HHS Extends Special Enrollment Period to Help People Transition to the Marketplaces, Issues New Resources for Partners, and Publishes Guidance Reinforcing Key Federal Requirements
Nevada Health Link Spearheads AI Implementation, Championing Cutting-Edge Technology for Unparalleled Consumer Engagement
The first State Based Marketplace to receive Centers for Medicare & Medicaid Services approval for implementing AI technology
MOUNTAIN VIEW, Calif. – In a groundbreaking move towards enhancing consumer experiences and setting new standards in health insurance exchange technology, Nevada Health Link proudly announces the successful integration of Artificial Intelligence (AI) into its State-Based Marketplace (SBM) platform. This first-of-its-kind initiative underscores Nevada Health Links's unwavering commitment to innovation, transparency, and consumer-centric strategies.
The implementation of a purpose-built interactive virtual agent (IVA) by the team at GetInsured marks a significant milestone in Nevada Health Links's journey. Nevada Health Link is the first marketplace to have Centers for Medicare & Medicaid Service’s (CMS) approval for the use of AI-based Interactive Virtual Agents to enhance the customer service experience. The state worked collaboratively with the CMS and GetInsured security teams for several months to ensure that all federal privacy and security requirements were met. This approval signifies a high level of confidence in the technology that the marketplace has implemented.
In December 2023, 85,094,448 individuals were enrolled in Medicaid and CHIP, a decrease of 785,863 individuals (0.9%) from November 2023
77,913,798 individuals were enrolled in Medicaid in December 2023, a decrease of 786,068 individuals (1.0%) from November 2023.
7,180,650 individuals were enrolled in CHIP in December 2023, an increase of 205 individuals (0.0%) from November 2023.
As of December 2023, enrollment in Medicaid and CHIP has decreased by 8,773,558 individuals (9.3%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
Medicaid enrollment has decreased by 8,816,761 individuals (10.2%).
CHIP enrollment has increased by 43,203 individuals (0.6%).
Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,992,937 individuals (32.4%) to 93,868,006.
Medicaid enrollment increased by 22,6350,766 individuals (35.3%).
CHIP enrollment increased by 342,171 individuals (5.0%).
Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.
However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.
As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.
Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.
I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...
...As I noted, however, in all three [states] it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper.
Of course, as one Alabama-based advocate put it...
Well, it looks like Ms. Adams may end up being disappointed...
BREAKING: The Mississippi House just passed Medicaid expansion by a 96-20 vote.
That's more than enough to overcome a veto from Gov. Tate Reeves.
It now heads to the Senate.
Today I want to address the question of Actuarial Value (AV)...that is, what percent of medical expenses (in aggregate) a given healthcare policy actually pays for. As a quick reminder, ACA policies are generally broken into four AV categories, labeled by metal levels: Bronze, Silver, Gold and Platinum, which generally cover roughly 60%, 70%, 80% or 90% of enrollees in-network medical expenses per year (there's a fifth category in front of Bronze called Catastrophic plans, but these have limited eligibility and hardly anyone enrolls in them anyway).
President Biden Announces New Landmark Rule to Protect Americans from Junk Health Insurance
Latest action to deliver better health care and prevent consumers from getting ripped off
Today, the Biden-Harris Administration is taking a major step to crack down on junk health insurance for American families and consumers and deliver better health. As the President has said, people hate being played for suckers and the current practice of offering low-quality insurance that people pay into, but then provides no coverage when people need it, is a bait and switch. That’s why the Biden-Harris Administration is issuing a final rule that protects consumers from junk health insurance and makes sure Americans aren’t scammed into low-quality coverage that leaves consumers on the hook for thousands of dollars in medical bills or denies life-saving care right before treatment. The President is committed to building on the promise of the Affordable Care Act and its critical consumer protections that ensure meaningful coverage for people’s health care needs.
Welp. With last weeks news that House Republicans have decided to once again go to war with the Affordable Care Act if they gain a federal trifecta this November, it's time once again to take a look at just how many of their constituents are at risk of losing their healthcare coverage entirely or, at best, facing massive premium increases (which in most cases would have the same effect by making their coverage cost far more than they could possibly afford).
Alongside this weekends release of the final, official 2024 ACA Open Enrollment Period (OEP) data, The Centers for Medicare & Medicaid Services (CMS) has also pulled together estimates of how many residents of each Congressional District selected ACA exchange plans during the 2024 OEP:
New Jersey Department of Banking and Insurance Acting Commissioner Justin Zimmerman today announced an expanded Special Enrollment Period for individuals who are no longer eligible for NJ FamilyCare and qualify for health insurance through Get Covered New Jersey, the state’s Official Health Insurance Marketplace. The expanded Special Enrollment Period will be available to anyone who lost NJ FamilyCare coverage due to resumption of eligibility reviews regardless of the date they lost coverage. Previously, individuals had 120 days to enroll after their NJ FamilyCare coverage ended.
As required by federal law, the Department of Human Services restarted eligibility reviews for NJ FamilyCare on April 1, 2023. Those who no longer qualify for NJ FamilyCare because their income is too high may be eligible to obtain health coverage through Get Covered New Jersey and may be able to get help paying for premiums.
