The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)
Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented for the following year (actually, it's the year after the following year, since the final rule is generally released in mid-December).
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.
via the Health & Human Services Dept. (via email, no link yet):
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. U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra released the following statement on today’s Open Enrollment announcement:
“We are off to a strong start - and we will not rest until we can connect everyone possible to health care coverage this enrollment season. The Biden-Harris Administration has taken historic action to expand access to health care, and ensure everyone can have the peace of mind that comes with being insured. With four out of five people eligible for coverage at $10 or less, do not miss your opportunity to sign up for high-quality, affordable health care. We urge everyone to visit HealthCare.gov and find the coverage that meets your needs.”
Biden-Harris Administration Launches Window-Shopping for Affordable and Accessible Health Care Marketplace
Ahead of 10th Open Enrollment period, Biden-Harris Administration announces high levels of health plan affordability, quality, and choice, and a record number of outreach efforts to connect Americans to coverage
The Biden-Harris Administration has made expanding access to health insurance and lowering health care costs for America’s families a top priority, and, starting today, consumers can preview their health care coverage options and see the savings available to them in the most competitive Marketplace in history. Consumers can now visit HealthCare.gov to view detailed information about 2023 health insurance plans and prices offered in their area in advance of the 2023 Marketplace Open Enrollment period that begins November 1, 2022.
Streamlining Eligibility & Enrollment Notice of Propose Rulemaking (NPRM)
The Centers for Medicare & Medicaid Services’ (CMS’) new proposed rule would make it easier for millions of eligible people to enroll in and retain their Medicaid coverage. The rule would reduce red tape and simplify applications, verifications, enrollment, and renewals for health care coverage through Medicaid and the Children’s Health Insurance Program (CHIP). The proposed rule responds to President Biden’s January 2021 and April 2022 Executive Orders to strengthen Medicaid and access to affordable, quality health coverage.
Historic investment of nearly $100 million builds on the Administration’s quadrupling of Navigators last year to help connect people to coverage
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is investing $98.9 million in grant funding to 59 returning Navigator organizations for the 2023 Open Enrollment Period to help consumers navigate enrollment through the Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP) and make health coverage more equitable and accessible to everyone.
Way back in the summer of 2020, then-Presidential candidate Joe Biden rolled out his official healthcare policy proposal. Part of the plan included the following:
Expanding coverage to low-income Americans. Access to affordable health insurance shouldn’t depend on your state’s politics. But today, state politics is getting in the way of coverage for millions of low-income Americans. Governors and state legislatures in 14 states have refused to take up the Affordable Care Act’s expansion of Medicaid eligibility, denying access to Medicaid for an estimated 4.9 million adults.
Biden’s plan will ensure these individuals get covered by offering premium-free access to the public option for those 4.9 million individuals who would be eligible for Medicaid but for their state’s inaction, and making sure their public option covers the full scope of Medicaid benefits. States that have already expanded Medicaid will have the choice of moving the expansion population to the premium-free public option as long as the states continue to pay their current share of the cost of covering those individuals.
January 10th was the last time that the Centers for Medicare & Medicaid Services (CMS) issued a detailed 2022 Open Enrollment Snapshot report which broke out 2022 ACA enrollment across every state.
As of 1/10/22, it had already reached an all-time record of nearly 14.9 million people (13.8 million via Qualified Health Plans, or QHPs, and another million or so who have enrolled in Basic Health Plans (BHPs) in Minnesota and New York specifically).
A few days later, CMS issued another update just ahead of the official January 15th OEP deadline (in most states) which updated the top line QHP tally to over 14.2 million. They broke this out by "over 10 million" enrollees on the federal exchange (HealthCare.Gov), plus another 4.2 million or more in the 18 states which operate their own ACA exchanges.
Tack on the 1.0M BHPs and that's at least 15.2 million nationally.
The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)
Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented.
