Category: Implementing the Affordable Care Act
2016 Federal Poverty Levels Are Out; What Does This Mean for the Marketplace and Medicaid?
First Compliance Review Focused on Policies and Procedures, but a Better Approach Exists to Assess Health Plan Compliance

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

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.
Recent Guidance About Marketplace Residency Requirement and Special Enrollment Period When Moving
A Look at Proposals for Improving Health Coverage Affordability

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.
Enroll Before Jan. 15 for Feb. 1 Coverage and Other Open Enrollment Reminders

With open enrollment set to close in two week, enroll now before or on January 15 to get coverage by February 1. As the clock ticks towards the end of January and the close of open enrollment, CHIR’s Sandy Ahn provides some reminders and references the Navigator Guide, your resource on eligibility, enrollment, and health insurance coverage.
What About “Don’t Discriminate Against Sick People” Do You Not Understand?

Although it’s a complicated law, there’s one thing about the ACA that’s not at all complicated: the requirement that insurers stop discriminating against sick people. Yet some insurance companies still appear confused by this rule. Sabrina Corlette looks at recent insurer attempts to discourage sicker, older people from enrolling in their plans – and the efforts of at least one state to combat them.
Deadline for January 1, 2016 Coverage Approaching: What to Do

The deadline for having health insurance starting on January 1, 2016 is quickly approaching. Consumers who want marketplace coverage must enroll by December 15, 2015 for a January 1, 2016 effective date. CHIR summarizes what to do and highlights Frequently Asked Questions related to open enrollment.