As noted yesterday, it's the12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I've broken into several entries.
This entry covers two types of ACA policies which don't get nearly enough attention. The first is the ACA's Basic Health Plan (BHP) program, which is currently only operating in two states: Minnesota and New York.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
As noted this morning, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
In this entry, I'm looking at the financial aid breakout for Qualified Health Plan (QHP) enrollees. ACA financial assistance falls into two categories: Advance Premium Tax Credits (APTC) and Cost Sharing Reductions (CSR). APTC reduces enrollees monthly premium costs; CSR reduces their deductibles, co-pays and other out-of-pocket expenses.
Thanks to the American Rescue Plan, APTC financial assistance is far more generous for most enrollees in 2022 than in prior years, as you can see by looking at the 3rd & 4th columns (avg. premium and avg. premium after APTC):
As I just noted, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
In this entry, I'm looking at the weekly Qualified Health Plan (QHP) selections by state and nationally. This first table shows the cumulative numbers for every week of OEP 2022. The final column includes additional enrollments after 1/15/22 in the states which had later deadlines, as well as some oddball clerical data corrections:
As I just noted, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
The next two tables look at the number of renewing enrollees who kept their existing (2021) ACA exchange policy vs. those who switched to a different policy for 2022. It's important to note that CMS only has data on this from the 33 states hosted on the federal exchange (HealthCare.Gov).
Of those, over 56% of renewing enrollees switched to a different policy (either through the same carrier or a different one). The other 44% either kept whatever policy they were enrolled in at the end of 2021 or were automatically switched to the closest equivalent in cases where that exact policy had been discontinued by the insurance carrier (this is known as being "crosswalked"):
As I just noted, today marks the 12th Anniversary of President Obama signing the ACA into law. To mark the occasion, the Centers for Medicare & Medicaid Services (CMS) has released the final, official 2022 Open Enrollment Period (OEP) report, which I'll be breaking into several entries.
First up is the top line numbers: Just how many people selected Qualified Health Plans (QHPs) during the 2022 OEP, which ran from November 1st, 2021 through different ending dates depending on the state. In the 33 states hosted via the federal ACA exchange (HealthCare.Gov), as well as 9 of the 18 state-based marketplaces (SBMs), the ending date was January 15th, 2022.
For the remaining SBMs, the ending date was: 12/22/21 in Idaho; 1/19/22 in Colorado; 1/28/22 in Massachusetts; 1/31/22 in DC, Kentucky, New Jersey, New York & Rhode Island; and 2/04/22 in California:
In March 2020, Congress offered states additional Medicaid funding as long as they agreed to keep everyone enrolled in the program for the duration of the federal public health emergency, regardless of their eligibility status. As of January 2021, nearly 10 million had joined Medicaid or the Children’s Health Insurance Program (CHIP) during the pandemic, pushing enrollment to a record high of more than 80 million people. (Some independent analyses put the current total higher, closer to 90 million.)
As part of the Biden-Harris Administration’s work to advance health equity and reduce health disparities, the Centers for Medicare & Medicaid Services (CMS) is seeking feedback on topics related to health care access, such as enrolling in and maintaining coverage, accessing health care services and supports, and ensuring adequate provider payment rates to encourage provider availability and quality. This Request for Information (RFI) is one of many actions CMS is taking to develop a more comprehensive access strategy in its Medicaid and CHIP programs.
“We are committed to providing equitable access to quality health care and removing any barriers to quality health care,” said Health and Human Services Secretary Xavier Becerra. “We want to hear directly from stakeholders so we can strengthen our programs for the more than 80 million Americans with Medicaid or CHIP health insurance. Together, by advancing health equity, we can ensure quality health care is within reach for everyone who needs it.”
What goes up usually goes back down eventually, and that's likely to be the case with Medicaid enrollment as soon as the public health crisis formally ends...whenever that may be.
Well, yesterday Ryan Levi and Dan Gorenstein of of the Tradeoffs healthcare policy podcast posted a new episode which attempts to dig into just when that might be, how many people could be kicked off of the program once that time comes and how to mitigate the fallout (I should note that they actually reference my own estimate in the program notes):
CMS Commits Over $49 Million to Reduce Uninsured Rate Among Children and Boost Medicaid Enrollment Among Parents, Pregnant People
The Centers for Medicare & Medicaid Services (CMS) committed a record $49.4 million to fund organizations that can connect more eligible children, parents, and pregnant individuals to health care coverage through Medicaid and the Children’s Health Insurance Program (CHIP). Awardees—including state/local governments, tribal organizations, federal health safety net organizations, non-profits, schools, and others—will receive up to $1.5 million each for a three-year period to reduce the number of uninsured children by advancing Medicaid/CHIP enrollment and retention.
This week, HHS’s office of the Assistant Secretary for Planning and Evaluation (ASPE) is also releasing a report analyzing new survey data that showed the uninsured rate fell in 2021 after the American Rescue Plan and outreach efforts took effect. According to the report, the uninsured rate for U.S. population was 8.9% for the third quarter of 2021 (July – September 2021), down from 10.3% for the last quarter of 2020 – corresponding to roughly 4.6 million more people with coverage over that time period. Coverage gains occurred among both children and working age adults, with the largest coverage gains for those with incomes under 200% of the poverty level (roughly $27,000 for a single adult or $56,000 for a family of four).
