On Monday, the Obama administration issued sweeping new standards for health insurers that operate Medicaid managed care plans for the states. The new rules are a big deal in part because they affect so many people: There are more than 72 million people enrolled in Medicaid.
April is National Minority Health Month and this year’s theme, accelerating health equity, reminds us that the quickening pace of change in the health arena provides strategic opportunities to narrow the disparities gaps between people of color and our white friends and neighbors. This month we celebrate the huge coverage gains among immigrants, several state initiatives to remove barriers to immigrant coverage, and Georgia’s big step toward making health insurance provider directories accurate and useful.
Recent actions by the Center for Medicare and Medicaid Services (CMS) represent an encouraging recognition–by one of the biggest payers of health care in the nation—that one-size-fits all payment reforms do not benefit everyone equally.
And they raise the question of whether some of these pay-for-performance programs should be adjusted to better address racial and ethnic health disparities.
After the close of each open enrollment session, enrollment assisters often debrief with each other to discuss what worked and what lessons they learned about successful enrollment. In several debrief meetings we joined recently around the country, discussion frequently touched on the increasing complexity of consumers’ needs and assisters’ growing interest in professional development.
As members of the enrollment team at Families USA, we were invited to help plan and facilitate some of these debrief meetings. Reflections about lessons learned from the last open enrollment were a crucial component of those meetings, but many also used this time to look ahead and plan for next year.
Earlier this week, CMS offered welcome clarification on special enrollment periods (SEP) for people in the coverage gap. It also issued updates about eligibility determination notices and hardship exemptions. We explain the updates below.
On Wednesday, CMS clarified the procedure for the special enrollment period (SEP) for consumers who move out of the “coverage gap.” People who are in the coverage gap live in states that have not expanded Medicaid.