CMS is committed to protecting consumers in the Marketplace. CMS has received reports of consumers in HealthCare.gov states whose coverage was switched by agents and brokers without their knowledge. In response, CMS is taking swift actions to protect consumers from unauthorized activity by agents and brokers, and to root out bad actors who are violating CMS rules.
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.
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).
It's been a long time since I've reported on any significant cybersecurity problems at any of the ACA exchanges. The last one I can think of off the top of my head was nearly a decade ago, and even that was about how some early flaws had been fixed.
Unauthorized enrollment or plan-switching is emerging as a serious challenge for the ACA, also known as Obamacare. Brokers say the ease with which rogue agents can get into policyholder accounts in the 32 states served by the federal marketplace plays a major role in the problem, according to an investigation by KFF Health News.
Biden-Harris Administration encourages everyone who needs affordable, quality health insurance to visit HealthCare.gov and sign up for coverage by the January 16 final deadline.
As I noted in the prior entry, QHP enrollment is running ahead of last year so far in 45 states so far, with it running more than 50% higher in over a dozen of them and more than twice as high in Mississippi.
Another way of looking at this is to compare the confirmed current QHP enrollment in every state as of the most recent data (12/02/23 for HC.gov states; 11/25/23 for SBM states) against the final total QHP enrollment as of the end of the 2023 Open Enrollment Period.
This is obviously isn't a fair comparison since there's still a full 40 days left for people to enroll and because auto-renewals still have to be added to the federal exchange states. However, it's still interesting to take a look.
For the SBM states, I've included their auto-renewals as reported in either the CMS snapshot report or, in a few cases, even more recent combined enrollment data from the SBMs themselves.
...The graph below shows how these numbers have increased since the same time period last year. I've had to adjust slightly for the fact that there's one fewer day included for both the federal exchange (32 days vs. 33) and the state exchanges (25 days vs. 26).
I've also had to adjust for the fact that Virginia moved from the federal exchange to its own state-based exchange this year, which is further complicated by CMS reporting 5 weeks for the federal exchange but only 4 weeks for state-based exchange. Otherwise, the subtotals are accurate, while the new/returning breakout for 2023 are estimates,but should still be pretty close:
More than 7 Million Selected Affordable Health Coverage in ACA Marketplace Since Start of Open Enrollment Period
Enrollment increases continue as the deadline for January coverage fast approaches
Nearly 7.3 million people have selected an Affordable Care Act (ACA) Health Insurance Marketplace plan since the 2024 Marketplace Open Enrollment Period (OEP) opened on November 1. This represents activity through December 2 (Week 5) for the 32 states using HealthCare.gov and through November 25 (Week 4) for the 18 states and the District of Columbia with State-based Marketplaces (SBMs). Total plan selections include more than 1.6 million people (23% of total) who are new to the Marketplaces for 2024, and 5.7 million people (77% of total) who have active 2023 coverage and returned to their respective Marketplaces to renew their coverage or select a new plan for 2024.
...The graph below shows how these numbers have increased since the same time period last year. I've had to adjust slightly for the fact that there's one fewer day included for both the federal exchange (18 days vs. 19) and the state exchanges (11 days vs. 12).
I've also had to adjust for the fact that Virginia moved from the federal exchange to its own state-based exchange this year, which is further complicated by CMS reporting 3 weeks for the federal exchange but only 2 weeks for state-based exchanges. I've done my best to adjust for all of these factors below (the subtotals are accurate; the new/returning breakout for 2023 are estimates but should be pretty close):
Back on November 9th, President Biden issued the first hint suggesting that the 2024 ACA Open Enrollment Period would be the most successful ever:
In the first week of Open Enrollment, 1.6 million people have signed up for a plan at HealthCare.Gov, including 301,000 new consumers – that’s a 50% increase from last year.
