2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Charles Gaba's blog

Starting today, November 1st, the Seventh Annual ACA Open Enrollment Period is upon us! As I do every year, here's a list of important things to remember when selecting a health insurance policy. Some of these are the same every year and apply nationwide; others are specific to the 2020 enrollment period and/or to particular states.

1. DON'T MISS THE DEADLINE!

California actually launched Open Enrollment for 2020 on October 15th, but for the other 49 states (+DC) it starts on November 1st. The deadline for Open Enrollment is December 15th in most states for coverage starting January 1st, 2020, but eight states which operate their own ACA exchanges have extended deadlines:

So last night I whipped up a bit of a fuss on Twitter with my response to an exchange between Pete Buttigieg and Rachel Maddow:

Asked by @maddow about a McKinsey client laying off thousands of insurance company workers — and whether Buttigieg’s work played a role — Buttigieg turns it around and warns that Medicare for All advocates would end every insurance worker’s job. pic.twitter.com/hbTGbkcFRR

— Dan Diamond (@ddiamond) December 11, 2019

Maddow: "When you did that cost & overhead assessment for Blue Cross Blue Shield of Michigan, a couple years after that, they laid off like 1,000 people. Was your work part of what led to those layoffs?

The Week 6 HealthCare.Gov Snapshot Report from CMS should be released sometime Wednesday afternoon, covering enrollment in 38 states from Dec. 1st - 7th.

As a reminder, here's what the Week 5 report looked like (for Nov. 1st - 30th):

There are two major things to account for when comparing the two years: First, there's a day missing due to Nov. 1st falling on a Friday instead of a Thursday this year. This likely accounts for around ~120,000 of the difference. Secondly, Nevada split off from HC.gov this year, which accounts for around ~19,000 of the gap the first 3 weeks. In addition, a small portion of the difference is likely due to Idaho and Maine expanding Medicaid; exchange enrollees earning between 100-138% FPL should be tranferred over to Medicaid instead.

via the New Hampshire Insurance Dept by email:

Deadline is Approaching for Open Enrollment Sign-ups

CONCORD, NH – New Hampshire residents should be aware that the deadline to enroll in individual health insurance for 2020 is this Sunday, December 15. After this date, the only way people can enroll in an individual insurance plan is if they qualify for a special enrollment period, typically during the 60 days following certain qualifying life events. Enrollees must pay the first monthly premium by the insurance company’s due date before 2020 coverage can take effect on January 1.

"Now is the time for New Hampshire residents who need individual coverage to enroll in a health plan for next year," said Insurance Commissioner John Elias. "Only if someone has a qualifying life event such as getting married or having a baby can they change their plan during the year. If consumers still have questions about what plan is best for their needs, they should reach out to an insurance agent or an enrollment assister for help understanding their options."

On the one hand, this isn't nearly as big of a technical disaster as the HealthCare.Gov launch was in 2013, I admit.

On the other hand, only 8 million people enrolled in ACA exchange plans in the first 2013-2014 Open Enrollment Period, whereas nearly 60 million are enrolled in Medicare.

via the House Energy & Commerce Committee via email:

Bipartisan House Leaders Raise Medicare Plan Finder Concerns

  • Committee Leaders Urge CMS to Open Special Enrollment Period for Beneficiaries Who Used Plan Finder to Make Enrollment Decisions

Washington, D.C. – Bipartisan House health leaders sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma expressing concerns over reports that the Medicare Plan Finder was confusing, generated incorrect results, and inadvertently led beneficiaries to select plans with lower premiums but higher overall costs.

via the Massachusetts Health Connector:

Massachusetts Health Connector Open Enrollment Continues through January 23, Offering High-Quality and Affordable Coverage to Residents

BOSTON – December 9, 2019 – Open Enrollment for health insurance through the Massachusetts Health Connector continues through January 23, 2020, providing residents time to find affordable coverage that delivers a wide range of benefits to make it easier and less costly to get health care.

Uninsured residents have until December 23 to apply, pick a plan and make a payment in order to have coverage starting January 1, and they have until January 23 to apply for coverage starting February 1. In contrast, Open Enrollment in other states served through the federal marketplace ends as early as December 15.

Covered California and the Challenged Athletes Foundation Team Up to Promote Open Enrollment and the Dec. 15 Deadline for Coverage During All of 2020

  • While Covered California’s Open Enrollment period runs through Jan. 31, 2020, consumers must enroll by the end of Dec. 15 to have their coverage begin on Jan. 1.
  • Covered California is teaming up with the Challenged Athletes Foundation, to host a Holiday Boot Camp to promote the importance of health, fitness and the open enrollment period. 
  • The Boot Camp will be led by Paralympian, 2019 Parapan Gold Medalist and World Record Holder Scout Bassett and Nike Master Trainer Betina Gozo.
  • Californians who choose to go without coverage could face a penalty when they file their 2020 taxes.

Covered California continued its statewide open enrollment campaign by teaming up with the Challenged Athletes Foundation in San Diego for its Holiday Boot Camp on Tuesday. The event comes as Covered California alerts consumers about a critical upcoming deadline. Consumers must sign up by Dec. 15 if they want their coverage to start on Jan. 1.

For three years running, thanks to a combination of the way the ACA's premiums subsidy formula works and the Silver Loading workaround, several million low-income people are eligible for fully ACA-compliant healthcare policies which end up costing them NOTHING in premiums after federal tax credits are applied.

Here's why: Under the ACA's subsidy formula, if you earn between 100% - 400% of the Federal Poverty Line ($12,490 - $49,960/yr if you're single), you're eligible for subsidies which bring the cost of the benchmark Silver ACA plan down to between 2.06 - 9.78% of your income, on a sliding scale.

If you earn less than 200% FPL (just under $25,000), you also qualify for heavy cost sharing reduction assistance as well...but only if you enroll in a Silver plan.

So, let's suppose you earn exactly $25,000/yr (just over 200% FPL). At that income, you'd qualify for subsidies bringing the benchmark Silver down to 6.5% of your income, or $135/month. If the benchmark plan costs, $600 at full price, you'd therefore be eligible for $465/month.

 

Tuesday, December 10th, is gonna be a pretty big day for federal healthcare policy, especially in the U.S. House of Representatives.

For one thing, it's my understanding that the big Prescription Drug Bill (H.R. 3, the Lower Drug Costs Now Act) is scheduled for a floor vote on Tuesday, although it's possible that it'll be bumped until later in the week given the grumbling by the Congressional Progressive Caucus.

For another, the House Energy & Commerce Committee is holding what I'm assuming are all-day hearings on not one, not two, but nine different Universal Coverage bills, including the Big Ones: Medicare for All and Medicare for America:

HEARING ON "PROPOSALS TO ACHIEVE UNIVERSAL HEALTH CARE COVERAGE"

Date: Tuesday, December 10, 2019 - 10:30am

 

(h/t @CarenaAK via Twitter)

The hits just keep on coming for CMS Administrator Seema Verma:

Medicare chief asked taxpayers to cover stolen jewelry

A top Trump health appointee sought to have taxpayers reimburse her for the costs of jewelry, clothing and other possessions, including a $5,900 Ivanka Trump-brand pendant, that were stolen while in her luggage during a work-related trip, according to documents obtained by POLITICO.

Seema Verma, who runs the Centers for Medicare and Medicaid Services, filed a $47,000 claim for lost property on Aug. 20, 2018, after her bags were stolen while she was giving a speech in San Francisco the prior month. The property was not insured, Verma wrote in her filing to the Health and Human Services department.

The federal health department ultimately reimbursed Verma $2,852.40 for her claim, a CMS spokesperson said.

via email from the House Energy & Commerce Committee:

Bipartisan House and Senate Committee Leaders Announce Agreement on Legislation to Lower Health Care Costs

  • Legislation ends surprise medical bills; funds Community Health Centers for five years; increases the purchasing age of tobacco to 21; lowers prescription drug and other medical costs by requiring more transparency and competition

WASHINGTON, December 8, 2019 — Senate Health Committee Chairman Lamar Alexander (R-Tenn.) and House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-N.J.) along with Ranking Member Greg Walden (R-Ore.) today announced they have reached a bipartisan, bicameral agreement on legislation to lower what Americans pay out of pocket for their health care.

Whether it actually makes it through both the House and Senate and gets signed by Trump or not, just getting this type of announcement itself is pretty unheard of these days for any significant policy.

As noted a few days ago, House Democrats have officially scheduled a floor vote on H.R. 3, the Lower Drug Costs Act of 2019, for next week:

Pelosi, Hoyer, Pallone, Neal and Scott Joint Statement Announcing Floor Vote on H.R. 3

Washington, D.C. – Speaker Nancy Pelosi, Majority Leader Steny Hoyer, Energy & Commerce Committee Chairman Frank Pallone Jr., Ways & Means Committee Chairman Richard E. Neal and Education & Labor Committee Chairman Bobby Scott released the following joint statement:

“Next week, the House of Representatives will pass the Elijah E. Cummings Lower Drug Costs Now Act.

“We have now received enough guidance from CBO to bring the Lower Drug Costs Now Act to the Floor and to reinvest its savings in one of the most transformational improvements to Medicare since its creation.

via the Washington Health Benefit Exchange:

Washington Health Benefit Exchange Issues Statement on Approval of Cascade Care Plan Designs

Washington Health Benefit Exchange (Exchange) board approved the design for Cascade Care plans today. Cascade Care plans are qualified health plans that have a standard health benefit design across health insurance carriers making it easier to understand and offer more value for Washington Healthplanfinder consumers.

Today, Pam MacEwan, CEO of the Washington Health Benefit Exchange, and Ron Sims, the Exchange’s Board Chair, issued the following statement regarding the approval of the designs as a step in implementing Senate Bill 5526 (Cascade Care):

via HealthSource RI:

The clock is ticking on picking the best health insurance plan for 2020. High quality and affordable health coverage is available through HealthSource RI, and Rhode Islanders have until December 23rd to purchase coverage that starts on January 1st.
 
Getting health insurance is even more important this year because coverage is now required in the state of Rhode Island. As of January 1st, residents who don’t have health insurance will pay a tax penalty when filing for the prior year.

AGAIN: The federal shared responsibility requirement (aka the individual mandate penalty) may have been zeroed out by Congressional Republicans, but in addition to the District of Columbia, four states (Massachusetts, New Jersey, California and Rhode Island) have reinstated it at the state level.

A few weeks ago, I did a write-up about a concerning development at HealthCare.Gov: The growing push under the Trump Administration to not only partner with 3rd-party web brokers (which has been done since the first days of the ACA under the Obama Administration), but to actively promote those third-party brokers over HealthCare.Gov itself.

In and of itself, this wouldn't be too problematic as long as people are still ultimately enrolling in fully ACA-compliant policies and receiving ACA subsidies if they're eligible for them. Hell, one of these 3rd-party authorized web brokers even has a banner ad at the top of my website...which I only allow because this particular one only sells on-exchange ACA-compliant policies.

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