10.2 Million Americans Covered in the Health Insurance Marketplaces: As of March 31, 2015, 10.2 million Americans had effectuated coverage in the health insurance marketplaces, according to a June 2 report from the Centers for Medicare and Medicaid Services (CMS). This is a point-in-time estimate representing individuals who have paid their premiums. The vast majority of enrollees — 85 percent — were receiving tax credits, averaging $272 a month, to help pay for their coverage. CMS will release similar snapshots of effectuated enrollment on a quarterly basis for the rest of 2015.
12.2 Million More Americans Enrolled in Medicaid and CHIP Since October 2013: The latest monthly enrollment report, released June 4, shows that Medicaid and Children’s Health Insurance Program (CHIP) enrollment grew by 12.2 million Americans, an increase of 21 percentage points, from the beginning of the first open enrollment period in October 2013 through March 2015.
Three States Receive Approval to Launch Their Own Health Insurance Marketplaces:On June 15, CMS granted conditional approval for three states currently using the federally facilitated marketplace (FFM) to launch new state-based marketplaces (SBMs). Pennsylvania and Delaware have conditional approval to launch SBMs for individual consumers in 2016, and Arkansas has conditional approval to start a marketplace for small businesses in 2016 and for individual consumers in 2017.
New Federal Guidance on Marketplaces:
- FAQs on Establishment Grant Funds: CMS issued an FAQ on June 8 clarifying how states can use section 1311 establishment grant funds after January 1, 2015, including using funds for certain outreach and operational activities.
- Final Rule on Summary of Benefits and Uniform Glossary: On June 12, the Departments of Health and Human Services (HHS), Labor, and Treasury finalized portions of a proposed rule for the Summary of Benefits and Coverage (SBC), the uniform explanation of benefits that insurers are required to provide for each insurance product they offer. The rest of the rule is expected to be finalized next year, giving more time for testing templates for the SBC with consumers and consulting stakeholders. Enroll America submitted comments on the entire proposed rule in March.
- Insurer Renewal Notices in the FFM: Also on June 12, CMS issued guidance to insurers on how they will need to inform enrollees about their expected premiums before re-enrolling them in the same plan or a similar plan for 2016.
- Hawaii: Hawaii Health Connector is transferring enrollment functions to HealthCare.gov and will transition to a supported SBM due to issues with financial sustainability. The Connector will stop handling enrollment for small businesses on June 15 and for individual consumers on September 30. The state will continue to handle consumer support.
- Vermont: After a major IT update, Vermont Health Connect now allows consumers to report changes in income or other life circumstances online. Up until now, staff were manually processing changes. The marketplace expects to clear a backlog of 10,200 changes in circumstances by November 1, when the next open enrollment period begins.