March 11, 2014 – March 17, 2014

Notable Updates

  • Federally facilitated marketplace (FFM) application tips: The Centers for Medicare and Medicaid Services (CMS) recommends that, for the last two weeks of open enrollment, FFM consumers only apply online or by phone to ensure they are able to complete the application process and pick a plan by March 31. If a consumer receives a determination by mail after March 31, he/she will not be able to enroll without a Special Enrollment Period. If a consumer has already applied by mail and not yet received a determination, he/she should call the call center to check on the application’s status.
  • Pre-Existing Condition Insurance Plan (PCIP) extended through April: PCIP enrollees who have not obtained other coverage may extend their plan until April 30, but must find other coverage for May 1. The PCIP program was created in 2010 to cover consumers with pre-existing conditions and was supposed to sunset at the end of 2013. It has been extended to help enrollees avoid coverage gaps due to potential difficulty enrolling through their state’s marketplace.
  • New guidance on covering same-sex spouses: CMS issued guidance clarifying that small group and individual market issuers who offer spousal coverage for opposite-sex married couples must also offer spousal coverage for same-sex married couples. States must enforce this regulation beginning in 2015.
  • CMS proposes new marketplace rules for next open enrollment: The proposed rule, Exchange and Insurance Market Standards for 2015 and Beyond, touches on a number of topics including policies that strengthen navigator standards and help stabilize premiums in 2015.
  • CMS releases final letter to insurers regarding 2015 FFM plans: The final letter provides operational and technical guidance, including requirements for broader provider networks and additional federal oversight of networks in FFMs.

Top Successes

  • Five million enrolled! CMS announced that cumulative marketplace enrollment has exceeded five million. Open enrollment closes in two weeks.
  • Robust outreach continues: The administration, state-based marketplaces (SBMs), issuers, assisters, and partner organizations have been working hard to reach target audiences and maximize enrollment this past week. Leading the way in reaching young adults was President Obama, whose interview with Zach Galifianakis boosted HealthCare.gov’s traffic this past week. 

Marketplace Enrollment Update

  • New enrollment report: Last week the U.S. Department of Health and Human Services released its monthly enrollment report for October 1, 2013 through March 1, 2014.
  • Report toplines:
    • 942,000 Americans selected marketplace plans in February, bringing the cumulative total to 4.2 million (2.6 million in FFMs and 1.6 million in SBMs).
    • 1.2 million Americans were determined or assessed eligible for Medicaid or the Children’s Health Insurance Program (CHIP) through the marketplaces in February. This brings the cumulative total to 4.4 million. (Note: This does not include individuals who applied for Medicaid/CHIP directly through their state Medicaid agency.)
  • Young adult enrollment: The 18-34-year-old cohort accounted for 27 percent of plan selections in February. This matches the proportion in January and is higher than the first three months of open enrollment (when young adults accounted for 24 percent of all plan selections).
  • More consumers receiving financial help: Through February, 83 percent of consumers who selected plans qualified for premium tax credits. This proportion is up from 79 percent over the first three months of open enrollment. Seventy-four percent of these consumers who selected plans with financial assistance in FFMs have picked silver plans. This suggests many are also taking advantage of the cost-sharing reductions available to them through these plans only.

Challenges

  • Millions still need to complete the enrollment process: According to the last HHS enrollment report, 4.5 million Americans had applied and gotten eligibility determinations from the marketplaces but had not yet selected a plan as of March 1. (Note: 4.5 million is the difference between the total 8.75 million Americans with marketplace eligibility determinations and the 4.24 million Americans who selected plans.) Another 1.6 million had pending or other application statuses. To help consumers enroll, FFMs and SBMs are augmenting their call centers with extra staff, assisters across the country are holding additional enrollment events, and CMS is contacting FFM consumers to encourage them to finish their applications.
  • Oregon’s website: Cover Oregon’s website will not be open to the public during this year’s open enrollment period. It has been open to assisters to use when helping consumers for several weeks, but state officials decided it is not sufficiently functional for the general public. Oregonians can enroll in a marketplace plan and obtain financial help by applying with an assister or submitting a paper application to the marketplace.

 

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