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OPEN ENROLLMENT WINDING DOWN, STATES MAKING CHANGES TO ACA PROGRAMS, and "SPECIAL CATEGORIES"

Posted by Susan Donegan on Fri, Jan 15, 2016

We’re continuing to read about plan changes, network changes, and price changes. Here’s a roundup of interesting datapoints, perspectives, and news.

The momentum of open enrollment continued to wind down, with growth of less than 75,000 consumers in week 10, from January 3 to January 9, 2016. (Healthcare Finance, 1/13/16)

The administration’s “special enrollment” categories have allowed people to wait until they become ill or need medical services to sign up, driving up costs broadly, insurers told federal health officials. “Individuals enrolled through special enrollment periods are utilizing up to 55 percent more services than their open enrollment counterparts” who sign up in the regular period, the Blue Cross and Blue Shield Association, told the administration. (The New York Times, 1/9/16)

Health insurers in the Affordable Care Act exchanges will see changes from the CMS this year to strengthen the market, including eliminating special enrollment periods and an early look at plans' risk-adjustment data, the top CMS official said on Monday. (Modern Healthcare, 1/12/16)

"We believe it is incredibly important, in the business we're in, that we insure all Americans," Chief Executive Mark Bertolini said. "We believe we have an obligation to stick it out and work with it until we know that it won't work. And I believe it is too early to give up on this process." (Business Insurance, 1/13/16)

About 11.3 million Americans have signed up so far for individual health insurance in 2016 through HealthCare.gov and the state-based exchanges, the U.S. government said on Thursday. The U.S. Department of Health and Human Services said that total included about 4 million people under age 35. (Reuters, 1/7/16).

8% ... was the average increase in annual deductibles for in-network services from 2015 to 2016 for insurers on public exchanges, according to an analysis of data contained in AIS's new online database Rx Benefit Data. (AIS Health Business Daily, 1/11/16)

About 1.4 million households that got financial help for health insurance under President Barack Obama's law failed to properly account for it on their tax returns last year, putting their subsidies at risk if they want to keep coverage. (The Charlotte Observer, 1/8/16)

Several states are making changes to their ACA programs:

Louisiana's new Democratic governor, John Bel Edwards, said in his inaugural address that he will spend his first day in office taking steps to expand Medicaid eligibility under the Affordable Care Act.(The Times-Picayune, 1/11/16)

Following through on a campaign pledge, Gov. Matt Bevin has notified federal authorities he plans to dismantle kynect, Kentucky's health insurance exchange created under the Affordable Care Act. (Courier-Journal, 1/11/16)

Arkansas Gov. Asa Hutchinson has told federal officials he wants to impose new limits on the state's hybrid Medicaid expansion that's providing coverage to more than 200,000 people.(KATV-TV Little Rock/The Associated Press, 1/4/16)

Tags: ACA. healthcare exchanges, ACA, HIX

 

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