Charles Gaba's blog

New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.

via the North Dakota Insurance Dept:

Godfread announces rates for 2024 ACA plans

BISMARCK, N.D. – Insurance Commissioner Jon Godfread has approved the rates for individual and small group health insurance plans compliant with the Affordable Care Act (ACA).

Individual and small-group health insurance plans that are ACA-compliant are purchased through the Healthcare.gov exchange or licensed agents. Three statewide insurance carriers operate on the individual market, available via Healthcare.gov and through insurance agents. Five major carriers exist in the small group market, primarily purchased by employers of small businesses.

“We’re releasing these rates to give consumers who purchase their health insurance on the individual or small group markets an idea of what’s to come for 2024,” said Godfread. “The changes in rates this year are on par with previous years, with no big jumps or decreases in rates. When purchasing health insurance, or any insurance policy, shop around and look at different coverage options and find one that best fits your and your family's needs.”

SEE IMPORTANT UPDATES AT BOTTOM.

Yesterday I crunched the numbers for two different reports from the Centers for Medicare & Medicaid services.

The first was the standard monthly Medicaid/CHIP enrollment report for June 2023:

In June 2023, 92,614,205 individuals were enrolled in Medicaid and CHIP.

  • 85,614,581 individuals were enrolled in Medicaid in June 2023, a decrease of 1,169,095 individuals (1.3%) from May 2023.
  • 6,999,624 individuals were enrolled in CHIP in June 2023, a decrease of 32,449 individuals (0.5%) from May 2023.

As of June 2023, enrollment in Medicaid and CHIP has decreased by 1,304,004 since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.

Washington HealthPlan Finder

via the Washington HealthPlan Finder:

Today, the Washington Health Benefit Exchange (Exchange) released a Data Snapshot Report, which shows the availability of affordable, Cascade Care plans are proving critical to keeping people covered and advancing equity during the Medicaid unwind.

Now that COVID-era protections have expired, Washington, like all states, has resumed regular annual eligibility checks for people covered by our state Medicaid program, Washington Apple Health. For the past year, the Exchange has joined partners across our state, led by the Washington Health Care Authority (HCA), to ensure Apple Health customers watch out for and respond to renewal notices.

Originally published 8/07/23

The good news is that RateReview.HealthCare.Gov has posted the preliminary 2024 rate filing summaries for every state, making it much easier to pin down which carriers are actually participating in the individual & small group markets next year, as well as what the carriers average requested rate changes are in states which don't publish that data publicly (or which make it difficult to track down if they do).

The bad news is that in many of those states, acquiring the actual enrollment data is even more difficult, as their rate filings tend to be heavily redacted. Alabama falls into this category.

New York State of Health

via NY State of Health:

  • Consumers Can Preview 2024 Plan Options Now, Enroll Starting November 16, 2023
  • Marketplace Helps New Yorkers Stay Covered Throughout Pivotal Renewal Process of State Public Health Programs
  • State’s Uninsured Rate Drops to Record Low of Less than 5 Percent
  • Enhanced Federal Financial Assistance Will Remain Available for 2024 Health Coverage

ALBANY, N.Y. (October 4, 2023) – NY State of Health, the state’s official health plan Marketplace, today announced the health and dental insurance plans offered through the Marketplace for the 2024 coverage year.

Via MNsure:

Enrolling Through MNsure Offers Great Savings on 2024 Health Insurance Plans

ST. PAUL, MN — Starting November 1, Minnesotans who need health insurance can sign up for 2024 coverage through MNsure, Minnesota’s official health insurance marketplace, where they can easily find, choose and purchase health insurance. MNsure’s open enrollment period begins November 1, 2023, and will run through January 15, 2024. Open enrollment is the annual opportunity to enroll in health coverage, change plans, and renew coverage.

MNsure estimates that Minnesotans who are eligible for tax credits will save $6,750 in 2024 and spend 5% less on private health plan premiums than they did this year, on average.

These significant savings are thanks to advanced premium tax credits, which act like an instant discount to lower the cost of monthly premiums – but are only available when you enroll in health insurance through MNsure. For example:

Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of June 2023:

via the Centers for Medicare & Medicaid Services (CMS):

In June 2023, 92,614,205 individuals were enrolled in Medicaid and CHIP.

  • 85,614,581 individuals were enrolled in Medicaid in June 2023, a decrease of 1,169,095 individuals (1.3%) from May 2023.
  • 6,999,624 individuals were enrolled in CHIP in June 2023, a decrease of 32,449 individuals (0.5%) from May 2023.
  • As of June 2023, enrollment in Medicaid and CHIP has decreased by 1,304,004 since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 1,175,034 individuals (1.4%).
    • CHIP enrollment has decreased by 128,970 individuals (1.8%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,043,140 individuals (32.5%) to 93,918,209
    • Medicaid enrollment increased by 22,709,822 individuals (35.4%).
    • CHIP enrollment increased by 333,318 individuals (4.9%).

Last month, Amy Lotven of Inside Health Policy found an excellent scoop from a new CMS report hiding in plain sight:

New CMS data, quietly released in late August, show about 178,000 consumers chose a qualified health plan (QHP) through a state or federal exchanges after losing Medicaid and CHIP coverage in the first two months of the Medicaid unwinding. Those sign-ups through the end of May are more than three times the 54,000 enrollments that CMS reported in July, which reflected only the April numbers.

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