Press Release: NY State of Health Hosts Online Informational Webinars in Spanish and Mandarin Tomorrow
Enrollment Remains Strong During Final Weeks of Open Enrollment
Enroll Today! 2019 Open Enrollment Ends January 31, 2019
Customer Service Center Hours Extended before Deadline
ALBANY, N.Y. (January 22, 2019) - NY State of Health, the state’s official health plan Marketplace, today reminded New Yorkers that now is the time to enroll in a Qualified Health Plan (QHP) for 2019 coverage. NY State of Health will hold webinars in Spanish and Mandarin tomorrow night, January 23, 2019. Open Enrollment for 2019 ends January 31. Consumers across the state have a choice of many quality health plans, and financial assistance is available to most individuals who buy coverage through NY State of Health.
A couple of weeks ago, I noted that Speaker of the House Nancy Pelosi, in an interview airing on MSNBC, stated that two of the major pieces of healthcare legislation she intends on pushing through this session are raising the ACA's tax credit eligibility threshold and "replacing" the now-repealed ACA individual mandate (i was never sure whether "replacing" meant reinstating it or actually replacing it with some other enrollment incentive).
I realize that the odds of any useful healthcare legislation managing to pass the Senate and become law under the Trump Administration is pretty slim, but hey, it's still good news, right!
UPDATE 4/16/19: Please note that this overview refers to the version of Medicare for America introduced in December 2018. There's a revised version of the bill being re-introduced in the near future which is expected to include several important changes. The only two which have been made public so far are: 1) Deductibles are expected to be eliminated altogether; and 2) the upper-end percent-of-income maximum premium is supposed to drop from 9.69% to an even 9.0%.
There's a half-dozen or more different healthcare policy overhaul bills which are being batted around by Congressional Democrats these days, ranging from the fairly modest ("lower the Medicare buy-in to age 50!") up through the full-blown, "pure" Single Payer bill being pushed by Bernie Sanders & other "Medicare for All" activists.
What's most remarkable about the current total is that the 2019 Open Enrollment Period hasn't ended yet in Massachusetts. Residents still have until midnight Wednesday, January 23rd to enroll.
Oh, yeah...and don't forget: Unlike most states, Massachusetts still has a healthcare coverage mandate law which imposes a financial penalty on MA residents who don't have adequate healthcare coverage (unless they qualify for a hardship or other special exemption):
State government plays a critical role in today’s health care system. Every policy decision we make has an impact on the individuals, children and families who need care. The Governor’s FY20 budget proposal builds on this momentum, preserving vital ACA protections that promote market stability and help to keep uninsured rates low. There are no eligibility cuts or broad-based benefit impacts proposed.
Last year there was much hand-wringing by myself and other healthcare wonks about whether or not the Trump Administration would attempt to kill off Silver Loading (and its even-wonkier cousin, Silver Switching). HHS Secretary Alex Azar and CMS Administrator Seema Verma kept sending out mixed and confusing signals about their intentions.
Eventually, Azar decided that while he doesn't like the practice, there wasn't enough time to change the rules before the 2019 Open Enrollment Period was set to begin, so he decided to take a pass for the time being.
Well, in yesterday's NBPP release, the HHS Dept. addressed the issue of CSR reimbursement funding directly...but they also made it clear that they're letting Silver Loading slide for another year:
We propose a premium adjustment percentage of 1.2969721275 for the 2020 benefit year, including a proposed change to the premium measure for calculating the premium adjustment percentage. Under §156.130(e), we propose to use average per enrollee private health insurance premiums (excluding Medigap and property and casualty insurance), instead of employer-sponsored insurance premiums, which were used in the calculation for previous benefit years, for purposes of calculating the premium adjustment percentage for the 2020 benefit year. The annual premium adjustment percentage sets the rate of increase for several parameters detailed in the PPACA, including: the annual limitation on cost sharing (defined at §156.130(a)), the required contribution percentage used to determine eligibility for certain exemptions under section 5000A of the Code (defined at §155.605(d)(2)), and the employer shared responsibility payments under sections 4980H(a) and 4980H(b) of the Code.
Here's what this seeming gobbledygook means, as explained by Matt Fiedler of the Brookings Institute:
Currently, enrollees in plans offered through a Federally-facilitated Exchange or a State-based Exchange using the Federal platform can take action to re-enroll in their current plan, can take action to select a new plan, or can take no action and be re-enrolled in their current plan. Since the program’s inception, these Exchanges have maintained an automatic reenrollment process which generally continues enrollment for current enrollees who do not notify the Exchange of eligibility changes or take action to actively select the same or different plan.
When people say “oh the shutdown only affects government workers,” remind them that IT requires maintenance. GOV websites that help businesses are going offline by the dozens per week https://t.co/1wGeTgsCyypic.twitter.com/sYmBwTYFSq
How many government servers were not patched in the past month? How many applications and website frameworks were not updated? How many pentests were postponed? How many logs were not examined for intruders?
Imagine if your private company simply stopped having employees show up for a month. The government is no different and the impact is larger than all but the most massive private sector orgs
Issuers Urge CMS To Offer Guidance On 2020 Exchange Policy As Rule Stalled
Two associations representing health plans tell CMS that with the annual exchange rule stalled at the White House Office of Management and Budget (OMB) due to the government shutdown, the agency should immediately issue informal guidance that the plans need to understand regulatory and operational changes for the 2020 plan year. Issuers will likely be asked to submit applications in May, and it is critical to get guidance as soon as possible for adequate preparation, the Association for Community Affiliated Plans (ACAP) and the Alliance for Community Health Plans (ACHP) say in a Jan. 15 letter.
CMS typically released the draft Notice of Benefit and Payment Parameters (NBPP) in the early fall and it was generally finalized prior to the new year, although last year the final version was delayed until spring, which also frustrated plans. This year, the proposed rule didn’t land at the OMB for review until Nov. 28.
