On January 27, 2023, the Centers for Medicare & Medicaid Services released a State Health Official (SHO) letter, “Medicaid Continuous Enrollment Condition Changes, Conditions for Receiving the FFCRA Temporary FMAP Increase, Reporting Requirements, and Enforcement Provisions in the Consolidated Appropriations Act, 2023.” The SHO letter is the second in a series of guidance related to section 5131 of the Consolidated Appropriations Act, 2023 (CAA), which established a fixed end date for the Medicaid continuous coverage requirement, a gradual phase-down for the enhanced federal match, and new guardrails for mitigating coverage loss for individuals who continue to be eligible. This expert perspective reviews the additional detail and operational expectations of states during the unwinding of Medicaid continuous coverage as laid out in the SHO letter.
How State-based Marketplaces Can Better Meet the Needs of the Unbanked and Underbanked
Wakely Consulting Group – Kathie Mazza and Diana Galatian
The Affordable Care Act (ACA) will make health insurance more accessible to millions of Americans. To effectuate coverage, flexible payment methods will help ensure insurance accessibility is not hampered by the absence of a traditional bank account, an all too common scenario for many uninsured households. It is estimated that as many as one in four uninsured individuals eligible for Advance Premium Tax Credits (APTCs) do not have a checking account, presenting a basic signup challenge as timely payment must be made to both initiate and maintain coverage on a monthly basis.
This brief, prepared by Wakely Consulting Group, offers some insights on this sizable population and explores various solutions that Marketplaces and issuers might consider in early 2014 to address the payment challenges presented by unbanked and underbanked individuals. These solutions could also be considered for premium payment streamlining in the 2015 open enrollment season beginning on November 15, 2014.