…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…
…to face the loss of employment, income, and/or their source of health insurance. There are a number of policy changes related to the pandemic that can impact enrollment and affordability on the marketplace. Some states that run their own marketplace may have established additional special enrollment periods due to the COVID-19 pandemic, so check with your state marketplace to see…
…do not stop at private health insurance. The expansion of Medicaid, which provides free health coverage for low income people expanded coverage to 12 million low income adults. Cuts to this program would send these individuals back to the individual market where they would almost certainly not be able to afford the premiums. As many as 3 million children who…
…the period with an estimated 243,000 more children living without health coverage. Florida has the next biggest loss, adding about 55,000 children to the uninsured count over the three-year period. As a consequence, 41 percent of children’s coverage losses during the Trump Administration occurred in Texas and Florida. The only state that bucked national trends and significantly reduced its number…
…that could overturn the ACA, and rising uninsured rates are insurers flocking back to the individual marketplace? A Sicker-than-expected Risk Pool, Policy Uncertainty Drove Insurer Exits in 2017 By 2017, many insurers had experienced significant losses in the individual market. Nationwide, insurers selling in the individual market lost $2.5 billion in 2014 alone. The following year was little better. Competitive…
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