…persist for years—a phenomenon that—as the authors suggest—shows how loss of insurance can create more permanent barriers to accessing the health care system, such as lacking a usual source of care. These findings underscore the need for policies that mitigate the risk of coverage gaps during the transition between Medicaid and other coverage programs. Jennifer Tolbert, Patrick Drake, and…
…percent). Why it Matters With the PHE recently extended into 2023, stakeholders continue to prepare for the massive wave of coverage transitions expected to occur once Medicaid renewals resume. Low levels of consumer awareness about the upcoming resumption of Medicaid renewals are a cause for concern as stakeholders seek to minimize coverage losses. While sources such as social media and…
By Jason Levitis* and Sabrina Corlette The unwinding of the Medicaid continuous coverage requirement will trigger the largest coverage transition since the Affordable Care Act (ACA) took effect. More people are projected to leave Medicaid than currently have marketplace coverage, creating a great risk of coverage loss but also a huge enrollment opportunity for marketplaces. States have already made tremendous…
…decline in non-ACA-compliant coverage, which can leave consumers at financial risk when they need care. This KFF study suggests that more generous premium subsidies have been key to increasing access to and take up of comprehensive health insurance on the individual market. Adrianna McIntyre, Evidence-Based Outreach Strategies for Minimizing Coverage Loss During Unwinding, JAMA Health Forum, October 2022. The author…
…EHB categories, such as maternity care. While federal regulators put a stop to Idaho’s “innovative” plans, the Healthy Future Task Force proposal would embrace this type of state action. While states can “innovate,” without a federal floor for coverage, this flexibility comes at a high price for consumers who may face medical underwriting, benefit exclusions, and other discriminatory industry practices…
…of the Affordable Care Act’s medical loss ratio standard. Plans participating in the public option program will need to agree to these standards and requirements as part of their contract arrangement with the state. Nevada’s actuarial study anticipates that these lower premiums could generate up to $341 million or $464 million in savings to the federal government (via lower federal…
…the U.S. Department of Justice is likely to appeal the ruling, some legal experts believe the Braidwood Management plaintiffs may prevail in the higher courts, too. The preventive services benefit is one of the more popular provisions of the ACA. The loss of this protection means that over 167 million people will need to pay out-of-pocket for dozens of critical…
…strategies to prevent coverage losses. What it Finds A projected 82.7 percent of Medicaid beneficiaries (71.7 million people, based on December 2021 enrollment data) will stay in Medicaid once the PHE ends, while 17.4 percent or 15 million current Medicaid enrollees will leave the program: 8.2 million people, or 9.5 percent of the individuals leaving Medicaid, are estimated to become…
…years, although there are a few insurers proposing only modest hikes, or even small reductions. See Figure 2. Paying it Forward (Not in a Good Way) After a banner year in 2020, many insurers had higher-than-expected utilization in 2021 and in early 2022, resulting in a market-wide $1.7 billion underwriting loss that many are seeking to recoup with higher premiums…
…But that is not the case. Congress’s real deadline to avert premium increases and coverage losses is August. That’s because most consumers will make 2023 coverage decisions in 2022, and there are substantial operational runways to set insurance rates, update eligibility systems and consumer-facing language to reflect PTC parameters, and calculate enrollees’ new eligibility and notify them—all before the open…
The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.
