April 7 – April 13, 2015

2015 Marketplace Enrollment Data Released by ZIP Code: On April 8, the Department of Health and Human Services released ZIP code–level estimates of how many people had selected plans in the federally facilitated marketplace (FFM) between November 15, 2014, and February 22, 2015. The data are also available on a county-by-county level here (including side-by-comparisons to each county’s enrollment estimate from the first open enrollment period [OE1]).

New Report on Medicaid Enrollment Includes State-by-State Counts of Newly Eligible Enrollees: The Centers for Medicare and Medicaid Services (CMS) posted the second installment of a quarterly report with state-by-state enrollment data for Medicaid and the Children’s Health Insurance Program, including counts of enrollees that became newly eligible for Medicaid due to their state’s decision to expand the program under the Affordable Care Act (ACA). The report covers monthly data from April through September of 2014.

Gallup Poll Finds Uninsured Rate Reaches (Another) Record Low of 11.9 Percent: On April 13, Gallup released its latest poll on health coverage, finding that the national uninsured rate continued to fall in the first three months of 2015 to 11.9 percent. The share of adults without health insurance has decreased by 5.2 percentage points — a decline of nearly one-third — in Gallup’s survey since the ACA’s coverage expansion took effect in the fall of 2013.

CMS Simplifies Opportunity for People in the Medicaid Gap to Get Covered if They Newly Qualify for Financial Help to Purchase Marketplace Coverage: According to new guidance from CMS, starting April 28, FFM applicants who are in the Medicaid coverage gap can get a Special Enrollment Period (SEP) if their income increases above 100 percent of the federal poverty level ($11,770 for an individual) and they attest that they were previously ineligible for Medicaid due to their state’s decision not to expand. Prior guidance required consumers in this situation to have previously applied for and been denied by their state’s Medicaid agency to demonstrate they were ineligible. This SEP applies only for non-Medicaid expansion states, and consumers can obtain this SEP and enroll in coverage by contacting the FFM call center at 800-318-2596.

Federal Court Blocks Enforcement of Missouri Law on Role of Certified Application Counselors: In an April 10 ruling, the U.S. Court of Appeals for the Eighth Circuit unanimously overruled a Missouri law that would have placed restrictions on the role of Certified Application Counselors (CACs). For instance, the law would have prevented CACs from discussing the covered benefits, features, and terms of specific health plans and informing consumers about non-marketplace coverage options. The Court found that federal regulation, which does not place these restrictions on CACs, pre-empted state law.  We will continue to monitor the case’s course through the legal system.

State-Based Marketplace (SBM) Updates:

  • California: On April 7, Covered California announced that more than 18,000 consumers had enrolled through the state’s tax filing SEP, which is available through April 30 for uninsured Californians who learned about the fine for not having health insurance when filing their 2014 taxes.
  • New Mexico: BeWellNM’s board of directors decided to continue to lease the HealthCare.gov enrollment platform while retaining its designation as an SBM.
  • Vermont: Vermont Health Connect is working to determine how to reconcile payments to issuers that had not gone through because of technical problems with the enrollment platform.
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