The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)
Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented.
This morning, CMS issued the final NBPP for the upcoming 2023 Open Enrollment Period. Since there's so many provisions included, this year I've decided to break it into multiple posts which only focus on one or a few of them at a time:
The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)
Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of tweaks to some of the specifics of how the ACA is actually implemented.
This morning, CMS issued the final NBPP for the upcoming 2023 Open Enrollment Period. Since there's so many provisions included, this year I've decided to break it into multiple posts which only focus on one or a few of them at a time:
I talked about it endlesslythroughout2017 & 2018, but it's been awhile since I last discussed the ACA's quirky Silver Loading pricing strategy in detail.
The ACA includes two types of financial subsidies. Advance Premium Tax Credits (APTC) reduce monthly premiums for low- and moderate-income.
Cost Sharing Reductions (CSR), meanwhile, reduce deductibles, co-pays and other out-of-pocket expenses for low-income enrollees.
In 2017, Donald Trump cut off CSR reimbursement payments in a failed attempt to sabotage the ACA, thinking this would cripple the ACA exchanges. Instead, insurance carriers implemented a very smart alternative pricing mechanism to make up for their CSR losses, which came to be known as "Silver Loading."
The carriers basically calculated how much they expected owe in CSR expenses the following year...and then simply added that amount to their premiums for the following year instead.
While there's several ways that carriers can add the extra CSR cost to their premiums, "Silver Loading" involves doing so by adding 100% of the extra cost to Silver plans only, as opposed to spreading it out across Bronze, Silver, Gold & Platinum plans.
It's been another month since my last attempt to estimate a grim but vitally important number: Just how many Trump voters vs. Biden voters have become fatal victims of the GOP/FOX News coordinated anti-vaxx/anti-mask campaign to date, and what sort of impact might this end up having on the midterm elections this November?
As I said at the time, I'm not going to attempt to justify this cynical bean counting anymore...the evidence is now overwhelming that Republican leadership, in coordination with outlets like FOX News and other right-wing outlets, made a conscious decision in spring 2021 to push hard against Americans getting vaccinated against COVID-19 for purely cynical political math reasons.
Enrollment Specialists Available at YMCAs Across the State on April 30th
New Yorkers Can Learn About the Availability of Expanded Financial Assistance
Year-Round Enrollment Opportunities Available
ALBANY, N.Y. (April 25, 2022) - NY State of Health, the state’s official health plan Marketplace, announced today that it will join the YMCA in celebration of their annual Healthy Kids Day, held this year on Saturday, April 30th. NY State of Health enrollment specialists are attending Healthy Kids Day events throughout the State, to educate New Yorkers about obtaining quality, low-cost health coverage through the Marketplace. Event attendees will be able to meet certified enrollment assistors at more than 25 YMCA locations to receive enrollment guidance and learn about the availability of increased financial assistance made available through the American Rescue Plan Act.
TRENTON —The New Jersey Department of Banking and Insurance today announced that it is accepting public comment on access to comprehensive reproductive care, coverage of reproductive services and related health impacts.
The department is collecting public comment as part of the implementation of the historic Freedom of Reproductive Choice Act recently signed by Governor Phil Murphy, which codifies the constitutional right to freedom of reproductive choice in New Jersey.
“In signing the Freedom of Reproductive Choice Act, Governor Murphy protected a woman’s right to make medical decisions about her reproductive health,” said Commissioner Marlene Caride. “The department is looking forward to hearing from the public as we examine the impact of insurance coverage on the availability of comprehensive reproductive care services.”
ST. PAUL, Minn.—New data released by the Minnesota Department of Health shows actions taken by state officials and the Biden administration helped drop the state’s uninsured rate in 2021 to 4.0%, the lowest level ever measured.
“The Minnesota Heath Access Survey shows that more Minnesota families have been able to access and maintain their health insurance during this critical time,” said MNsure CEO Nate Clark. “Minnesota has been able to reduce the uninsured rate thanks in part to targeted, effective policies, including the expansion of premium tax credits that lower the cost of monthly premiums for private health plans available through MNsure.”
Access Health CT Announces New Special Enrollment Period for Connecticut Residents with Lower Income
HARTFORD, Conn. (April 25, 2022) — Access Health CT (AHCT) today announced a new Special Enrollment Period (SEP) for Connecticut residents with lower income beginning April 25. This new SEP will provide access to no- or very low-cost health insurance plans made possible by the American Rescue Plan Act (ARPA).
To be eligible for this SEP, Connecticut residents must:
Be new or returning customers who are not currently enrolled in a health insurance plan through Access Health CT.
Have a household income at or below 150% of the Federal Poverty Level (FPL).
If you don't know what 150% FPL is, it depends on your household size:
NOTE: With national COVID deaths continuing to thankfully drop off (the 7-day avg. is down to ~410/day now), I've decided to switch to monthly updates going forward unless COVID deaths start spiking again.
I also recently stopped posting the relative case rates as they've been pretty much stable for the past couple months and the rise of home-based testing, which usually isn't reported to county/state health departments anyway, has made that data somewhat less meaningful.
I've been posting weekly looks at the rate of COVID-19 cases & deaths at the county level since the point at which every U.S. adult could theoretically have received 2 COVID vaccination doses nearly a year ago, broken out by partisan lean (i.e, what percent of the vote Donald Trump received in 2020), as well as by the vaccination rate of each county in the U.S. (nonpartisan).
I go by county residents who have received the 2nd COVID-19 shot only (or 1st in the case of the J&J vaccine).
I base my percentages on the total population via the 2020 U.S. Census including all ages (i.e., it includes kids under 12).
For most states + DC I use the daily data from the Centers for Disease Control, but there are some where the CDC is either missing county-level data entirely or where the CDC data is less than 90% complete at the county level. Therefore:
