November 3 – November 9, 2015

New Doctor Look-Up Tool on HealthCare.gov: Starting November 3, one in four consumers on HealthCare.gov see a new Doctor Look-Up Tool and can use this feature to search for providers covered by the health plans in their area. This feature is being launched as a pilot in order to gauge initial consumer experience and data accuracy. The tool includes data from more than 90 percent of issuers offering plans on HealthCare.gov, and the Centers for Medicare and Medicaid Services (CMS) is continuing to make updates as they receive more information on provider networks.

Uninsured Rate Hits New Low in Federal Survey: On November 5, results from the latest National Health Survey Interview were released, finding that the uninsured rate for non-elderly adults had fallen to 12.7 percent for the first half of 2015. In the first two years of the Affordable Care Act’s coverage expansion (2014-2015), the survey found that the total number of Americans without health insurance declined by 16.3 million, including a reduction of 7.5 million between 2014 and 2015.

White House Launches Healthy Communities Challenge: Twenty localities across the country are participating in the White House’s Healthy Communities Challenge to help residents get covered during the third open enrollment period (OE3). The communities were chosen based on their high uninsured rates, and after OE3, the administration will determine the winner based on which area has made the most progress enrolling more consumers in coverage.

New Resources for Assisters in the Federally Facilitated Marketplace (FFM):

  • Roadmap to Resources: CMS has published a roadmap that outlines resources for assisters in states using the HealthCare.gov enrollment platform, including eligibility and enrollment policies and the best ways to receive updates from CMS.
  • Helping Immigrants Enroll: A new fact sheet reviews marketplace and Medicaid eligibility for immigrants in the FFM and walks through how assisters can help those consumers enroll in coverage and verify their identities.

Four States Changing How They Coordinate With HealthCare.gov on Medicaid Applications: As of November 1, consumers in Louisiana, North Dakota, and Oregon who apply for health coverage through HealthCare.gov and are assessed eligible for Medicaid will have their applications transferred to the state Medicaid agency, where the final determination will be made. Meanwhile, in Alaska, HealthCare.gov will now give consumers full Medicaid-eligibility determinations on behalf of the state. See here for a full list of each state’s transfer policies.

State Updates:

  • California: On November 3, the California Department of Managed Health Care announced it was fining two issuers for deficiencies in provider networks displayed on the state marketplace.
  • Hawaii:
    • The executive director of the Hawaii Health Connector is stepping down in December, after over a year of managing the marketplace and overseeing the transition to using the HealthCare.gov enrollment platform.
    • In a November 6 report to the board of directors, the executive director identified issues consumers are having with enrolling on HealthCare.gov, including limited access to language assistance. The marketplace switched to using the federal platform for OE3, and over 30,000 Hawaiians will need to renew through HealthCare.gov to maintain 2016 marketplace coverage.
  • New York: Health Republic, a nonprofit issuer created under the Affordable Care Act’s co-op program, will shut down and cancel coverage on November 30, a month earlier than previously planned. As a result, people currently enrolled in the co-op’s coverage will need to enroll in a new plan by November 30, with online enrollment available through November 15, to maintain coverage December 1. New York State of Health has created a hotline dedicated to helping those consumers, open 8:00 a.m. to 8:00 p.m. on weekdays and 9:00 a.m. to 1:00 p.m. on Saturdays: 1-855-329-8899.
  • Michigan: On November 4, the Department of Insurance and Financial Services Consumers announced that Consumers Mutual, a co-op plan, would no longer offer 2016 coverage. Consumers who are currently enrolled in coverage through the co-op can select new coverage during open enrollment.
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