June 30 – July 13, 2015

County-Level Data for Plan Selections in the Federally Facilitated Marketplace: On July 2, the Department of Health and Human Services (HHS) posted a dataset on plan selections by county during the second open enrollment period for states using the HealthCare.gov platform. The plan selection data includes break-downs by eligibility for financial help, race/ethnicity, and age.

Gallup Poll Finds National Uninsured Rate Fell to 11.4 Percent: On July 10, Gallup released its latest poll on health coverage, finding the uninsured rate for adults in the United States decreased slightly over the last three months to 11.4 percent. Since the fall of 2013, when the ACA’s coverage expansion took effect, the uninsured rate has fallen by 5.7 percentage points — a decline of one-third.

New Nominee for Administrator for the Centers for Medicare and Medicaid Services: Andy Slavitt, who has served as acting administrator for the Centers for Medicare and Medicaid Services (CMS), was nominated last week to fill the position on a permanent basis.

Final Preventive Services Regulations Issued: On July 10, the Departments of Treasury, Labor, and HHS released final rules on preventive services. The rule finalizes interim rules for preventive services for all non-grandfathered plans, including clarifying appropriate cost-sharing when preventive services are provided in conjunction with other services or by out-of-network providers. The rule also covers accommodations for religious organizations that object to including contraceptive services in the health coverage they offer employees.

Guidance for Insurers on Notices for the Third Open Enrollment Period: On July 9, CMS released guidance saying that they do not anticipate updating federal standard renewal notices for this year. Insurers can base their notices off of last year’s standard notices, along with updated guidance on renewals from last month.

States Select Benchmark Plans for 2017 Essential Health Benefits: Coloradothe District of ColumbiaIllinois, and Washington state have selected the essential health benefit (EHB) benchmark plan for qualified health plans (QHPs) offered in their states starting in 2017. All QHPs must cover ten essential health benefits, and states can select among 10 plans available in their state to use as the EHB benchmark plan for issuers to design their QHPs:

  • the three small group plans with the highest enrollment,
  • the three state employee plans with the highest enrollment,
  • the three federal employees plans with the highest enrollment, and
  • the non-Medicaid HMO plan with highest enrollment.

The default benchmark for a state that does not proactively select a plan is the small group plan with the highest enrollment.

State-Based Marketplace Updates:

  • Oregon: On July 1, the Oregon Insurance Division announced final health insurance rates for the 2016 plan year. In the individual market, rate increases ranged from 8.3 percent to 37.8 percent depending on insurer. The increase comes after a public review process by the Oregon Insurance Division, including a specific review of 2014 costs compared with premiums, and new expectations for claims for the covered population. A recent study by the Kaiser Family Foundation found that in 11 major cities, preliminary premiums for Silver benchmark plans would increase by an average of 4.4 percent for 2016.
  • Vermont: On June 30, Vermont Health Connect awarded Navigator grants to five recipients representing 15 organizations for outreach and enrollment efforts. The grants run from July 1, 2015, through June 30, 2016. Vermont Health Connect awarded $1.7 million in Navigator grants last year.
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