California

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via Covered California:

  • The weighted average rate for Covered California’s dental coverage in 2023 will decrease by 1.7 percent, marking the second consecutive year that premiums have gone down for consumers.
  • More than 294,000 Covered California enrollees have supplemented their health insurance by purchasing optional adult dental coverage, an increase of 28 percent over the previous year.
  • Eligible consumers can add dental coverage to their plan when they sign up for health insurance during Covered California’s current special-enrollment period, or during open enrollment, which will start this fall.

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Sherman, set the Wayback Machine to 2015:

MICHIGAN: Another One (Mostly) Bites The Dust; 12th CO-OP Drops Off Exchange, May Go Belly-Up

It appears that East Lansing-based Consumers Mutual Insurance of Michigan could wind down operations this year as it is not participating in the state health insurance exchange for 2016.

But officials of Consumers Mutual today are discussing several options that could determine its future status with the state Department of Insurance and Financial Services, said David Eich, marketing and public relations officer with Consumers Mutual.

Consumers Mutual CEO Dennis Litos said: "We are reviewing our situation (financial condition) with DIFS and should conclude on a future direction this week.”

While Eich said he could not disclose the options, he said one is “winding down” the company, which has 28,000 members, including about 6,000 on the exchange.

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via Covered California:

  • The Inflation Reduction Act extends the increased financial help initially provided by the American Rescue Plan through the end of 2025.
  • The increased subsidies expanded health care coverage, leading to record enrollment in California and across the nation, and lowered insurance costs for people who signed up through an Affordable Care Act marketplace.
  • The landmark legislation will continue to make coverage more affordable at a time when many individuals and families are facing increased challenges in the current economic environment.

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via Jefferson Public Radio:

For years, consumer advocates and some legislators have been battling to rein in escalating health care costs. Now the state has created a new agency to limit future growth in health care costs — and it will have the power to enforce that mandate.

...In California and nationally, the most cited reason for people being uninsured or underinsured is cost. Even those with robust insurance sometimes struggle to afford hospital bills and their medication. Some take extreme measures, such as rationing their dosages or traveling south of the border for more affordable care. Half of Californians skipped or postponed medical care in 2021 because of costs, according to a California Health Care Foundation report.

...The recently approved state budget includes $30 million to create the office, whose key responsibility will be to set and enforce limits on cost growth for the industry, including hospitals, health insurers and physician groups.

via Covered California:

Covered California Announces 2023 Plan Rates: Lower Than National Average Amid Uncertain Future of American Rescue Plan Benefits

  • California’s individual market will see a preliminary rate increase of 6 percent in 2023, due in part to the return of normal medical trends that existed prior to the COVID-19 pandemic and the uncertain future of the American Rescue Plan.
  • Despite the uncertainty, the rate change is below the national average thanks to Covered California’s 1.7 million enrollees and the state’s healthy consumer pool, which remains among the best in the nation.
  • Covered California also announced that a 13th carrier would join the marketplace, and an existing carrier would expand to become the second one to offer statewide coverage.
  • All Californians will have two or more choice of carriers, 93 percent will be able to choose from three or more, and 81 percent will have four or more choices.
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via Covered California:

  • With Congress scheduled to recess at the end of July, and health insurance marketplaces finalizing their rates for the 2023 coverage year, timely action to decide on the future of the American Rescue Plan’s benefits is critical.
  • The law, which provides increased and expanded federal financial assistance and helped millions of Americans sign up for health insurance through the Affordable Care Act, is set to expire at the end of this year.
  • An estimated 220,000 Californians could become uninsured, with premiums doubling for 1 million low-income consumers.
  • Middle-income consumers would lose all federal financial help, and their premiums would increase by an average of $272 per month if Congress does not act to extend the law.

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via the Centers for Medicare & Medicaid Services:

  •  States will have an additional year to use American Rescue Plan funds to strengthen the home care workforce and expand access to services

 Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is notifying states that they now have an additional year — through March 31, 2025 — to use funding made available by the American Rescue Plan (ARP) to enhance, expand, and strengthen home- and community-based services (HCBS) for people with Medicaid who need long-term services and supports. This policy update marks the latest action by the Biden-Harris Administration to strengthen the health care workforce, help people receive care in the setting of their choice, and reduce unnecessary reliance on institutional care.

CMS Logo

via the Centers for Medicare & Medicaid Services:

Today, the U.S. Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) approved California, Florida, Kentucky, and Oregon actions to expand Medicaid and Children’s Health Insurance Program (CHIP) coverage to 12 months postpartum for a total of an additional 126,000 families across their states, annually—supporting 57,000; 52,000; 10,000; and 7,000 parents, respectively.

I originally wrote about this issue back in 2017.

As explained in this Health Affairs article by Katie Keith and Timothy Jost:

The final Senate compromise, which was adopted as part of the ACA, largely reinforces the Hyde Amendment, which has been included in annual Congressional appropriations legislation since the 1970s and prohibits the use of federal funds for abortion services unless the pregnancy is a result of rape or incest, or would endanger the woman’s life (non-Hyde abortions).

The ACA allows the coverage of abortion services through the marketplaces but includes a number of restrictions and requirements that insurers must follow before covering non-Hyde abortions. Many, though not all, of these restrictions are outlined in Section 1303 of the ACA, which includes specific rules related to the coverage of abortion services by Qualified Health Plans (QHPs) and has been the subject of previous litigation. In particular, Section 1303:

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via Covered California:

  • On the 12th anniversary of the signing of the Affordable Care Act, Covered California reminds consumers that eligible Californians can sign up through special enrollment if they have a qualifying life event.
  • Californians who have recently lost their health insurance, got married, had a baby, have been affected by the COVID-19 pandemic, or paid a penalty for not having coverage are among those eligible for special enrollment.
  • Coverage is more affordable than ever thanks to the increased financial help available through the American Rescue Plan, and consumers can benefit from lower premiums throughout 2022.

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