…recent job loss or receipt of unemployment benefits, receipt of failure to file notices due to IRS backlogs in processing income tax returns, and policies discouraging enrollment among eligible immigrants. Due to both general and pandemic-related difficulties experienced by many consumers during the 2021 Open Enrollment period, Navigators advocated for reopening the federal marketplace for an additional enrollment period. Navigators…
…to fully subsidize COBRA premiums for Americans who lost their employer sponsored insurance. As talks for another COVID-19 relief package ramped up last fall, AHIP again highlighted the need for temporary COBRA funding as job losses and furloughs continued. KFF estimates that COBRA subsidies could cost the government $106 billion, while many of those opting for COBRA would be passing…
…patients in a limited Medicaid benefit to pay for testing with a 100% federal match, but the process can be cumbersome and to date only 17 states have adopted it, according to Kaiser Family Foundation. In the remaining states, and as a backstop for uninsured patients not picked up by the Medicaid option, FFCRA and subsequent legislation established a $2…
…“no wrong door” approach that is currently in place, which helps ensure that consumers enroll in the coverage program for which they are eligible, whether it be Marketplace, Medicaid, or CHIP. Additionally, a main purpose of the Marketplace is to provide a single, one-stop-shop for all available qualified health plans (QHPs). When the options for enrollment are scattered across different…
…enrollment opportunity. Some events that trigger a special enrollment opportunity are: Loss of minimum essential coverage or other qualifying coverage. For example, if you lose your employer-sponsored coverage because you quit your job, were laid off, or if your hours were reduced. This also includes “aging off” a parent’s plan when you turn 26 or if you lose student health…
…hours at work were cut back due to the COVID-19 pandemic, resulting in a temporary loss of income. Can I qualify for premium tax credits? Possibly. If you are already enrolled in a marketplace plan (either through HealthCare.gov or your state’s marketplace), you should report the change in income. If you previously qualified for premium tax credits, and your income…
…comprehensive cap on both in-network and out-of-network prices could encourage more broad price reductions, but policymakers may have more difficulty ensuring compliance among providers who attempt to circumvent this measure. Fiedler finds that providers may respond to a loss of negotiation power by seeking other allowances from insurers, such as by demanding higher prices for other services, using alternative payment…
…South; 61 percent of the increase in the child uninsured rate occurred in this region. Although losses in children’s coverage were widespread across income, age, and race and ethnicity, they were largest among white and Latino children. Losses in children’s coverage can largely be attributed to declines in Medicaid and CHIP enrollment. Factors driving the loss of public coverage include…
…businesses, with a projected 48 million people under age 65 living in families with a COVID-19-related job loss, and over 10 million of these individuals are projected to lose their health coverage at the same time. While the White House and Congress negotiate a relief package to mitigate these negative economic effects, the Biden administration is likely to take immediate…
…medical loss ratio (MLR) formula. This guidance means that policyholders will receive an estimated 2.4 percent ($298 million) of the risk corridor payout in the form of MLR rebates. At the same time, 2020 has been a highly profitable year for many health insurers, due to depressed utilization of health care services during the COVID-19 pandemic. In a recent “Expert…
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