are…
-
CMS Offers Welcome News on Reimbursement Rates for Eligibility Activities and Related Customer Service
Beyond the fact that millions will gain more affordable coverage options in 2014, the availability of 90% federal funding for new or enhanced Medicaid eligibility systems is one of the most promising aspects of health reform. New systems offer so many advantages, and coupled with new requirements for electronic verification of eligibility, will transform the…
-
Medicaid Payment Provision Seeks to Address Access
By Anne Edwards, M.D., FAAP, Chair of the American Academy of Pediatrics Committee on State Government Affairs Pediatricians and other child advocates continue to work with their state Medicaid programs to implement a significant provision in the Patient Protection and Affordable Care Act (ACA) to increase access to care in the program. Long sought by the…
-
Emerging Policies on Dental Coverage for Kids
By Joe Touschner With the final rule on EHBs, another on market reforms, and some additional guidance from HHS, we’re getting a clearer picture of how one important set of benefits—dental care—will work for kids in EHB-covered plans next year. As readers know, those are new private plans in the individual and small group market. …