July 14 – July 27, 2015

2.7 Million Households Received Financial Help to Purchase Marketplace Coverage in 2014 According to New Report from Internal Revenue Service: On July 17, a letter to members of Congress from the Internal Revenue Service included preliminary data related to tax filing and health coverage for 2014 —  the first year that millions of Americans had the opportunity to purchase marketplace coverage with the help of premium tax credits and when certain consumers had to pay a fine for not having coverage. According to the report’s initial findings, 2.7 million households received tax credits to purchase marketplace coverage, 7.5 million households paid the fine for not having coverage when filing their taxes, and 12 million qualified for exemptions from the fine (such as individuals who were incarcerated or who were members of a recognized religious sect with religious objections to insurance).

New Guidance for Domestic Violence Special Enrollment Period: Starting July 27, the federally facilitated marketplace (FFM) will permanently offer a Special Enrollment Period (SEP) for survivors of domestic violence and spousal abandonment, and for survivors’ dependents. Once determined eligible for the SEP, individuals have 60 days to sign up for a plan.

Government Accountability Office Released Report on Enrollment Controls in FFM: On July 16, the Government Accountability Office (GAO) released on a report on applications for enrollment in the FFM, finding that 11 out of 12 false identities were able to enroll in coverage and be determined eligible for financial help.

State Updates:

  • California:
    • Marketplace premiums for the 2016 plan year will increase by an average of 4 percent, less than last year’s average increase of 4.2 percent. According to Covered California, re-enrollees will be able to find plans within their same metal level with premiums averaging 4.5 percent lower.
    • On July 14, Covered California announced $10 million in Navigator grants to over 60 organizations across California for the upcoming open enrollment period. Last year, Covered California funded $17 million in Navigator grants to over 60 organizations.
  • Connecticut: On August 1, the state is changing the income requirements for Medicaid for parents and caregivers from a maximum of 201 percent of the federal poverty level (FPL) to a maximum of 155 percent FPL. For a family of four, this change means the income threshold will go from about $48,000 per year to $37,000. This new income threshold is still among the most generous in the nation. The state’s marketplace, Access Health Connecticut, is reaching out to around 1,300 consumers who will need to transition from Medicaid to marketplace coverage as a result.
  • Minnesota
    • MinnesotaCare, one of Minnesota’s Medicaid programs, is processing a back-log of 180,000 re-enrollments, with a goal of addressing all cases by August 31.
  • Pennsylvania: In the first seven months of the commonwealth’s Medicaid expansion, 439,000 Pennsylvanians enrolled.
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