October 20 – October 26, 2015

Countdown to Open Enrollment: Updates to the Federally Facilitated Marketplace (FFM): Leading up to the upcoming open enrollment period, which will run from this Sunday, November 1, 2015, through January 31, 2016, the Centers for Medicare and Medicaid Services (CMS) launched several consumer-facing improvements and the 2016 “window shopping” feature on HealthCare.gov. On October 25, consumers were able to begin to “window shop” for plans in their area, as well as receive estimates for financial help they can qualify for and, for the first time, yearly costs for each available plan. Other improvements to HealthCare.gov include tailoring the experience based on whether shoppers are new and simplifying the password-reset process.

13.6 Million Americans Gained Medicaid/CHIP Health Coverage: On October 26, CMS published the latest monthly enrollment report for Medicaid and the Children’s Health Insurance Program, finding that 13.6 million additional Americans gained coverage through the programs from October 2013, the start of the first open enrollment period (OE1), through August 2015. As of August 30, more than 72.4 million individuals were enrolled. In states that expanded Medicaid under the Affordable Care Act (ACA), enrollment increased by nearly 31 percent; non-expansion states saw an increase of over 10 percent.

Basic Health Program Funding Methodology Updated: On October 21, CMS released an updated methodology for federal funding of the Basic Health Program (BHP) for 2017 and 2018. BHP is an optional program for states to offer health coverage tailored to people with incomes between 138 and 200 percent of the federal poverty level (FPL) as an alternative to traditional marketplace coverage. Minnesota and New York are the first states implementing BHP for the 2016 coverage year. The 2017/2018 methodology is very similar to the 2016 methodology, with minor revisions to account new FPLs and inflation levels.

GAO Reviews Intersection Between Medicaid and the FFM: On October 22, the U.S. Government Accountability Office (GAO) published a report identifying potential for coverage gaps and duplicate coverage between Medicaid and the FFM, and recommending steps for CMS to take to address the problems.

State Updates:

  • California: Covered California previewed its plan for OE3 in a report released on October 22. With 750,000 Californians uninsured and eligible for financial help in the marketplace, Covered California expects enrollment to increase by between 295,000 and 450,000 consumers. Based on a survey finding that one-third of the remaining uninsured aren’t aware financial help is available, Covered California plans to center its messaging on affordability as it launches a new advertising campaign and opens twice as many storefronts where in-person enrollment help is available.
  • Colorado:
    • On October 12, the Connect for Health Colorado board of directors appointed Kevin Patterson as the marketplace’s CEO (he had been serving as interim CEO since May 2015).
    • On October 23, the Colorado Division of Insurance (DOI) announced approved health insurance rates for 2016. On average, premiums will increase by 9.8 percent. The DOI estimates that current enrollees who qualify for financial help could reduce their premiums by 46 percent if they re-enroll in the lowest-cost plan available in the same metal tier.
  • Illinois: Get Covered Illinois awarded 10 organizations nearly $5 million in federal outreach and education grants to reach consumers during the 2016 open enrollment period.
  • South Carolina: Consumers’ Choice Health Insurance Company, a nonprofit issuer created under the ACA’s co-op program, will no longer offer 2016 coverage because of concerns over financial stability. People who are currently enrolled in coverage through the co-op will be able to select new plans during open enrollment starting November 1.
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