State Health Insurance Marketplaces

Special Enrollment Period Boosts ACA Enrollment by 200k Enrollees

by Kelsey Waddill

The Affordable Care Act’s federal marketplace has gained 200,000 new enrollees since the beginning of the special enrollment period, the Biden administration announced. “These numbers are...

White House Sets Up Federal Marketplace Special Enrollment Period

by Kelsey Waddill

The Biden administration has signed an executive order that sought to strengthen Medicaid and Affordable Care Act marketplace coverage and opened a special enrollment period on the Affordable Care...

6 Strategies to Evolve the Affordable Care Act Marketplaces

by Kelsey Waddill

The Affordable Care Act marketplace presents many opportunities for developing new strategies and technological solutions, particularly for states that are transitioning to state-based marketplaces,...

Private Payers Face More Medicaid Competition on ACA Marketplaces

by Kelsey Waddill

Private payers are facing steeper competition from Medicaid health plans on the Affordable Care Act marketplaces, a Robert Wood Johnson Foundation study found. Researchers surveyed six...

Major Payers Find HHS Finalized Nondiscrimination Rule Too Narrow

by Kelsey Waddill

Major payers and payer organizations objected to the finalized HHS nondiscrimination rule—Affordable Care Act Section 1557—saying that the rule eliminates much of the specific language in...

BCBS Companies Hold Almost 50% of Market Share on ACA Marketplaces

by Kelsey Waddill

The federal and state health insurance marketplaces are dominated by Blue Cross Blue Shield-affiliated companies and there has also been a dramatic shift in enrollment from national and regional payers...

Special Enrollment Period Trends on State ACA Marketplaces

by Kelsey Waddill

State health insurance marketplaces are playing a pivotal role in helping the uninsured access healthcare coverage by opening special enrollment periods, Commonwealth Fund researchers found. By...

CMS Releases Final 2021 Payment Notice, Extends QHP Timeline

by Kelsey Waddill

CMS has released the final 2021 payment notice along with news that it will extend the qualified health plan timeline by one week to account for coronavirus uncertainties in premium rate...

ACA Battle Continues, States and Feds File Supreme Court Briefs

by Kelsey Waddill

The coalition of Democrat states led by California and the House of Representatives filed their briefs in defense of the Affordable Care Act (ACA) just ahead of the May 6 deadline, while the coalition...

Medicaid Expansion States May See Lower Uninsurance Amid COVID-19

by Kelsey Waddill

As national unemployment mounts closer to historic levels, Medicaid expansion states will fare the surging uninsurance far better than nonexpansion states, according to a recent report from the Urban...

14M Workers In Vulnerable Industries Are Medicaid, ACA Eligible

by Kelsey Waddill

Over 14 million workers in industries hit hard by coronavirus are eligible for Medicaid or subsidized healthcare insurance on the ACA marketplace if they become unemployed, regardless of whether they...

Key Fixes to NY Commercial Payer Exchange to Ease New Enrollment

by Sara Heath

New York’s off-exchange insurance market needs revamping in light of the coronavirus pandemic, as more residents and immigrants face job loss and fall off their employer-sponsored health plans,...

CA Boosts Worker’s Comp, Insurance Benefits for COVID-19 Diagnosis

by Sara Heath

A notice out of California Insurance Commissioner Ricardo Lara’s office seeks to remind insurance companies that all workers exposed to COVID-19 while working on the frontline are eligible for...

How Payers Use Special Enrollment Periods To Boost Coverage

by Kelsey Waddill

Health Care Service Corporation (HCSC) will be offering a special enrollment period for members of their group health insurance plans as many seek coverage in light of the growing pandemic. For more...

States Seek CMS Approval For Medicaid, ACA Exchange Flexibility

by Kelsey Waddill

CMS has approved Florida’s Section 1135 waiver, allowing the state to avoid some of the administrative processes that may weigh down the escalating efforts against coronavirus. For more...

Challenges in Adopting a State-Based Health Insurance Marketplace

by Samantha McGrail

As several states look to launch a state-based health insurance marketplace (SBM), experts warn that policymakers should weigh the decision carefully and pursue a marketplace only as part of a...

CA Sees 41% New Enrollment Spike in State Health Insurance Market

by Kelsey Waddill

Covered California, California’s state health insurance market, saw an increase in enrollment since instituting the individual mandate statewide and offering state subsidies on top of the...

Tenth Circuit Court Upholds HHS Risk Adjustment Calculations

by Kelsey Waddill

The Tenth Circuit Court of Appeals determined that the rules HHS used to calculate 2014 through 2018 risk adjustments were neither arbitrary nor capricious. In order to help healthcare payers predict...

Despite Early Low Enrollment, Federal Exchange Enrollment Steady

by Kelsey Waddill

The 2020 federal exchange enrollment remained steady at around 8.4 million enrollees, CMS announced. However, CMS Administrator Seema Verma expressed dissatisfaction with enrollment. Her...

NJ Prepares for Consumer Activity on State-Based Exchanges

by Kelsey Waddill

The New Jersey Department of Banking and Insurance announced that it will offer $2 million for health navigators to help enrollees and re-enrollees with the transition from a federal-facilitated...