Last year I briefly attempted to keep track off the dozens of various state-based "ACA 2.0" protection/improvement bills flying around various state legislatures. I eventually abandoned this project since it became too difficult to keep up with, but I'm still reporting case studies as they come to my attention...and Louise Norris has just alerted me to some pretty big changes going into effect in Colorado this April.
First up: Short-term plans are being heavily neutered. In addition to being limited to 6 months per year (which is still longer than the Obama Administration's 3-month cut-off)...
Short-term plans will have to charge older adults no more than three times as much as they charge younger adults. Short-term plans are generally not available after a person is 64, but a quick check of plans currently available in Colorado show that some insurers are charging a 64-year-old up to seven times as much as a 21-year-old. That will have to stop as of April.
Last April, Maryland was one of several states which took action to counteract portions of the Trump Administration's attempts to sabotage the Affordable Care Act. In particular, Maryland (which has a Democratically-controlled state legislature but a moderate (by today's standards) Republican Governor) passed and signed into two important bills:
Believe it or not, the 2019 ACA Open Enrollment Period officially ended last night...but only in 43 states. In the remaining seven (+DC), Open Enrollment hasn't ended yet. 2019 ACA Open Enrollment is still ongoing for over 23 million people!
In the District of Columbia (population 694,000) and New York (population 19.85 million), open enrollment runs through Jan. 31st for coverage starting March 1st.
This is a very quick post as I’m in the middle of the Families USA healthcare conference, but it’s a significant one: The Massachusetts Health Connector, which wrapped up their 2019 ACA Open Enrollment Period last night, just reported the following:
Here is an update as of today, with Open Enrollment having ended last night.
Note: These numbers below should be considered something of a high-water mark. There will be fluctuations as plan-selecteds lose their window, members terminate, but also some applicants end up enrolling in March coverage.
Total enrollments (Including all January, February and March enrollments to date): 292,006
Plan selected/unenrolled: 8,079
Our new enrollment (people who did not have Health Connector coverage as of Nov. 1) is 60,361. This is a 23 percent increase from last year’s 49,034 at the same point in time.
Our retention rate is currently 89.7 percent, up about 2.6 percent from last year.
Working together, we are stronger. That’s why Families USA brings together community leaders from across the nation each year to improve the lives of America’s families. In 2019 we will meet for the 24th annual Health Action Conference on January 24-26, in Washington, D.C. at the Hyatt Regency Washington on Capitol Hill.
No other national grassroots health care conference brings together the swath of consumer activists and policymakers to inform, engage and inspire America’s health care agenda. We will be rolling up our sleeves to greet a new Congress and state legislatures in 2019.
DC Health Link Pulling Out All the Stops for African-American “Week of Action”
Friday, January 18, 2019
Marching in MLK, Jr. Day Parade, barber shop outreach, and visiting churches highlight opportunities to boost African-American health insurance enrollment
With less than two weeks left to the January 31 deadline to sign up for 2019 coverage, DC Health Link is ramping up outreach efforts to the African-American community, where the uninsured rate remains high. DC Health Link, in partnership with various community organizations, is encouraging uninsured African-Americans to enroll in quality, affordable health insurance during DC Health Link’s “African-American Week of Action.”
Press Release: NY State of Health Hosts Online Informational Webinars in Spanish and Mandarin Tomorrow
Enrollment Remains Strong During Final Weeks of Open Enrollment
Enroll Today! 2019 Open Enrollment Ends January 31, 2019
Customer Service Center Hours Extended before Deadline
ALBANY, N.Y. (January 22, 2019) - NY State of Health, the state’s official health plan Marketplace, today reminded New Yorkers that now is the time to enroll in a Qualified Health Plan (QHP) for 2019 coverage. NY State of Health will hold webinars in Spanish and Mandarin tomorrow night, January 23, 2019. Open Enrollment for 2019 ends January 31. Consumers across the state have a choice of many quality health plans, and financial assistance is available to most individuals who buy coverage through NY State of Health.
A couple of weeks ago, I noted that Speaker of the House Nancy Pelosi, in an interview airing on MSNBC, stated that two of the major pieces of healthcare legislation she intends on pushing through this session are raising the ACA's tax credit eligibility threshold and "replacing" the now-repealed ACA individual mandate (i was never sure whether "replacing" meant reinstating it or actually replacing it with some other enrollment incentive).
I realize that the odds of any useful healthcare legislation managing to pass the Senate and become law under the Trump Administration is pretty slim, but hey, it's still good news, right!
There's a half-dozen or more different healthcare policy overhaul bills which are being batted around by Congressional Democrats these days, ranging from the fairly modest ("lower the Medicare buy-in to age 50!") up through the full-blown, "pure" Single Payer bill being pushed by Bernie Sanders & other "Medicare for All" activists.
State government plays a critical role in today’s health care system. Every policy decision we make has an impact on the individuals, children and families who need care. The Governor’s FY20 budget proposal builds on this momentum, preserving vital ACA protections that promote market stability and help to keep uninsured rates low. There are no eligibility cuts or broad-based benefit impacts proposed.
Last year there was much hand-wringing by myself and other healthcare wonks about whether or not the Trump Administration would attempt to kill off Silver Loading (and its even-wonkier cousin, Silver Switching). HHS Secretary Alex Azar and CMS Administrator Seema Verma kept sending out mixed and confusing signals about their intentions.
Eventually, Azar decided that while he doesn't like the practice, there wasn't enough time to change the rules before the 2019 Open Enrollment Period was set to begin, so he decided to take a pass for the time being.
Well, in yesterday's NBPP release, the HHS Dept. addressed the issue of CSR reimbursement funding directly...but they also made it clear that they're letting Silver Loading slide for another year:
We propose a premium adjustment percentage of 1.2969721275 for the 2020 benefit year, including a proposed change to the premium measure for calculating the premium adjustment percentage. Under §156.130(e), we propose to use average per enrollee private health insurance premiums (excluding Medigap and property and casualty insurance), instead of employer-sponsored insurance premiums, which were used in the calculation for previous benefit years, for purposes of calculating the premium adjustment percentage for the 2020 benefit year. The annual premium adjustment percentage sets the rate of increase for several parameters detailed in the PPACA, including: the annual limitation on cost sharing (defined at §156.130(a)), the required contribution percentage used to determine eligibility for certain exemptions under section 5000A of the Code (defined at §155.605(d)(2)), and the employer shared responsibility payments under sections 4980H(a) and 4980H(b) of the Code.
Here's what this seeming gobbledygook means, as explained by Matt Fiedler of the Brookings Institute:
Currently, enrollees in plans offered through a Federally-facilitated Exchange or a State-based Exchange using the Federal platform can take action to re-enroll in their current plan, can take action to select a new plan, or can take no action and be re-enrolled in their current plan. Since the program’s inception, these Exchanges have maintained an automatic reenrollment process which generally continues enrollment for current enrollees who do not notify the Exchange of eligibility changes or take action to actively select the same or different plan.