November 17 – November 23, 2015

HHS Releases Wide-Ranging Proposed Rule for 2017 Plan Year and Beyond: On November 20, the Department of Health and Human Services (HHS) proposed a set of rules — the annual Benefit and Payment Parameters — for continuing to implement the Affordable Care Act’s (ACA) health insurance marketplaces. Under the proposed rule, the marketplaces’ fourth open enrollment period (OE4), for plan year 2017, would run from November 1, 2016, through January 31, 2017; HHS is asking for comments on dates for OE5 and beyond. The proposed rule also covers provider network adequacy, standardized plan designs for the federal marketplace, changes in child age rating, and new post-enrollment duties for Navigators. Comments are due by 5:00 p.m. ET on December 21, 2015.

More Than 1 Million Plan Selections in Two Weeks in States: More than half a million Americans picked plans on the federally facilitated marketplace (FFM) in the second week of OE3 (November 8-14), according to the latest enrollment snapshot. That brings the preliminary total to nearly 1.08 million plan selections. About one-third of plan selections came from new consumers, with the rest from people actively renewing their coverage.

New State-by-State Counts of How Many People Were Able to Enroll in Medicaid Because of Expansion: A new edition of a quarterly state-by-state report shows how many Americans were able to enroll in Medicaid under the ACA’s expansion. The data comes from the Medicaid Budget and Expenditure System, and it also includes updated statistics for July 2014 through March 2015.

Update From CMS on Risk-Corridor Payments: In a memo issued on November 19, the Centers for Medicare and Medicaid Services (CMS) outlines plans to fulfill payments to issuers under the ACA’s risk-corridor program for the 2014 plan year in future fiscal years.

New Study on Savings for Returning Enrollees Who Shop Around: A new Kaiser Family Foundation analysis of marketplace premiums finds that there will be a new lowest-cost Silver plan in 7 out of 10 counties for 2016 in states using the enrollment platform. Consumers enrolled in the lowest-cost Silver plan for 2015 could save an average of $322 in premiums over the course of a year by switching to the lowest-cost Silver plan for 2016.

State Updates:

  • California: As of November 17, more than 34,000 new consumers picked 2016 plans on Covered California, and 33,000 new and returning consumers signed up for newly available dental coverage through the marketplace.
  • Connecticut: More than 5,400 new consumers selected plans on Access Health CT as of November 17. This presentation to the marketplace’s board of directors breaks down enrollees by metal level, issuer, and demographics.
  • Hawaii: Because of limited remaining funding, the Hawaii Health Connector’s senior leadership voted to recommend that the marketplace transfer its authority from the marketplace, a private non-profit entity in Hawaii, to the state ahead of schedule, starting December 1. For OE3, Hawaii transitioned to using as its enrollment platform.
  • Minnesota:
    • As of November 17, over 23,000 Minnesotans had enrolled in coverage through MNsure during OE3, with 6,964 in marketplace plans, 5,091 in MinnesotaCare, and 11,226 in Medical Assistance. The majority of marketplace plan selections — 4,583 — came from new consumers.
    • On November 18, the MNsure board of directors announced its appointment of Allison O’Toole as the marketplace’s permanent CEO, She has served as interim CEO since May.
  • Vermont:
    • As of November 17, Vermont Health Connect finished processing 18,000 marketplace re-enrollments, out of around 30,000 people currently enrolled, using its new automated system. In previous years, the marketplace needed to manually re-enroll each individual consumer.
    • Two new audits of the state marketplace identified flaws in its eligibility-determination systems and its technological fixes to the enrollment platform. The marketplace’s responses to each audit outlined progress the state has made to address the identified issues.
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