Marketplace
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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…
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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…
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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…
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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…
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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…
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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…
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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…
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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. …
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Children Need Exchange Coverage Too
By Maureen Hensley-Quinn, National Academy for State Health Policy As state and federal government officials race to meet Affordable Care Act (ACA) implementation deadlines much of their attention has been focused on adults who will be newly eligible for health coverage. Health insurance exchanges (exchanges) or marketplaces need to be prepared to serve children’s needs as…
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Obama Administration Releases FY2014 Budget
By Tara Mancini President Obama (finally) released his budget recommendations for fiscal year 2014. Although the budget was postponed for two months, there aren’t too many surprises here as we’ve heard many of his considerations during the delay. The good news is that as promised the budget does not contain any significant cuts to Medicaid,…
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Senate HELP Committee Examines Upcoming Market Changes Under ACA
It was a strange feeling testifying before the Senate Health, Education, Labor and Pensions (HELP) Committee., given that, about 15 years ago, I was sitting on the other side of the dais as a staff member of the Committee. Today, my role was dramatically different, as I was called to speak as a witness at a…
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Federal Navigator Funding Opportunity Announced
At long last, organizations can now apply for federal navigator funding in 33 states where the federal government will run the Health Insurance Marketplace or there is a State Partnership Exchange. The program will fund a total of $54 million dollars in grants (actually cooperative agreements). Grants will range from $600,000 to $8.1 million based…
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CMS Releases Proposed Standards for Navigators and In-Person Assisters
Organizations interested in applying for navigator grants and other stakeholders will want to take a close look at the proposed rules on navigator conflict of interest, training and meaningful access standards. While subject to a 30-day comment period and final rulemaking, the proposed rules add some clarity regarding expectations for federally-funded navigators and in-person assisters…
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Vermont Preliminary Rate Filings Offers First Look at Exchange Pricing
By Christine Monahan, Georgetown University Center on Health Insurance Reforms In the midst of much analysis of the impact of the Affordable Care Act (ACA) on health insurance premiums, Vermont became the first state to release preliminary rate filings for plans to be sold in their health insurance exchange in 2014. The good news is that people generally haven’t…
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CMS Issues Guidance on Arkansas Type Premium Assistance Plans
So as Tricia Brooks blogged about yesterday while I was taking the day off, CMS issued some interesting Q and A’s last Friday on how a state might consider taking a premium assistance approach to expanding their Medicaid program. The Q and A’s, to my mind, were a helpful contribution to the ongoing discussions in…
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Diving Deep on Two New Rate Studies
By Christine Monahan and Katie Keith, Georgetown University Center on Health Insurance Reforms With many of the Affordable Care Act’s (ACA) most significant reforms expected to go into effect in 2014, policymakers and the media have increasingly turned their attention to the law’s price tag for consumers. Republican lawmakers, for example, sounded the alarm about…
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Building the New Insurance Marketplaces: Future of One State-Based Exchange Threatened
By Sabrina Corlette, Center on Health Insurance Reforms The District of Columbia is not technically a state, but it is one of the few that plans to run its own health insurance marketplace (called the “Exchange”) under the Affordable Care Act. Early on, however, DC planners realized that they had a very small pool from…
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New Options for Young Invincibles
By Christina Postolowski, Young Invincibles The Affordable Care Act (ACA) will provide enormous new benefits to young Americans – in fact, it already has. Last month, Gallup released a poll showing that the uninsured rate for young adults under 26 decreased yet again, a drop of six percent since 2009. The drop is due in…
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CMS Q&A Shines Light on “Arkansas Plan”
Just in time for the holiday weekend, CMS issued a Q&A regarding the state option to expand Medicaid by using premium assistance to buy coverage through a qualified health plan in the new insurance marketplaces. Over the past few weeks, “the Arkansas plan” worked itself into a media frenzy and had Medicaid stakeholders concerned over…
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A Look At What State Legislatures Are Up To On Navigators
By Katie Keith, Georgetown University Center on Health Insurance Reforms In addition to our efforts to track state legislation on the Affordable Care Act’s market reforms (check out our most recent blog on the 2014 market reforms here), our team is also tracking legislation that relates to exchange establishment and development. In this blog—brought to…