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.
Tax Season Special Enrollment Periods
Manatt Health Solutions
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.
The Federal government and nine State-based Marketplaces – in California, Connecticut, Kentucky, Maryland, Minnesota, New York, Rhode Island, Washington and Vermont – have already announced plans to establish a Special Enrollment Period (SEP) to permit individuals subject to the tax penalty to enroll in 2015 coverage outside of this year’s OEP, thereby minimizing the penalty they could incur when filing their 2015 taxes. This document, prepared by Manatt Health Solutions, provides a summary of the tax season SEPs being utilized by each of these Marketplaces.