June 16 – June 29, 2015

Supreme Court Ruling Preserves Availability of Tax Credits in Federally Facilitated Marketplace States. On June 25, the Supreme Court released its decision in King v. Burwell, a case challenging the availability of premium tax credits in federally facilitated marketplace (FFM) states. In a 6-3 ruling, the Court held definitively that tax credits are available to consumers in every state. This protects the financial assistance that millions of Americans are currently receiving to pay for their marketplace plans, and ensures that future enrollees will similarly be able to access affordable health coverage.

12.3 Million More Americans Covered by Medicaid/CHIP Since October 2013: The number of individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) increased by 12.3 million (more than 21 percent) from the start of the first open enrollment period through April 2015, according to the latest monthly report, released June 23.

Centers for Disease Control and Prevention Survey Finds 2014 Had Largest One-Year Drop in the Uninsured Rate Since They Started Collecting Data: On June 23, the Centers for Disease Control and Prevention (CDC) released its annual National Health Interview Survey, finding that the uninsured rate for non-elderly adults had fallen 4 percentage points, from 20.4 percent in 2013 to 16.3 percent, in 2014. The decrease is the largest one-year drop since the survey began collecting data in 1997.

FFM Contacting Consumers Who May be Eligible for Medicaid/CHIP But Did Not Receive a Full Assessment Due to System Glitch in 2014: Starting in late June, the FFM is sending notices to consumers who had been (1) determined or assessed to be ineligible for Medicaid/CHIP by the FFM in the plan year 2014 and (2) requested full evaluations from their state’s agency. Because of a system issue, the FFM did not transfer those consumers’ applications to their state agency for full evaluation. The Centers for Medicare and Medicaid Services (CMS) is sending notices to these consumers outlining the steps they need to take if they are still interested in having a full evaluation completed. Consumers can either apply directly to Medicaid/CHIP or they can contact the FFM call center, which will help them update and re-submit their application. If consumers are determined to have been eligible for Medicaid/CHIP since their original application, they can receive retroactive coverage. CMS is also sending consumers’ initial applications to states for full evaluation, in addition to contacting consumers about their options.

State-Based Marketplace Updates

  • Vermont: BlueCross and Blue Shield of Vermont is requesting repayment from the marketplace for claims they paid for consumers who were no longer enrolled. Because of a system issue, updated enrollment data had not been transferred to issuers.
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