Charles Gaba's blog

via the Colorado Dept. of Regulatory Agencies (DORA):

OmniSalud program will provide $0 premium health plans to 11,000 qualified individuals.

DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), is pleased to announce that for 2024, it will increase the availability of financial assistance for health insurance in the OmniSalud program to 11,000 individuals. This a 10 percent increase from 10,000 individuals in 2023. 

OmniSalud allows Coloradans without documentation (including DACA recipients) and who are ineligible for federal subsidies for health insurance, to get health insurance that meets the requirements of the Affordable Care Act (ACA). Those who qualify can receive financial help, called SilverEnhanced Savings, to make that insurance more affordable. The OmniSalud program is offered through Colorado Connect, Connect for Health Colorado’s public benefit corporation and online enrollment platform. 

Until October 2013, I wasn't a healthcare wonk. I wasn't an expert on the ACA specifically or health insurance in general. I didn't know my ass from a hole in the ground when it came to risk pools, cost sharing, deductibles, out of pocket caps, guaranteed issue, community rating or any of the other industry buzz words.

Hell, I didn't even know that Medicaid is the same program as California's Medi-Cal or Wisconsin's BadgerCare Plus (that's just how those states brand the program).

What I did know was that the Patient Protection & Affordable Care Act, which had been signed into law 3 1/2 years earlier, was a Big Fucking Deal®, as President Biden had put it...and I knew that the main provisions of the ACA were about to go into effect.

Ten days earlier, on the same day that the federal and state ACA exchanges had opened for business (with some of them, including the main one at HealthCare.Gov experiencing catastrophic technical failures), At the same time, Texas Senator Ted Cruz had spearheaded a federal government shutdown (sound familiar?) in protest of the new law.

Those first few weeks were pretty chaotic for the ACA, to put it mildly.

Via MNsure:

ST. PAUL, MN — Minnesotans who need health insurance for 2024 can easily find free application and enrollment help from a MNsure-certified broker at 23 locations, known as Broker Enrollment Centers. Thanks to new partnerships with insurance agencies, MNsure has added four new enrollment centers in greater Minnesota and one in the east Twin Cities metro area, with all current partners returning.

Most Minnesotans who need health insurance are eligible to enroll in health insurance during MNsure’s upcoming open enrollment period, which begins November 1, 2023, and ends January 15, 2024. Open enrollment is the once-a-year opportunity to compare options, sign up for health coverage, or change plans through MNsure, Minnesota’s official health insurance marketplace. Minnesotans who qualify for health coverage through Medical Assistance or MinnesotaCare and members of federally recognized tribes can enroll in health insurance through MNsure at any time throughout the year.

This actually happened way back in January, but I didn't stumble upon the press release until now:

Shaheen Reintroduces Legislation to Lower Health Care Costs & Expand Access to Insurance for Millions More Americans

  • Provisions of the Improving Health Insurance Affordability Act were signed into law through the Inflation Reduction Act & the American Rescue Plan Act
  • Estimates suggest 8.9 million Americans have lower premiums thanks to enhanced tax credits
  • **Shaheen’s efforts mark the most significant update to Affordable Care Act in a decade

(Washington, DC) – U.S. Senator Jeanne Shaheen (D-NH) today reintroduced her legislation, the Improving Health Insurance Affordability Act. The bill would make permanent enhanced tax credits that led to record Marketplace enrollment, while reducing health care costs for millions of additional Americans.

 

10/11/23: SEE IMPORTANT UPDATES BELOW!

In August I noted that Amy Lotven of Inside Health Policy had reported that Virginia's brand-new state-based ACA health insurance exchange had been officially approved by the Centers for Medicare & Medicaid Services:

Virginia is slated to become the nation’s 19th state-based exchange now that CMS has given officials the greenlight to fully transition away from healthcare.gov starting Nov. 1 for the 2024 plan year. Meanwhile, the State Corporation Commission (SCC), which administers the exchange, has suspended the state’s reinsurance program that had lowered premiums by about 20% for 2023, so individual plan rates are set to increase by an average 28.4%, according to a presentation made during an Aug. 9 hearing on the 2024 rates.

New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.

via the North Dakota Insurance Dept:

Godfread announces rates for 2024 ACA plans

BISMARCK, N.D. – Insurance Commissioner Jon Godfread has approved the rates for individual and small group health insurance plans compliant with the Affordable Care Act (ACA).

Individual and small-group health insurance plans that are ACA-compliant are purchased through the Healthcare.gov exchange or licensed agents. Three statewide insurance carriers operate on the individual market, available via Healthcare.gov and through insurance agents. Five major carriers exist in the small group market, primarily purchased by employers of small businesses.

“We’re releasing these rates to give consumers who purchase their health insurance on the individual or small group markets an idea of what’s to come for 2024,” said Godfread. “The changes in rates this year are on par with previous years, with no big jumps or decreases in rates. When purchasing health insurance, or any insurance policy, shop around and look at different coverage options and find one that best fits your and your family's needs.”

SEE IMPORTANT UPDATES AT BOTTOM.

Yesterday I crunched the numbers for two different reports from the Centers for Medicare & Medicaid services.

The first was the standard monthly Medicaid/CHIP enrollment report for June 2023:

In June 2023, 92,614,205 individuals were enrolled in Medicaid and CHIP.

  • 85,614,581 individuals were enrolled in Medicaid in June 2023, a decrease of 1,169,095 individuals (1.3%) from May 2023.
  • 6,999,624 individuals were enrolled in CHIP in June 2023, a decrease of 32,449 individuals (0.5%) from May 2023.

As of June 2023, enrollment in Medicaid and CHIP has decreased by 1,304,004 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.

Washington HealthPlan Finder

via the Washington HealthPlan Finder:

Today, the Washington Health Benefit Exchange (Exchange) released a Data Snapshot Report, which shows the availability of affordable, Cascade Care plans are proving critical to keeping people covered and advancing equity during the Medicaid unwind.

Now that COVID-era protections have expired, Washington, like all states, has resumed regular annual eligibility checks for people covered by our state Medicaid program, Washington Apple Health. For the past year, the Exchange has joined partners across our state, led by the Washington Health Care Authority (HCA), to ensure Apple Health customers watch out for and respond to renewal notices.

Originally published 8/07/23

The good news is that RateReview.HealthCare.Gov has posted the preliminary 2024 rate filing summaries for every state, making it much easier to pin down which carriers are actually participating in the individual & small group markets next year, as well as what the carriers average requested rate changes are in states which don't publish that data publicly (or which make it difficult to track down if they do).

The bad news is that in many of those states, acquiring the actual enrollment data is even more difficult, as their rate filings tend to be heavily redacted. Alabama falls into this category.

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