The projected population consists of expected retention of existing policies and new sales. The sources of new entrants include the previously uninsured population, grandfathered and transitional policies voluntarily migrating to ACA-compliant plans, and previously insured populations from other markets or carriers. The morbidity adjustment reflects projected Anthem and market changes in morbidity, including changes driven by economic conditions and from the expiration of the enhanced ACA premium tax credits available under The American Rescue Plan Act (ARP) as of December 31, 2022. Membership projections reflect contraction similar to pre-ARP population in 2021. Exhibit E shows the morbidity factor.
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.
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.
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.
Every year since the very first ACA Open Enrollment Period (OEP) in 2013-2014, at least a few of the state-based exchanges (and sometimes the federal exchange) have made last-minute deadline extensions. It's actually turned into a bit of a running joke with me.
The 2022 OEP has been no exception: Already during the 2022 OEP we've seen Idaho, New Mexico, Connecticut and Kentucky bump out their December deadline (for January coverage).
Sure enough, a couple of days ago the Kentucky exchange, kynect, posted the following:
Due to the December 11th natural disaster throughout the Commonwealth and reports of technical issues during Open Enrollment, a Special Enrollment Period (SEP) for kynect health coverage is now available to impacted residents.
A Special Enrollment Period allows enrollment dates to be extended or added. Prior to this Special Enrollment Period announcement, the deadline to enroll for a Qualified Health Plan with coverage starting January 1st, 2022 was December 15th, 2021.
The Special Enrollment Period will be granted for citizens with the following circumstances:
Any person who attests that their ability to enroll in a Qualified Health Plan was affected by severe weather in December 2021.
Any person who attests that they encountered system errors, including long wait times with the call center, that prevented them from enrolling in a Qualified Health Plan prior to December 15th, 2021.
Well, this was inevitable: I got so far behind on my annual ACA rate filing project that the final/approved rates have started to be released before I even get around to some of the preliminary/requested rate filings.
Overall, individual rates are dropping by around 3.8% on average (the carriers had requested a 2.7% increase), while small group market plans are increasing by 10.4% on average (very close to the 10.7% average request).
Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.
Way back in October 2013, when the first ACA Open Enrollment Period (OEP) launched, there were infamously massive technical problems with the federal exchange (HealthCare.Gov) as well as some of the state-based exchanges (such as those in Massachusetts, Maryland, Oregon, Nevada and Hawaii).
Over the next few years, some of those exchange websites were replaced with brand-new ones (MA & MD). Some of the states scrapped theirs altogether and moved onto the mothership at HC.gov (OR, HI & NV, although Nevada has since split back off onto their own exchange again, and seems to have gotten it right this time).