The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources.
Consumer Impact Analysis Presentation
Wakely Consulting Group – Julia Lerche
As the 2015 open enrollment period approaches, one of the most significant challenges faced by marketplaces stems from the complicated nature of premium subsidy calculations, which may lead to potentially large swings in consumers’ after-subsidy premiums and could have tax liability implications. While marketplaces are attempting to make the renewal process as smooth as possible for consumers by facilitating auto-renewals into QHPs and, in the case of the FFM, rolling over 2014 APTCs into 2015, this approach could potentially be detrimental to some consumers, depending on factors such as income changes, premium variation, or a change in the benchmark plan. This slide deck was presented by Julia Lerche of Wakely Consulting Group on a Medicaid affinity group conference call facilitated by the State Network on August 5, 2014, along with a white paper describing the issue, and provides several scenarios in order to explain the potential impact of rate changes on consumers. This information can be utilized to inform modifications to carrier notices and communication planning (messaging, targeted outreach, education) for consumers, navigators/assistors and the media.