New Jersey Department of Banking and Insurance Establishes Extended Special Enrollment Period at Get Covered New Jersey for Individuals Losing NJ FamilyCare Coverage
TRENTON – New Jersey Department of Banking and Insurance Commissioner Marlene Caride today announced the creation of an extended 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.
Per federal law, the Department of Human Services is restarting eligibility reviews for NJ FamilyCare as of April 1, which will result in some individuals who are no longer eligible being disenrolled from the program. For those who no longer qualify for NJ FamilyCare because their income is too high, they may be eligible to obtain health coverage through Get Covered New Jersey and may be able to get help paying for premiums.
Oscar Health will exit the California individual ACA insurance market for plan year 2024 as part of a push to make its insurance business profitable.
On a May 9 call with investors, transcribed by Seeking Alpha, Oscar Health CEO Mark Bertolini said the company is exiting underperforming markets to improve its profitability.
"The company has been disciplined in managing its portfolio and improving the sustainability of our margins over time," Mr. Bertolini said.
Oscar Health plans to reenter the California market in the future, Mr. Bertolini said.
Interim CFO Sid Sankaran said the California market represents less than 5 percent of Oscar Health's membership, with around 35,000 members in the state.
This suggests that Oscar has roughly 700,000 ACA exchange enrollees nationally, FWIW.
Shapiro Administration Working With Community Organizations To Help All Pennsylvanians Amid Major Federal Changes To Medicaid Renewals
Reading, PA - Pennsylvania Department of Human Services (DHS) Acting Secretary Dr. Val Arkoosh joined representatives from the Berks Community Health Center and Pennie® today to highlight how the Shapiro Administration, Pennie, and community organizations are collaborating to support Pennsylvanians through federal changes to Medicaid and CHIP renewal requirements so they can protect their health and stay covered.
CMS will beef up its outreach strategy and scale up a pilot program that connected navigators to specific consumers who are not eligible for Medicaid but could enroll in an Affordable Care Act plan through healthcare.gov to help ensure people who lose benefits during the ‘unwinding’ maintain their coverage, according to a slide-deck from a recent webinar.
As part of the effort, healthcare.gov will send those consumers additional reminder letters about enrolling in ACA coverage, with the first batch slated to go out in mid-May, and the assisters will contact those customers shortly afterward.
HHS has estimated that about 2.7 million of the 15 million or so Medicaid beneficiaries expected to lose coverage during the redetermination may be eligible for subsidized coverage through the marketplaces.
...Well, just one day after the Bright Healthcare bombshell news broke, Texas-based health insurance broker Jenny Chumbley Hogue sounded the alarm on another large carrier bailing on Texas next year:
Apple Health (Medicaid) renewal letters have begun mailing
The Washington State Health Care Authority (HCA), Washington Health Benefit Exchange (Exchange), and the Department of Social and Health Services (DSHS) have begun mailing letters to Washington Apple Health (Medicaid) clients reminding them to update their contact information and renew coverage to see if they still qualify.
For the first time in over three years, people on Apple Health could lose coverage if their family income has gone up. Federal requirements during the COVID-19 public health emergency (PHE) led to income checks being suspended to keep clients enrolled in Apple Health during the pandemic. However, last December’s federal omnibus spending bill directed states to resume evaluating eligibility of Medicaid enrollees on April 1 to wind down COVID-19 pandemic emergency measures.
This time, however, I have a heads up...it isn't official yet, but it looks like Missouri and Alaska are about to become the 33rd & 34th states to do so. Via David Lieb of the Associated Press:
JEFFERSON CITY, Mo. (AP) — Lower-income new mothers could gain a full year of Medicaid health-care coverage in Missouri under legislation given final approval Friday as part of a national push to improve maternal health.
Back in January, as the 2023 Open Enrollment Period wound down, I posted a colorful graph which tracked ACA Qualified Health Plan (QHP) enrollment over ten years of Open Enrollment Periods.
Today I'm doing the same thing for ACA Medicaid Expansion. The data comes from the Centers for Medicare & Medicaid Services monthly Medicaid Budget & Expenditure System reports.
Also keep in mind that if the remaining 10 states had expanded Medicaid under the ACA by now, the grand total would have been up to 3.5 million higher (around 27.9 million nationally).
Aside from various holdout states jumping in as the years have passed, the most notable milestone was the month that the COVID pandemic hit the U.S. in full force, shutting businesses down across the country in March 2020.
No further analysis or comment here; I just think this is a pretty cool graphic...and keep in mind that most of the ~23.5 million people represented here (again, likely over 24M today) would have been utterly screwed without the Affordable Care Act being in place when the pandemic hit. Click the image for a higher-resolution version; the states are listed on the right-hand side, though they might be difficult to make out:
Newly proposed standards and requirements would better ensure access to care, accountability, and transparency for Medicaid or CHIP services, including home and community-based services.
The Centers for Medicare & Medicaid Services (CMS) today unveiled two notices of proposed rulemaking (NPRMs), Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM),that together would further strengthen access to and quality of care across Medicaid and the Children’s Health Insurance Program (CHIP), the nation’s largest health coverage programs. These rules build on Medicaid’s already strong foundation as an essential program for millions of families and individuals, especially children, pregnant people, older adults, and people with disabilities.