ARP

New Hampshire

A couple of weeks ago I noted that all 11 California health insurance carriers participating on the state's ACA exchange, CoveredCA.com, have agreed not to reset deductibles for current off-exchange enrollees who shift to an on-exchange plan during the ongoing COVID Enrollment Period.

This is a HUGE deal, especially in California, where an estimated 430,000 residents are enrolled in off-exchange ACA policies which are virtually identical to their on-exchange equivalent, with the sole distinction of those enrolled in them not being eligible for ACA subsidies.

With subsidies being beefed up and the 400% FPL subsidy cliff having been killed (for the next 2 years, at least), this means that hundreds of thousands of Californians have just become eligible for thousands of dollars in savings...as long as they transition to the same plan on-exchange.

Your Health Idaho, which had been scheduled to end their COVID-19 Enrollment Period on March 31st, has understandably extended the deadline out by another month in light of the American Rescue Plan's expanded/enhanced subsidies. Via email:

Enhanced Subsidies Go into Effect at Your Health Idaho April 1

Your Health Idaho Continues to Enroll Idahoans through April 30, 2021

BOISE, Idaho –Your Health Idaho, the state insurance exchange, will remain open throughout the month of April so Idahoans can take advantage of enhanced financial assistance, which lowers consumer’s monthly premiums. 

For the first time ever, tax credits, which act like an instant discount, may be available for those who were not previously eligible and will be increased for Idahoans who already receive them. For some Idahoans, these savings can be significant. For example, a Treasure Valley married couple in their 20s making $50,000 a year could pay less than $10 a month and a family of four making $105,000 could pay as little as $200 a month.

Platinum Blonde

In the United States, major medical insurance policies for those who don't have healthcare coverage through their employer, Medicare, Medicaid, CHIP, the Veteran's Administration or some other source are available via the ACA's individual market exchanges. The individual market for residents of 36 states is HealthCare.Gov; the remaining 14 states + DC each have their own ACA exchange, such as Covered California, NY State of Health and so forth.

There are usually dozens of ACA policies available via the ACA exchanges, but they fall into five major categories: Catastrophic, Bronze, Silver, Gold and Platinum plans (other major distinctions include HMOs vs. PPOs and other variables,but those are for another day).

With rare exceptions, Catastrophic plans are only available to enrollees under 30 years old. ACA premium subsidies can't be used to help pay for Catastrophic plans either, so enrollment is rare; during the 2020 Open Enrollment Period, only 89,000 ACA exchange enrollees selected Catastrophic plans out of over 11.4 million total, or just 0.8%.

HealthSource RI becomes the latest state-based exchange to jump onboard the August 15th train...

Governor McKee and HealthSource RI Announce New Enrollment Period Extended Through August 15

  • Historic level of financial assistance is now available through HealthSource RI.
  • New Enrollment Period has been extended through August 15, 2021, adding three months to the previous May 15, 2021 deadline.
  • Starting April 1, most HSRI customers will have a lower monthly bill.
  • Beginning in summer 2021, HSRI will make more financial assistance available to people who previously did not qualify to receive it based on their income.
  • Individuals and families who have received unemployment payments in 2021 will be newly eligible for additional financial help for this year or may qualify for health coverage at no cost.
  • Rhode Islanders should enroll in coverage as soon as possible to take full advantage of these new benefits. 
  • The deadline to enroll is August 15, 2021.

A few weeks ago, Pennie (Pennsylvania's ACA exchange), like several other state-based exchanges, put out a simple statement celebrating the passage of the American Rescue Plan (ARP) and the dramatic improvement in ACA affordability that it brings for the next two years. Like most of the other exchanges, Pennie's initial press release was pretty bare-bones, as the bill had just been signed into law and there were a ton of logistical details to be worked out.

Today, at their monthly board meeting, Pennie provided some further info on how they plan to proceed:

Pennie’s American Rescue Plan Policy Goals

  • Implement ARP provisions as soon as possible, and as broadly as possible, to maximize savings for Pennie customers
  • Automate these provisions, to the extent possible, to ensure that the benefits under the new law reach Pennie customers without requiring customer action
  • Ensure that customers who need to take an action are given specific instructions on what they need to do to maximize their benefits
  • Use this unique opportunity to connect more Pennsylvanians to comprehensive coverage and reduce the number of uninsured throughout the Commonwealth

The Kaiser Family Foundation has updated their ACA Exchange Subsidy Calculator tool, which lets you plug in your household information and calculate how much you're eligible for in subsidies, as well as telling you things like:

  • Your percent of the Federal Poverty Level (FPL)
  • The full-price benchmark Silver plan
  • Your net price for the benchmark Silver plan
  • The net price of theleast-expensive Bronze plan
  • The maximum you'd have to pay in out-of-pocket costs

It's been updated to reflect the newly-expanded & enhanced subsidies available under the American Rescue Plan for 2021 & 2022. The official ACA exchange websites will have this data available over the next few weeks depending on which state you live in (HealthCare.Gov is supposed to go live on April 1st; Covered California on April 12th; other states will vary):

via Connect for Health Colorado:

Connect for Health Colorado Extends Enrollment Period through at least August 15

DENVER — Yesterday afternoon, President Biden announced that the federal health insurance marketplace, HealthCare.gov, will extend the current enrollment period through August 15, 2021, to help as many people as possible get covered following the passage of the American Rescue Plan Act of 2021.

Connect for Heath Colorado® Chief Executive Officer, Kevin Patterson, released the following statement in response:

“We will follow the federal decision so that we can help as many Coloradans as possible get covered this year. Keeping our doors open through at least mid-August maximizes the number of people who can apply for financial help and enroll through our Marketplace, especially as our state recovers from the pandemic. We will share more details soon about how Coloradans who are newly eligible for benefits under the American Rescue Plan can get those additional savings.”

A lot has happened since I last ran some back-of-the-envelope math to get a feel for how many Americans are enrolling in ACA exchange policies durign the 2021 COVID Enrollment Period, which started in most states on February 15th.

At the time, HealthCare.Gov had reported 206,000 Qualified Health Plan (QHP) selections as of February 28th. I also had some partial COVID SEP data from a handful of the state-based ACA exchanges, as of various dates. I had 225,000 QHPs confirmed nationally.

At the time, I concluded that based on the enrollment pace of the first few weeks...

As noted above, Medicaid expansion states have only increased average SEP enrollment by around 2/3 as much as Non-expansion states. Since all 15 state-based exchanges have expanded Medicaid, this suggests that the 206K via HC.gov probably represents more like 80% of the total, meaning perhaps 258,000 nationally (~168,000 more than average).

June 16, 2020:

On March 20th, the Vermont Health Connect ACA exchange joined other state-based exchanges in launching a formal COVID-19 Special Enrollment Period.

On April 15th, just ahead of the original SEP deadline, they bumped it out by a month.

Then, with the May deadline approaching, I took a look and sure enough, they've bumped it out another month.

And now, with the June deadline having come and gone...

Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period until August 14, 2020.

I admit that this is starting to get a bit silly. At a certain point I'm guessing at least one of the state exchanges will just say "screw it" and open 2020 enrollment up for the full year.

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