Medicaid Enrollment Rises by Nine Million: On November 19, the Department of Health and Human Services (HHS) released the Medicaid and Children’s Health Insurance Program (CHIP) enrollment report for September. Enrollment grew by 9.1 million Americans — a 16 percent increase — since the first open enrollment period (OE1) began. Enrollment increased by 23 percent in states that expanded Medicaid; non-expansion states saw an increase of 6 percent.
New Guidance on Hardship Exemptions and Proposed Rule Issued for the Third Open Enrollment Period and Beyond
- Guidance on Hardship Exemptions: On November 21, the Centers for Medicare and Medicaid Services (CMS) issued guidance granting an automatic hardship exemption to individuals who would have qualified for Medicaid if their state had decided to expand its Medicaid program. Eligible individuals can claim this exemption when they file their taxes and do not have to obtain a Medicaid denial or an exemption though the marketplace. However, some consumers in states that have not yet expanded Medicaid may still benefit from applying for coverage now in order to gain a Special Enrollment Period following an increase in their income.
- Proposed rule on OE3 and beyond: On November 24, HHS released a proposed rule, the Notice of Benefit and Payment Parameters for 2016, which proposes changes relevant to the next open enrollment period and beyond. The rule proposes that all future open enrollment periods will be October 1 through December 15, explores alternative auto-enrollment processes for consumers, and addresses a variety of other issues related to in-person assistance, Special Enrollment Periods, essential health benefits, network adequacy, premium stabilization programs, and the Small Business Health Options (SHOP) marketplace. Public comments on this proposed rule are due December 22.
6.7 Million Enrolled in Marketplace Coverage in October: HHS corrected its point-in-time marketplace enrollment number from 7.1 million to 6.7 million as of October 15. The adjustment was made after it became clear that stand-alone dental plan enrollments were erroneously counted as health plan enrollments in the point-in-time count.
CMS Shares Tips and Resources for Assisters and Consumers Using HealthCare.gov:
- Resetting passwords and unlocking accounts:If consumers are having trouble accessing accounts they’ve created before, they can follow these steps to find their username and re-set their password.
- Uploading copies of green cards:The HealthCare.gov application does not currently list green cards as a document on the drop-down menu that residents can upload to verify their eligibility. CMS is working on a permanent fix, but in the meantime recommends users select another type of document, such as passport or “Other,” and upload the green card.
- Model notices:CMS posted new sample notices for the federally facilitated marketplace on data matching, auto-enrollment confirmation, and eligibility determinations, along with a cover sheet for Form 1095-A, the tax form for marketplace enrollees.
Enrollment Updates from State-Based Marketplaces:
- California:11,357 new marketplace selections and 33,368 Medicaid/CHIP enrollments as of November 18.
- Connecticut:2,659 new marketplace selections and 8,945 Medicaid/CHIP enrollments as of as of November 21.
- Kentucky: 4,107 marketplace selections (including renewals) and more than 16,000 Medicaid/CHIP enrollments as of November 21.
- Massachusetts: 14,101 new marketplaces selections and 23,792 Medicaid/CHIP enrollments as of November 22.