Charles Gaba's blog

District of Columbia

A few weeks ago I wrote about a bill pending in the District of Columbia Council, of all legislative bodies, which, had it passed, would have seriously undermined ACA protections for thousands of DC residents with employer-based healthcare coverage, as well as potentially setting precedent for similar bills in other states:

Yes, that's right: This is an attempt to bypass ACA rules for an industry which employs over 4 million people nationally (I don't know how many in DC specifically).

Again, here's what PEOs are:

Access Health CT Logo

Via Access Health CT's News/Press Releases page:

Stats as of December 9, 2022

Qualified Health Plans (QHP):

  • QHP Enrollment In 2023 Coverage: 93,479
  • 2022 OE Acquisition Summary: 9,137

Medicaid:

  • Completed applications/ redeterminations processed through the integrated eligibility system: 12,966

I've never been entirely sure what the "Acquisition Summary" figure refers to, but I've confirmed that it's already included in the larger number.

MNsure Logo

via MNsure, Minnesota's ACA exchange:

ST. PAUL, Minn.—Minnesotans have just one week left to sign up for health insurance through MNsure before the December 15, 2022, deadline for coverage starting January 1, 2023.

MNsure, Minnesota’s health insurance marketplace, is where Minnesotans can select medical and dental coverage and access premium tax credits (discounts) to lower the cost of monthly premiums. Tax credits aren’t available anywhere else, and next year households receiving tax credits are expected to save an average of $560/month.

“Many Minnesota families who have never been eligible for discounts through MNsure now qualify for tax credits in 2023 because of recent changes to federal rules,” said MNsure CEO Nate Clark. “If your family has been relying on health insurance you get through an employed family member, now is the time to check MNsure.org/newoptions and see whether you can access lower-cost health insurance for next year.”

ACA Signups Logo

Yesterday I reported that the Centers for Medicare & Medicaid have issued a new 2023 Open Enrollment Period (OEP) report which raises the official Qualified Health Plan (QHP) enrollment tally for 2023 to nearly 5.5 million people nationally.

However, as I noted, the actual confirmed 2023 OEP tally is over a million higher than that thanks to the nearly 1.2 million Basic Health Plan (BHP) enrollees in New York and Minnesota, as well as some other more recent oddball enrollment data released by various state-based exchanges. All told, this brought the grand total up to over 6.8 million.

HOWEVER, it turns out the actual confirmed total is much higher than that as well, thanks to another ~2.9 million current exchange enrollees across the 18 state-based exchanges who have already been automatically re-enrolled in their current policies for another year (or, alternately, auto-mapped to a similar healthcare plan in cases where their current policy is being discontinued).

Connect for Health Colorado Logo

via Connect for Health Colorado:

Thousands of Residents Have Used the Marketplace to Enroll in 2023 Health Insurance

DENVER— This Thursday, December 8, is Get Covered Colorado Day. This day of action encourages as many Coloradans as possible to enroll in 2023 health coverage during the annual Open Enrollment Period, which runs through January 15. In the first five weeks of this year’s Open Enrollment, approximately 145,000 residents enrolled in a plan through Colorado’s official health insurance marketplace, Connect for Health Colorado.

Seeing how Connect4HealthCO announced 57.5K enrollees just 6 days ago, it's pretty safe to assume that they didn't have over 87,000 more Coloradans suddenly enroll in less than a week. Presumably the 145K figure includes auto-renewals of the remaining current enrollees who haven't actively signed up for a 2023 policy yet.

Nevada Health Link Logo

via Nevada Health Link:

Nevadans can enroll in plans on NevadaHealthLink.com through January 15, 2023

(CARSON CITY, Nev.) – The Open Enrollment Period (OEP) through NevadaHealthLink.com is the most convenient time for Nevadans to enroll or make changes to their qualified health and dental plans; this year 17,925 Nevadans have enrolled in plans in the first 30 days of open enrollment. The 2023 Plan Year OEP began on November 1 and runs through January 15, 2023.

ACA Signups Logo

As I noted earlier today, the Centers for Medicare & Medicaid Services have released an updated 2023 ACA Open Enrollment Period data report, which runs through 12/03/22 for the 33 states hosted by the federal exchange and 11/26/22 for the 18 states which operate their own exchanges.

There were several major takeaways, including an overall 18% year over year enrollment increase so far, with new enrollments up 28%, active renewals for current enrollees up 17% and so forth.

However, there's another important factor to look at when comparing 2023 ACA enrollment to date vs. the same point in 2022 (actually one day less): Medicaid expansion.

The table below breaks out every state's 2023 enrollment vs. the same point in 2022, including which type of exchange they use as well as their ACA Medicaid Expansion status as of this writing:

ACA Signups Logo

via the Centers for Medicare & Medicaid Services:

  • Plan selections represent an 18% increase over last year, including 1.2 million enrollees who are new to the Marketplace

ACA Marketplace National Enrollment Snapshot

November 29th, 2022, via the Centers for Medicare & Medicaid Services:

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.

As of August 2022, 64,942,984 people are enrolled in Medicare. This is an increase of 111,278 since the last report.

  • 34,939,872 are enrolled in Original Medicare.
  • 30,003,112 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage. 
  • ...As of August 2022, 90,550,412 people are enrolled in Medicaid and CHIP. This is an increase of 587,411 since the last report.
  • 83,494,001 are enrolled in Medicaid
  • 7,056,411 are enrolled in CHIP

As I noted at the time:

CMS Logo

via the Centers for Medicare & Medicaid Services:

As part of the Biden-Harris Administration’s ongoing commitment to increasing health data exchange and investing in interoperability, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services. CMS proposes to modernize the health care system by requiring certain payers to implement an electronic prior authorization process, shorten the time frames for certain payers to respond to prior authorization requests, and establish policies to make the prior authorization process more efficient and transparent. The rule also proposes to require certain payers to implement standards that would enable data exchange from one payer to another payer when a patient changes payers or has concurrent coverage, which is expected to help ensure that complete patient records would be available throughout patient transitions between payers.

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