The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)
Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented for the following year (actually, it's the year after the following year, since the final rule is generally released in mid-December).
The smallest of these, which is also the smallest state in the country, is Wyoming, which has had a long & storied history when it comes to Medicaid expansion fakeouts. The "Equality State" legislature has considered expanding Medicaid to the roughly 19,000 residents who would become newly eligible for the program eight times since the ACA was signed into law in 2010, only to see approval of it fail at one stage or another every time.
Pennsylvanians must visit pennie.com before December 15 for coverage beginning January 1st.
Harrisburg, PA –– December 15th marks the Open Enrollment Period deadline for 2023 health coverage beginning New Year’s Day through Pennie, Pennsylvania’s official online health insurance marketplace.
Pennie keeps insurance costs down, and Open Enrollment is the prime opportunity for Pennsylvanians to receive savings on quality health plans. Pennie is the only source for financial savings to lower monthly premiums or out-of-pocket costs. Nine out of 10 customers qualify for savings, which averages over $530 a month.
SACRAMENTO, Calif. — A new federal rule takes effect on Monday, opening the door for nearly 400,000 people to enroll in a more-affordable health plan through Covered California. The change means families who have been ineligible for financial help because one member is insured through an employer may now be eligible for subsidies to lower the cost of their premiums if they enroll in a health plan offered through Covered California.
“The door to more-affordable health coverage is opening today for hundreds of thousands of Californians,” said Jessica Altman, executive director of Covered California. “There are families across California who will now be able to save hundreds of dollars a month, and thousands of dollars a year, if they switch from employer-sponsored coverage to a Covered California plan.”
...With this announcement, in addition to the previously announced market exits, Bright HealthCare will not offer Individual and Family health plans in Alabama, Arizona, Colorado, Florida, Georgia, Nebraska, North Carolina, Texas, and Tennessee after 2022(1), or Medicare Advantage plans outside of California and Florida. This focused footprint reduces Bright Health’s overall regulated capital need and is expected to release excess regulated capital of approximately $250 million upon settlement of all medical liabilities and approval from state regulators.
Enhanced direct enrollment (EDE) is a new pathway for consumers to enroll in health insurance coverage through the Federally-facilitated Exchange. This pathway allows CMS to partner with the private sector to provide a more user-friendly and seamless enrollment experience for consumers by allowing them to apply for and enroll in an Exchange plan directly through an approved issuer or web-broker without the need to be redirected to HealthCare.gov or contact the Exchange Call Center.
In short, EDEs are basically a private version of HealthCare.Gov which are authorized by the federal government to hook directly into the HC.gov back end. This means that people who enroll via an EDE website are enrolling in on-exchange ACA coverage (including ACA financial subsidies as appropriate); they're just doing so via a 3rd party web interface. There's actually several dozen different EDEs, several of which have advertised on this site.
Washington state seeks federal approval to expand health insurance to previously uninsured
State request will bring health coverage to individuals regardless of immigration status
In an effort to expand health coverage options to all residents, Washington state submitted a groundbreaking Section 1332 Waiver Application to the federal government for approval on Friday, May 13. The waiver, if approved, will allow all Washington residents regardless of immigration status to enroll in health and dental coverage through the state marketplace, Washington Healthplanfinder. If approved, the coverage will be available starting in 2024 to the newly eligible Washingtonians.
A few weeks ago I wrote about a bill pending in the District of Columbia Council, of all legislative bodies, which, had it passed, would have seriously undermined ACA protections for thousands of DC residents with employer-based healthcare coverage, as well as potentially setting precedent for similar bills in other states:
ST. PAUL, Minn.—Minnesotans have just one week left to sign up for health insurance through MNsure before the December 15, 2022, deadline for coverage starting January 1, 2023.
MNsure, Minnesota’s health insurance marketplace, is where Minnesotans can select medical and dental coverage and access premium tax credits (discounts) to lower the cost of monthly premiums. Tax credits aren’t available anywhere else, and next year households receiving tax credits are expected to save an average of $560/month.
“Many Minnesota families who have never been eligible for discounts through MNsure now qualify for tax credits in 2023 because of recent changes to federal rules,” said MNsure CEO Nate Clark. “If your family has been relying on health insurance you get through an employed family member, now is the time to check MNsure.org/newoptions and see whether you can access lower-cost health insurance for next year.”
