Congressional Budget Office (CBO) Projects 12 Million Marketplace Enrollees and 19 Million Fewer Uninsured Adults in 2015: On January 26, CBO released a revised Budget and Economic Outlook that includes updated estimates of the health coverage expansion under the Affordable Care Act. CBO projects that, for 2015, 12 million Americans will be enrolled in marketplace coverage, 11 million more Americans will be covered in Medicaid/CHIP, and 19 million more adults will be insured due to the coverage expansion. The marketplace estimate is slightly lower than its previous projection of 13 million enrollees in 2015, reflecting CBO’s expectation that enrollment will ramp up more gradually in the years ahead.
Federal Poverty Level (FPL) Updated for 2015: The Department of Health and Human Services (HHS) posted new FPL guidelines. These guidelines are used to determine eligibility for many federal programs that have income-based requirements. The new levels will be used for income-based Medicaid determinations this year, but the health insurance marketplaces will continue using the 2014 FPL to determine eligibility for financial help for 2015 coverage.
2015 Marketplace Enrollment Released by ZIP Code: On January 21, HHS released ZIP code–level estimates of plan selections for 2015 coverage in the federally facilitated marketplace (FFM). The data are up-to-date as of January 16 and available on a county-by-county level here.
New Report on Medicaid Enrollment Includes Counts of Newly Eligible Adults Enrolled by State: The Centers for Medicare and Medicaid Services (CMS) posted the first report with state-by-state enrollment in Medicaid/CHIP that includes counts of how many adults who enrolled were newly eligible due to Medicaid expansion. The report covers monthly data from January through March of 2014 and is the first installment of a quarterly report.
CMS Takes Steps to Enhance Consumer Privacy on HealthCare.gov: On January 24, CMS announced it added a new layer of protection for the data consumers enter into HealthCare.gov’s window-shopping tool. In addition, CMS announced it is considering ways it can further limit the consumer information shared with third-party websites from HealthCare.gov.
Tax Time Update for Marketplace Enrollees:
- New Tax Fact Sheet: HHS describes what consumers need to know to prepare for this year’s tax season, including steps for 2014 marketplace enrollees to take to ensure that their tax credit or penalty amount is correct.
- Tips for Resolving Any Errors on the 1095-A Form: 2014 enrollees will receive a 1095-A form from their marketplace that they will use to file their taxes. If consumers see that their demographic information on the form is incorrect, they can make corrections when filing their taxes. However, if information about their health coverage is incorrect, they should contact their marketplace call center. The FFM can issue corrected forms to consumers starting in early March. More information is available in this Frequently Asked Questions document.
Fact Sheet for Assisters Helping Consumers Enroll in Medicaid and the Children’s Health Insurance Program (CHIP): A new CMS fact sheet for assisters outlines Medicaid and CHIP eligibility rules for income and immigration status, benefits and cost protections for consumers, hardship exemptions available in non-expansion states, and tips for specific consumer scenarios.
As Medicaid Applications Increase, States Work to Address Enrollment Backlog: Some states are having trouble keeping up with the high number of Medicaid applications they are receiving.
- California: On January 20, a California judge ruled that any applicant in the state who had been waiting for longer than 45 days for their coverage to take effect will receive temporary benefits.
- Oregon: The state’s Medicaid program is still processing 43,000 pending applications, around 30,000 of which came through HealthCare.gov. Oregon officials are contacting consumers who may have information missing from their applications. In the meantime the Oregon Health Authority says that consumers can use Medicaid eligibility notices from HealthCare.gov to obtain health care services.
State-Based Marketplace Updates:
- Massachusetts: On January 22, the Massachusetts Health Connector announced that Louis Gutierrez, a private-sector IT executive who also served as the state’s Chief Information Officer, is being appointed as executive director.
- Washington State: The Washington Health Benefit Exchange board released results from a survey of marketplace and Medicaid enrollees, finding that a majority had not experienced problems with enrollment, although many reported technical issues and wanted more customer service staff to be available.
Note: Collecting and reporting of enrollment numbers varies by marketplace. To fully understand the enrollment numbers below it may be necessary to view the original source for context (source links are provided).
- FFM: A total of 7.2 million Americans selected a new marketplace plan or were automatically renewed through HealthCare.gov as of January 16.
- District of Columbia: A total of 19,473 marketplace plan selections (new and renewing consumers) in OE2 and 39,137 Medicaid/CHIP enrollments (since the start of OE1) as of January 11.
- Kentucky: A total of 91,430 marketplace plan selections (new and renewing consumers) and 34,049 Medicaid/CHIP enrollments during OE2 as of January 6.
- Maryland: A total of 93,806 marketplace plan selections (new and renewing consumers) and 91,393 Medicaid/CHIP enrollments during OE2 as of January 22.
- Massachusetts: A total of 77,268 marketplace plan selections and 196,549 Medicaid/CHIP enrollments during OE2 as of January 21.
- Minnesota: A total of 44,130 marketplace plan selections and 61,814 Medicaid/CHIP enrollments during OE2 as of January 23.
- Rhode Island: A total of 28,789 marketplace plan selections (new and renewing consumers) during OE2 as of January 17.
- Vermont: 2,506 new marketplace plan enrollments (with effectuated coverage) and 5,475 Medicaid/CHIP enrollments in OE2 as of January 19.