While the few months of open enrollment are typically what most people think of when they think about marketplace health coverage, the truth is that enrollment happens all year long. Between helping consumers sign up for coverage when they experience certain life changes, enrolling people in Medicaid, and trying to educate the public about the Affordable Care Act, enrollment assisters are busy 365 days a year.
This week, the House Ways and Means Committee in Congress will vote on legislation that would eliminate caps on how much money marketplace consumers must repay the federal government if they receive more premium tax credits (a form of financial assistance) than they should based on their projected annual income. Families USA is concerned that the bill could deter people from signing up for health insurance if there is no longer a reasonable cap on how much they could be required to repay.
In addition to enrolling consumers in marketplace insurance, assisters can serve another valuable role: helping consumers register to vote. Applications for health coverage, whether through HealthCare.gov and state-based marketplaces, provide clients with access to voter registration, which makes it easy for assisters to help people register to vote. Here’s what assisters should know about voter registration and how they can help consumers navigate this process.
Outside of open enrollment, consumers still have the opportunity to enroll in qualified health plans when they experience certain life changes, such as marriage or a permanent move to an area with new coverage options. These opportunities to enroll outside of open enrollment are called special enrollment periods, or SEPs.
At the end of February, the Centers for Medicare and Medicaid Services (CMS) announced significant changes to the federal marketplace process for consumers to enroll in health insurance through special enrollment periods (SEPs). While the new SEP process has not been entirely laid out yet, we have significant concerns that these changes will negatively affect consumers, especially low-income consumers and immigrants. Here we describe some principles the new process should follow to meet the needs of consumers.
There's a lot to like in the new “Notice of Benefit and Payment Parameters” rule from the federal government, both about what insurers must offer in the health plans they sell on the federal marketplace in 2017 and about other issues related to enrollment. However, we had hoped the government would release its originally proposed, firmer standards for provider networks and make other parts of this rule mandatory, not voluntary, for insurers.
Overall, the rule, released by the Centers for Medicare and Medicaid Services (CMS) last week, takes significant steps toward making health insurance and care more affordable and making it easier for consumers to compare health plans. In this blog we discuss a number of specific provisions of the rule that will most affect people who buy health insurance through the marketplace.
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.
Must-read guide for enrollment assistance organizations looking to share people’s stories for story banking.
Everyone who files taxes must indicate whether or not they have health insurance. This infographic explains the steps most tax filers must take to accurately report their health insurance information.
A new report released last week confirms the findings that enrollment experts emphasized on our teleconference with reporters last Wednesday: We still have a ways to go in getting “hard-to-reach” populations enrolled in health coverage.