Health insurance brokers can play a unique role in helping all forms of marketplaces to reach out to uninsured households and assist residents with new enrollments, as well as coverage renewals. Recently, several marketplaces implemented pilot programs intended to leverage the resources of agencies that are particularly interested in building their direct enrollment business under the Affordable Care Act (ACA). The success of these initiatives is demonstrated by these marketplaces’ plans to expand their efforts for the upcoming open enrollment period.
The State Network hosted its Annual Meeting in New Orleans, LA on April 29 – May 1, 2015, bringing together state officials and technical experts to provide technical assistance and discuss lessons learned on continuing implementation of the coverage provisions of the Affordable Care Act (ACA). The Annual Meeting included peer-to-peer sharing between stakeholders from exchanges, Medicaid agencies, departments of insurance, and governors’ offices throughout the topic specific breakouts on key ACA implementation issues.
Waivers available under Section 1332 of the Affordable Care Act offer potentially great flexibility to states in achieving the goals of the ACA through very different means than originally envisioned. They take effect as early as January 1, 2017, and require legislative authorization, substantial public engagement, and negotiation with the federal government. Moreover, without grant dollars to fund the development process, unlike for the establishment of state-based exchanges, 1332 waiver proposals will present additional time and resource challenges for states.
States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by authorizing states to rethink the law’s coverage designs. Under State Innovation Waivers, states can modify the rules regarding covered benefits, subsidies, insurance marketplaces, and individual and employer mandates.
The second open enrollment period (OEP) under the Affordable Care Act ended on February 15, with more than 11.4 million people enrolled in coverage through the Federal and state Marketplaces. Attention now turns to the 2014 tax filing season. Many tax filers who were uninsured for all or part of 2014 are learning for the first time that they must pay a penalty, and have missed the opportunity to enroll in 2015 coverage. These gaps in consumer awareness, combined with the timing of this year’s OEP, have led to several Marketplaces allowing certain uninsured consumers additional time to enroll in order to avoid paying a penalty next year.
As of January 27, 2015, two states have received approval from the Centers for Medicare and Medicaid Services to expand Medicaid through private market-based coverage. These premium assistance programs have paved the way for the non-expansion states who continue to discuss how they might expand their Medicaid programs. These new models offer viable alternatives for covering previously uninsured populations while addressing those states’ concerns about some of the budgetary, political, and market challenges associated with traditional Medicaid expansion.
This webinar addressed which ACA provisions are waivable, including the individual mandate, the employer mandate, essential health benefits, and exchange standards; how the coverage and fiscal guardrails might be applied by HHS and Treasury, which have yet to provide much guidance beyond a regulation that defines the waiver application process; and how 1332 waivers might be combined with Medicaid 1115 waivers to better achieve state goals across programs.
During the initial open enrollment period under the Affordable Care Act, the federal government and states operating state-based exchanges conducted various types of reporting on key indicators of interest to policymakers and the public.
As those interested in conducting surveys to measure the public’s participation and experience in health insurance marketplaces under the Affordable Care Act (ACA) continue to investigate the most effective ways of doing so, access to questions utilized in previously conducted surveys will be very useful.
Between October 2013 and April 2014 access to health insurance in Oregon expanded in two ways, leading to unprecedented changes in insurance coverage in the state. First, the state extended Medicaid coverage to many previously ineligible low-income adults. Second, the state created a health insurance marketplace that provided a resource where individuals could learn what they are eligible for, explore financial assistance options available to them, and compare commercial plans.