A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

Kaiser study estimates 17 million will be eligible for insurance subsidies

Posted on November 5, 2013 | Comments Off

An analysis performed by the Kaiser Family Foundation found that nearly 6 in 10 Americans eligible to participate in the Affordable Care Act’s (ACA) health insurance marketplaces, which equates to 17 million individuals, will qualify for insurance subsidies. To receive a subsidy through the ACA, individuals must earn between 100-400% of the federal poverty line. Most of the individuals qualifying for subsidies reside in Texas, California, and Florida. The analysis was based on population and economic data collected by the Census Bureau for 2012 and 3013, stated that.

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Commonwealth study finds 17% of potentially eligible Americans visited ACA marketplaces in October

Posted on November 4, 2013 | Comments Off

A new survey conducted by The Commonwealth Fund indicated that 17% of individuals possibly eligible for insurance under the Affordable Care Act (ACA) visited the law’s online marketplace. The survey, performed October 9th-27th via the Commonwealth Fund Affordable Care Act Tracking Survey, also found that 20% of those that visited the marketplaces were between ages 19-29, and 20% of those that visited actually enrolled in a plan. The survey additionally reported that 60% of those in the sample group were aware of the purpose of marketplaces and 37% of those that did not enroll in coverage cited healthcare.gov‘s technical malfunctions as the reason for not enrolling.

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CCIIO issues enrollment period FAQs

Posted on October 29, 2013 | Comments Off

The Center for Consumer Information and Insurance Oversight (CCIIO), within the Centers for Medicare and Medicaid Services (CMS), published an FAQ concerning the open enrollment period for individuals purchasing qualified health plans (QHPs) under the Affordable Care Act (ACA). The guidance states that individuals will be able to enroll in QHPs throughout the entire enrollment period, which lasts through March 31st, and not be subject to the individual shared responsibility payment. According to the ACA, individuals would have to enroll in a plan by the 15th of each month in order for their QHP coverage to be effective at the start of the following month. Individuals that enrolled in plans after the 15th would not be covered for another two months. The issue pertains to individuals that would enroll in QHPs between February 16th and February 28th of 2014. These individuals would not be covered until April 1st, and would therefore be subject to the minimum essential coverage penalty under the ACA (the minimum essential coverage provision states that an individual must pay a penalty if he or she does not have coverage for more than three consecutive months in a year). This guidance removes that snafu in the law and states that CCIIO will provide additional guidance on the issue in 2014.

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CMS issues loaded Marketplace final rule

Posted on October 24, 2013 | Comments Off

Today, the Centers for Medicare and Medicaid Services (CMS) published a final rule concerning financial integrity and oversight for Marketplaces and qualified health plans (QHP). Some of the key components addressed in this rule include: clarifications and amendments to market reform rules, standards for special enrollment periods, and standards for survey vendors that may conduct enrollee satisfaction surveys for QHP issuers. One specific amendment in the rule enables QHP issuers to use a “simplified methodology” in determining cost-sharing reductions for qualifying plan enrollees, which CMS states will protect federal funds and minimize administrative burden.

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Editor’s Comment: What Policy Options Exist if the Healthcare.gov Website Remains Non-Functional?

Posted on October 23, 2013 | Comments Off

The federal healthcare.gov website is limping along. The Administration has now taken a number of steps to begin to quickly and decisively address the problem, including adding a “surge” of technology experts to their contract teams and appointing a high-level overseer with extensive business management expertise. But fixing the website could take a long time…

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CMS issues RFC for exemptions to individual mandate

Posted on October 22, 2013 | Comments Off

Yesterday, the Centers for Medicare and Medicaid Services (CMS) issued a Request for Comment (RFC) concerning new exemptions to the individual mandate under the Affordable Care Act (ACA). This particular RFC asks for additional information on the burden experienced by health care sharing ministries, and if such burden would qualify for an exemption from the individual mandate.

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Update: Ohio expands Medicaid

Posted on October 22, 2013 | Comments Off

After the measure to expand Medicaid failed in the Legislature this summer, the Ohio Controlling Board voted 5-2 to approve Medicaid expansion under the Affordable Care Act (ACA). This decision, which will likely be met by a multitude of legal challenges in the coming months, makes Ohio the 25th state to accept enhanced federal funding to help insure the state’s most impoverished residents. Our map has been updated to reflect these changes.

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Verifying Income Eligibility for Premium Subsidies and Cost-Sharing Assistance under the ACA: Impact of the Continuing Appropriations Act of 2013

Posted on October 17, 2013 | Comments Off

Although similar at first blush, the two provisions are quite different in their actual wording and their potential impact. The provision that ultimately became law requires that the Secretary take steps to assure that Exchanges comply with the ACA’s income verification requirements…

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CMS releases draft application for ACA exemptions

Posted on October 16, 2013 | Comments Off

The Centers for Medicare and Medicaid Services (CMS) issued a draft application and a corresponding data collection comment request concerning exemptions from the individual mandate. Under the Affordable Care Act (ACA), certain groups of individuals, such as those experiencing financial hardships or those that belong to a religious organization that opposes the use of insurance, are deemed exempt from the individual mandate and are therefore not required to pay the $95 penalty in 2014. This specific draft application, which is for individuals requesting a hardship exemption, is 6 pages in length and requires applicants to provide the type of hardship they are experiencing and their tax information. CMS anticipates that more than 12 million individuals will apply for the individual mandate exemption. The data collection comment request outlines options for states to rely on the Department of Health and Human Services (HHS) to determine eligibility exemptions, and asks the Office of Management and Budget (OMB) to approve the annual information collection requirements associated with the application.

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Implementation Brief Notice of Proposed Rulemaking: Small Employer Tax Credit

Posted on October 16, 2013 | Comments Off

This Implementation Brief examines a Notice of Proposed Rulemaking (NPRM) issued by the Internal Revenue Service (IRS) on August 26, 2013 concerning the tax credit available to small employers that offer health insurance coverage to their employees…

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