Obama Administration Creates a New Special Enrollment Period

Implementing the ACA

This is the first year that the marketplace is denying financial assistance to individuals who failed to file their 2014 tax return and reconcile their premium tax credits. Many of these individuals may not have had to file a tax return previously and cannot afford coverage in 2016 without financial assistance. Therefore, the administration is providing a special enrollment period for these individuals as long as they file a 2014 tax return and reconcile their 2014 premium tax credits before March 31, 2016. CHIR’s Sandy Ahn summarizes this time-limited special enrollment period.
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First Compliance Review Focused on Policies and Procedures, but a Better Approach Exists to Assess Health Plan Compliance

Implementing the ACA

The administration recently published the results of its compliance review of health plans participating in federally facilitated marketplaces. The review, however, focused more on process, such as whether plans have the appropriate policies and procedures in place. While this information is somewhat helpful, CHIR’s Sabrina Corlette and Sandy Ahn discuss why these types of compliance reviews fall short of helping regulators assess whether plans are meeting the ACA’s patient protection standards. Continue reading

Little Known Provision Keeps Kids From Slipping Through Cracks Due to Differences in Eligibility Rules

Implementing the ACA

For the most part, the ACA tries to align the ways that Medicaid and the health insurance marketplaces determine eligibility for their respective programs. But every once in a while, there’s a risk that someone might fall through the cracks. This initially appeared to be the case when our colleague Tricia Brooks was asked to help with a complex family situation in which a child seemed to be caught between the differences between each program’s rules, putting him at risk of being uninsured. Fortunately, Tricia was able to unearth a little known but important rule that helps kids get the coverage they’re entitled to. Continue reading

2016 Insurer Participation Remains Stable in State-Based Marketplaces

State of the States

In the wake of the high-profile closures and departures of some health plans from the individual market, a close analysis of plan participation in the state-based marketplaces demonstrates that consumer choices remain relatively stable. In CHIR’s latest blog post for the Commonwealth Fund, Emily Curran, Justin Giovannelli and Kevin Lucia assess insurers’ participation in the state-run marketplaces and the policy levers in place to help foster competition. Continue reading

A Look at Proposals for Improving Health Coverage Affordability

Implementing the ACA

Welcome to 2016. With first votes being cast in the 2016 election cycle less than two weeks away and House Speaker Paul Ryan (R-WI) promising to unveil an ACA replacement plan to steer the 2016 party agenda, the policy debate on health reform is far from over. We here at CHIR are keeping an eye on reform proposals, and in this post, CHIR’s Hannah Ellison examines various proposals to improve affordability of coverage under the ACA. Continue reading

The Failure of the ACA’s Health CO-OPs: Lessons for Policymakers

Implementing the ACA

The failure of 12 of the Affordable Care Act’s CO-OP plans reveals much about the huge barriers facing new companies entering the highly concentrated health insurance market. Sabrina Corlette takes a look at some of the lessons that policymakers – and regulators with oversight over the proposed mergers in the health insurance industry – can draw from the CO-OPs’ experiences. Continue reading