January 19, 2016 – January 25, 2016

strong>New Guidance on Special Enrollment Periods: In guidance released January 19, the Centers for Medicare and Medicaid Services (CMS) decided it would close six Special Enrollment Periods (SEPs) that had been made available to address barriers that CMS says are no longer preventing consumers from enrolling in coverage. In addition, CMS clarified eligibility for receiving an SEP due to a move, and announced it will be assessing the SEP enrollees’ applications and eligibility, which may include requesting additional information from some consumers, to inform future policymaking.

Marketplace Enrollees Who Receive Financial Help Are Paying $113 a Month on Average in Premiums: On January 21, the Department of Health and Human Services (HHS) released a new report on premiums and tax credits for marketplace enrollees. For people enrolled in marketplace coverage between November 1 and December 26, 2015, 83 percent qualified for advance premium tax credits to lower their costs; the average tax credit enrollees received was $294 a month, and the net premiums for enrollees receiving tax credits was $113. Re-enrollees who picked a new plan for 2016 saved an average of $43 a month by switching plans.

New Report on How States Are Streamlining Medicaid Enrollment and Renewal: In a new survey report for all 50 states and the District of Columbia, the Kaiser Family Foundation examines each state’s choices in adopting Medicaid eligibility expansion and streamlining enrollment and renewal under the Affordable Care Act.

State Updates:

  • California: Thousands of marketplace enrollees have accessed health care — including treatment for broken bones, maternity care, organ transplants, and cancer treatments — from 111 hospitals since January 2014, according to a report Covered California released on January 19.
  • Connecticut: In a January 21 meeting of the board of directors, Access Health CT discussed requiring more documentation from consumers enrolling through SEPs.
  • Massachusetts: In the past two months, MassHealth, the state’s Medicaid program, has sent out renewal packets in the mail to 99,000 current enrollees. Most enrollees will need to take action to re-apply by February 29 to keep their coverage. Some enrollees, who were contacted in early December, had a January 18 deadline to fill out a new application. Any consumer who does not take action will receive a cancellation notice, but can re-apply through the Massachusetts Health Connector at any time.
  • Minnesota: A state health care task force voted on January 15 to maintain Minnesota’ state-based marketplace and explore expanding the state’s Medicaid program, MinnesotaCare.
  • Vermont: Vermont Health Connect is working to clear a backlog of applications from marketplace enrollees reporting life changes.

Enrollment Updates:

  • Federally Facilitated Marketplace: As of January 16, more than 8.8 million people were enrolled in marketplace coverage in states using the HealthCare.gov enrollment platform. This tally is just a couple thousand short of enrollment through HealthCare.gov during all of the second open enrollment period.
  • California: More than 290,000 new marketplace consumers had enrolled through Covered California as of January 18.
  • Colorado: As of January 15, nearly 143,000 Colorado were enrolled in marketplace coverage, and nearly 48,000 had gained coverage through Medicaid and CHP+ (the state’s Children’s Health Insurance Program) since November 1.
  • Connecticut: More than 15,000 new consumers enrolled in marketplace coverage as of January 19, bringing the total in Access Health CT to nearly 109,000.
  • Minnesota: On January 15, MNsure announced that 75,000 Minnesotans were enrolled in marketplace coverage, with another nearly 65,000 covered by MinnesotaCare and Medical Assistance.
  • Rhode Island: Nearly 32,000 consumers had enrolled in marketplace coverage through HealthSourceRI as of January 16, including more than 5,000 new enrollees for 2016.
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