Grandfathered Policies: These are non-ACA compliant policies which people were already enrolled in prior to March 2010, when the ACA was signed into law. Anyone enrolled in one of these can keep renewing them until the day they die if they wish (as long as they keep paying the premiums), or until the carrier chooses to (voluntarily) discontinue the policy.
Transitional (or "Grandmothered") Policies: These are non-ACA compliant policies which people enrolled in between March 2010 and October 2013. This category was created by President Obama and the HHS Dept. in November 2013 during the ugly "If You Like Your Plan You Can Keep It!" backlash. Basically, the ACA originally would have required that these policies be terminated as of 12/31/13. However, after a bunch of people received cancellation notices from their carrier, there was a massive backlash, leading Obama to announce an extension program.
As I (and many others) have been noting for many months now, the official end of the federal Public Health Emergency (PHE), whenever it happens, will presumably bring with it reason to celebrate...but will also likely create a new disaster at the same time:
What goes up usually goes back down eventually, and that's likely to be the case with Medicaid enrollment as soon as the public health crisis formally ends...whenever that may be.
Well, yesterday Ryan Levi and Dan Gorenstein of of the Tradeoffs healthcare policy podcast posted a new episode which attempts to dig into just when that might be, how many people could be kicked off of the program once that time comes and how to mitigate the fallout (I should note that they actually reference my own estimate in the program notes):
The Biden-Harris Administration is announcing today that more than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have access to Food and Drug Administration (FDA) approved, authorized, or cleared over-the-counter COVID-19 tests at no cost. People with Medicare can get up to eight tests per calendar month from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency.
The Biden-Harris Administration is announcing that, beginning today, as many as 720,000 pregnant and postpartum people across the United States could be guaranteed Medicaid and Children’s Health Insurance Program (CHIP) coverage for a full 12 months after pregnancy thanks to the American Rescue Plan (ARP). Medicaid covers 42 percent of all births in the nation, and this new option for states to extend Medicaid and CHIP coverage marks the Biden-Harris Administration’s latest effort to address the nation’s crisis in pregnancy-related deaths and maternal morbidity by opening the door to postpartum care for hundreds of thousands of people.
Today, the Centers for Medicare & Medicaid Services (CMS) released the 2021-2030 National Health Expenditure (NHE) report, prepared by the CMS Office of the Actuary, that presents health spending and enrollment projections for the coming decade. The report notably shows that despite the increased demand for patient care in 2021, the growth in national health spending is estimated to have slowed to 4.2%, from 9.7% in 2020, as supplemental funding for public health activity and other federal programs, specifically those associated with the COVID-19 pandemic, declined significantly.
As noted yesterday, it's the12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I've broken into multiple entries.
In this entry, I'm looking at the metal level breakout of the plans selected by ACA exchange enrollees. As a reminder, ACA policies fall into four categories: Bronze, Silver, Gold, Platinum, plus a special fifth "Catastrophic" category.
The 4 metal level categories represent policies which cover roughly 60%, 70%, 80% or 90% of the average enrollee's in-network healthcare expenses over the cours of the year. This doesn't mean that a Silver (70%) plan, for instance, will cover 70% of your specific medical expenses; it's an aggregate average.
As noted yesterday, it's the12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I've broken into multiple entries.
In this entry, I'm looking at enrollment from the angle of various demographic factors, including Age, Gender, Race/Ethnicity and Rural status.
There's a ton of data in the big table below (click the image for a high-res version), so I've also included percentage summaries at the bottom:
As noted yesterday, it's the12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I've broken into several entries.
This entry covers two types of ACA policies which don't get nearly enough attention. The first is the ACA's Basic Health Plan (BHP) program, which is currently only operating in two states: Minnesota and New York.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
As noted this morning, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
In this entry, I'm looking at the financial aid breakout for Qualified Health Plan (QHP) enrollees. ACA financial assistance falls into two categories: Advance Premium Tax Credits (APTC) and Cost Sharing Reductions (CSR). APTC reduces enrollees monthly premium costs; CSR reduces their deductibles, co-pays and other out-of-pocket expenses.
Thanks to the American Rescue Plan, APTC financial assistance is far more generous for most enrollees in 2022 than in prior years, as you can see by looking at the 3rd & 4th columns (avg. premium and avg. premium after APTC):
As I just noted, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
In this entry, I'm looking at the weekly Qualified Health Plan (QHP) selections by state and nationally. This first table shows the cumulative numbers for every week of OEP 2022. The final column includes additional enrollments after 1/15/22 in the states which had later deadlines, as well as some oddball clerical data corrections:
