Turning Medicaid into a block grant would ultimately mean cuts in services to people who need health care the most. It would also put states completely on the hook for unanticipated health care costs.
Covered California could be the first exchange in the country to sell health insurance to undocumented immigrants and Deferred Action for Childhood Arrivals (DACA) recipients. The state marketplace is trying to use a Section 1332 “state innovation” waiver to obtain federal approval for a plan to offer coverage to all Californians, regardless of immigration status. While the proposal does not allow undocumented people and DACA recipients to receive financial assistance to help them with the costs of insurance, it is an important step toward universal coverage.
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.
Governor Matt Bevin recently submitted his proposal to change the state’s Medicaid expansion to the Center for Medicare and Medicaid Services for federal review and approval. A federal comment period will start soon. Many of the proposed changes are likely to harm the hundreds of thousands of Kentuckians who currently have coverage under the program
This is the first in a series of analyses that examines the impact of efforts by conservative states to use Section 1115 waivers to modify their Medicaid expansions. Our analysis uses data these states report to CMS. First up: How charging Medicaid patients premiums hurts their care and state budgets.
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.
With this decision, CMS is making it clear that policies that make it harder for the lowest-income people in the program to get health care are inconsistent with the goals of Medicaid. The decision also defined some boundaries regarding what is and is not appropriate for approval through the Medicaid waiver process.
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.
In early January, the Center for Medicare and Medicaid Innovation announced its first program focused on addressing a patient’s social needs. This 5-year, $157 million pilot program, called Accountable Health Communities, will try to bridge the gap between clinical and social services, testing whether addressing these needs can improve health, lower costs, and improve quality for Medicare and Medicaid beneficiaries.
Must-read guide for enrollment assistance organizations looking to share people’s stories for story banking.