via the Centers for Medicare & Medicaid Services (CMS), by email:
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.
50,443,950 are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage.
Last week I noted that the Centers for Medicare & Medicaid Services (CMS) finally released their first 2023 Open Enrollment Period report, which included 3.0 million Qualified Health Plan (QHP) enrollees through 11/19/22 for the 33 states hosted by HealthCare.Gov plus another 387,000 QHP enrollees via the 18 state-based ACA exchanges.
In a footnote, the press release also noted that around 1.07 million New Yorkers have enrolled in NY's ACA-created Basic Health Plan (BHP) program, which is designed specifically for people who earn between 138% of the Federal Poverty Level (FPL) (the cut-off for ACA-expanded Medicaid eligibility) and 200% FPL.
Access Health CT Waives Requirement for Certain Small Businesses to Enroll in a Group Health Insurance Plan Through December 15
Small businesses can enroll in group health insurance at any time of year, but they usually need a certain percentage of employees to participate in the plan
HARTFORD, Conn. (Nov. 23, 2022) — Access Health CT (AHCT) Small Business today announced it will waive the minimum number of employees typically required to enroll in a small group health insurance plan now through Dec. 15.
Small businesses can enroll in a group health insurance plan at any time of year. However, they usually need a certain percentage of employees to participate in the plan. During this period, any small business with 50 or fewer employees in Connecticut can enroll in a group health insurance plan regardless of how many employees participate.
Executive Board votes to cut copays to $5, no deductibles
Washington, DC–The DC Health Benefit Exchange Authority (DCHBX) Executive Board unanimously voted to adopt recommendations based on the work of the DCHBX Standard Plans Working Group to help address health disparities in pediatric mental health treatment. Starting in Plan Year 2024, children covered by a standard plan on DC Health Link will only have a $5 copay, with no deductibles, for outpatient mental health visits, including specialist visits, and no limit on the number of visits. Additionally, this vote reduces prescription copays for child mental health care to $5, with no deductibles.
The action taken by DCHBX means that parents who had copays as high as $45 for their children's mental health visits will only pay $5 starting in 2024. Additionally, parents who were paying as high as $25 in copays for even the lowest-cost generic prescriptions for their children, will have only a $5 copay starting in 2024.
New Yorkers Enrolling by December 15 will be Covered on January 1
ALBANY, N.Y. (November 23, 2022) – NY State of Health, the state's official health plan Marketplace, is working with food pantries for the sixth consecutive holiday season to help consumers access high-quality, affordable health insurance for the upcoming year. Certified enrollment specialists will be available at food pantries across the state during November and December to provide consumers with enrollment assistance. Consumers must enroll by December 15, 2022, for health coverage starting January 1, 2023.
I don't just mean that they aren't eligible for federal financial subsidies--that's a prohibition which I can at least understand, even if I don't agree with it. I mean that they aren't allowed to enroll in ACA exchange-based QHPs even at full price, as noted in Section 1312(f)(3):
(3) Access limited to lawful residents.--If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.
Usually during the annual ACA Open Enrollment Period, the Centers for Medicare & Medicaid Services issue weekly "snapshot" reports of how enrollment is going via the federal ACA exchange (HealthCare.Gov).
Biden-Harris Administration Announces Nearly 40% Increase in New Sign-Ups on HealthCare.Gov
Today, during his remarks on lowering costs for American families, President Biden announced that the number of new enrollees who have signed up for high-quality, affordable health insurance on HealthCare.Gov is up almost 40% compared to the same time last year.
...HHS will release the first formal report on Open Enrollment data next Tuesday, November 22.
The Centers for Medicare & Medicaid Services (CMS) announced today that the first improper payment rate for the Federally-facilitated Exchange (FFE) program was less than 1% for Benefit Year 2020, thanks in large part to the agency’s implementation of effective automated processes for the program’s eligibility determinations and payments. This finding highlights CMS’ commitment to being responsible stewards of public funds, and to ensuring the sustainability of its programs for future generations.
Improper payments are payments that do not meet CMS program requirements. These can be overpayments or underpayments, or payments where insufficient information was provided to determine whether a payment was proper. Most improper payments involve situations where a state or provider missed an administrative step. The vast majority of improper payments are not fraud, and improper payment estimates are not fraud rate estimates.