CMS Releases NPRM Regarding 2016 Marketplace Benefit and Payment Parameters

CMS issued a proposed rule outlining several new provisions related to transparency and uniform standards for issuers and Marketplaces for the 2016 benefit year. The rule seeks comments on allowing Marketplace enrollees to default renew into a lower cost plan as opposed to their current plan. It also proposes enhanced public access to information about Qualified Health Plan rate increases, a requirement that issuers provide up-to-date provider directories for their plans, an alternative to the existing standards for prescription drug coverage and other essential health benefits, and streamlined SHOP administration and rules. Comments are due 30 days after the date of publication.

CMS Releases September Medicaid and CHIP Eligibility and Enrollment Report; Finds 9.1 Million New Enrollees Since October 2013

CMS’ latest Medicaid/CHIP eligibility enrollment report found that approximately 9.1 million additional individuals have enrolled in Medicaid and CHIP since October 1, 2013, when the first round of ACA Marketplace Open Enrollment began. This represents a 16% increase compared to July through September of 2013. States that have implemented Medicaid expansion have experienced a 23% increase in enrollment, compared to a 6% increase in states that have not expanded their programs.

Estimates of 2015 ACA Marketplace Premium Increases Range from 2-5%

After CMS released data on 2015 Qualified Health Plans offered on the Federally Facilitated Marketplace, multiple sources estimated that premium prices will increase between 2% and 4% next year. Kaiser Family Foundation estimates that average premiums will increase by 2% for silver-level plans and 4% for bronze-level plans. According to the Washington Post, Avalere Health found that premiums will rise between 3 and 5% and the New York Times determined that average premiums have risen by approximately 4% each year since 2007.

Obama Administration Revises Marketplace Enrollment Figures

The Obama Administration revised its estimate of Marketplace plan enrollment from 7.3 million to 6.9 million after the House Committee on Government Oversight and Reform found that 400,000 of these individuals signed up for standalone dental plans as opposed to medical Qualified Health Plans, according to the Washington Post. HHS Secretary Burwell confirmed the mistake on Twitter, and suggested it would be communicated as “unacceptable” throughout the Department. The Administration expects the enrollment number to increase to 9.1 million by the end of the 2015 Open Enrollment season.

Report Finds Large Increase in Federal Funding for Medicaid in Fiscal Year 2014

report released by the National Association of State Budget Officers found that federal funding for Medicaid increased by 17.8% in Fiscal Year 2014. State spending for the program was significantly smaller, increasing by just 2.7% during the same period. The Association concluded that the spending disparity is largely due to the influx of federal matching funds to support the ACA’s Medicaid expansion.