Get Covered

I actually posted this a couple of weeks ago, but am reposting it as a standalone entry for clarity. Via Connect for Health Colorado:

American Rescue Plan Makes Health Insurance More Affordable for More Coloradans Shopping through the Exchange

DENVER — Yesterday afternoon, President Biden signed the American Rescue Plan Act of 2021(American Rescue Plan) into law. Connect for Heath Colorado® Chief Executive Officer, Kevin Patterson, released the following statement in response to provisions which strengthen the Affordable Care Act and increase affordability:

“We are thrilled and getting ready to implement the health coverage provisions outlined in this law. This expansion of financial help will provide greater access to savings on the health plans we offer. This means more affordable health insurance for many more Coloradans.”

Covered California

Yesterday's press release from Covered California included a TON of important information about how they're handling the massive subsidy upgrade/expansion under the American Rescue Plan, but it left out one other critically important item which was caught by Inside Health Policy reporter Amy Lotven:

Insurers participating in Covered California have agreed to help move their off-exchange individual plan enrollees into the marketplace so they can benefit from the new Affordable Care Act subsidies available under the American Rescue Plan (ARP) and will not reset the deductibles, Covered California Executive Director Peter Lee said Thursday (March 18) in a webinar with reporters and key stakeholders.

...Off-exchange enrollees could get an average $500 premium drop, which means they could save as much as $12,000 under the two-year provision, Lee says. About 430,000 Californians and 1.5 million people nationally who are enrolled off-exchange plans are newly eligible for help, the exchange estimates.

The Maryland Health Benefit Exchange has issued a new press release which on the surface doesn't seem terribly unusual--it touts an impressive number of Maryland residents having gained healthcare coverage since they first launched their COVID-19 Special Enrollment Period (SEP).

What's unusual about this PR is that it's listing the cumulative number of people who've gained coverage since they launched their first COVID SEP a year ago:

MORE THAN 140,000 COVERED SINCE MARYLAND HEALTH CONNECTION LAUNCHED COVID-19 SPECIAL ENROLLMENT ONE YEAR AGO

  • 236,000 WHO STILL LACK COVERAGE COULD GET IT FOR FREE OR WITH SIGNIFICANT FINANCIAL HELP

(MARCH 17, 2021) BALTIMORE — Yesterday marked one year since the Maryland Health Benefit Exchange launched a Coronavirus Emergency Special Enrollment Period in response to the public health emergency declared by Gov. Larry Hogan.

HealthCare.Gov Logo

The Centers for Medicare & Medicaid Services (CMS) has just sent out guidance about how the newly-expanded & enhanced subsidies will work for those currently enrolled in (or newly enrolling in) healthcare policies via the federal ACA exchange, HealthCare.Gov.

It's important to note that the following guidelines only apply to residents of the 36 states hosted via HC.gov. The timing, policy and procedures for the new/expanded subsidies for residents of the 15 states which operate their own ACA exchanges may vary.

With that in mind, here's how CMS says things will work via HealthCare.Gov.

The first section is mostly just an overview of the ARP and a refresher on how ACA subsidies are calculated...

American Rescue Plan and the Marketplace

The New Law

President Biden

Yesterday I wrote a long, wonky post about an unusual case involving a legally-present (green card), unemployed Nigerian immigrant.

The short version is that because his income is so low, he normally wouldn't be eligible for ACA subsidies...except because he lives in Maryland, a Medicaid expansion state, he would normally be eligible for Medicaid...except that because he's an immigrant who's been in the United States for less than five years, he isn't eligible for Medicaid...except that, thanks to an obscure provision baked into the Affordable Care Act, he is eligible for ACA subsidies after all!

‘(B) SPECIAL RULE FOR CERTAIN INDIVIDUALS LAWFULLY PRESENT IN THE UNITED STATES.—If—

‘‘(i) a taxpayer has a household income which is not greater than 100 percent of an amount equal to the poverty line for a family of the size involved, and

via MNsure:

Over 2,200 Minnesotans have signed up for health coverage through MNsure's special enrollment period so far

  • Special enrollment runs through May 17

ST. PAUL, Minn.—2,285 Minnesotans have signed up for private health insurance coverage since the start of MNsure's special enrollment period on February 16. This three-month special enrollment period, which runs through Monday, May 17, is available to any Minnesotan who is uninsured or who is not currently enrolled in a qualified health plan through MNsure. 

Minnesotans who want coverage to start on April 1 must enroll by 11:59 p.m. on Wednesday, March 31. Plans selected during the month of April will have an effective date of May 1, and plans selected by the May 17 deadline will have an effective date of June 1.

In early February, I posted a deep dive into HR 369, the Health Care Affordability Act, and how it would reduce net ACA premiums by permanently eliminating the income "subsidy eligibility cliff" (#KillTheCliff) and making the underlying subsidy formula more generous for all enrollees (#UpTheSubs).

I'm re-posting an updated, modified version of this analysis for two reasons:

  • First, because HR 1319, the American Rescue Plan, is about to actually pass and be signed into law, with a slightly different formula from HR 369 embedded within it (if only for two years).
  • Second, because my earlier analysis also threw in two other subsidy enhancement tables which confused the issue (California's state-based subsidies, and the predecessor to HR 369, both of which are/were less generous)

In this version I'm using the actual Advanced Premium Tax Credit (APTC) table under the American Rescue Plan, and I'm cutting out all references to the other two tables to avoid confusion.

Get Covered 2021!

 

Nearly every state (+DC) has re-opened enrollment on their respective ACA exchanges in response to both the ongoing COVID-19 pandemic and the American Rescue Plan (ARP), which substantially expands and enhances premium subsidies to millions of people!

If you've never enrolled in an ACA healthcare policy before, or if you looked into it years ago but weren't impressed, please give it another shot now. Thanks to the ARP (and some other reasons), it's a whole different ballgame this spring & summer.

Here's 10 important things to understand when you #GetCovered:

In previous years, New York State of Health has typically been pretty good about providing timely Open Enrollment reports, so I was mildly irritated by their total radio silence on the issue throughout the 2021 Open Enrollment Period (OEP).

My suspicion was that, like many other states which have expanded Medicaid, New York likely saw a significant drop in on-exchange Qualified Health Plan (QHP) enrollment this season due to the massive job & income loss caused by the COVID-19 pandemic last year, as people "downshifted" from QHPs over to Medicaid. In addition, New York is one of only two states which has the ACA's Basic Health Program (BHP) in place; BHP (called the Essential Plan in NY), is sandwiched in between QHPs and Medicaid, for residents earning between 138 - 200% FPL.

Late last night, NYSoH finally got around to releasing their 2021 OEP numbers. Sure enough, my suspicions were correct:

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