On November 15, 2023, the Centers for Medicare & Medicaid Services released its proposed 2025 Notice of Benefit and Payment Parameters, the annual regulation which governs core provisions of the Affordable Care Act. This expert perspective focuses on aspects of the proposed rule likely to be of interest to state officials, including requirements for State-Based Marketplaces to align with the standards of the Federally Facilitated Marketplace, proposals for states to update essential health benefits, and initiatives to ease the eligibility and enrollment process for consumers.
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.