Charles Gaba's blog

See my prior post about short-term, limited duration plans & their regulation history under the Obama, Trump & Biden Administrations.

via the Centers for Medicare & Medicaid Services:

Short-Term, Limited-Duration Insurance; Independent, Noncoordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance (CMS-9904-P)

Jul 07, 2023

Original story: 6/29/23:

I haven't written about #ShortAssPlans ("Short-Term, Limited Duration") healthcare policies since back in January, when it was announced that the Biden Administration would be announcing new regulations on them sometime in April 2023. Obviously that time has come and gone, but it looks like the Office of Management & Budget (OMB) is finally ready for the Centers for Medicare & Medicaid Services (CMS) to roll the new rule out:

via the Maryland Health Benefit Exchange:

MARYLAND WINS FEDERAL APPROVAL FOR “REINSURANCE” FOR ANOTHER FIVE YEARS

  • Program has helped drive down rates for Marylanders who buy their own health coverage to among the most affordable in the nation

BALTIMORE (July 5, 2023) – The Reinsurance Program that helped drive down costs for consumers who purchase their own health insurance in Maryland to among the lowest rates in the nation has been renewed for the next five years.

The U.S. Department of Health and Human Services and the Department of the Treasury informed Maryland health and insurance officials that they have approved the state’s application for the period from Dec. 31, 2023, when the current authorization expires, until Dec. 31, 2028.

Mark Farrah Associates is an electronic publisher of business information and analytics for the U.S. healthcare industry; they aggregate industry data and market metrics for their own database products that they sell on a subscription basis.

They typically release state-level breakout estimates of the total U.S. individual market once or twice a year. They haven't done so in 2023 as of yet, but today they did release this overview analysis:

A few days ago, a federal Trump-appointed district court judge in Louisiana ruled that the federal government is no longer allowed to fight disinformation online in a devastating ruling:

District Court Judge Terry Doughty, who was appointed by President Donald Trump, issued a preliminary injunction on Tuesday that bars several federal departments and agencies from various interactions with social media companies.

On Wednesday, the Justice Department filed a notice that it will appeal the injunction with the Fifth Circuit Court of Appeals in New Orleans. The government also expects to ask the court to stay the district judge's decision, meaning it would not go into effect while the appeal is heard.

Last month I posted an explainer about a situation in California which boiled down to a huge pot of extra revenue (~$330 million per year, give or take) being fought over between Governor Gavin Newsom and the Democratically-controlled State Legislature.

The bottom line is that this funding was intended to go towards reducing health insurance premiums for ACA exchange enrollees via Covered California as supplemental subsidies to be added on top of federal ACA tax credits...but the passage of the American Rescue Plan and the subsequent Inflation Reduction Act kind of made that moot, since the federal subsidies were made more generous than what the state subsidies would have been anyway.

As a result, Gov. Newsom decided that the extra revenue should go into the general state fund, while Democrats on the state legislature wanted to redirect it to eliminate deductibles and other types of cost sharing for ACA enrollees instead. This led to an impasse for the past several months:

As I wrote about back in March and updated in May, 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.

New York

via New York State of Health:

June 30, 2023

Governor Kathy Hochul today encouraged eligible New Yorkers to renew their health insurance coverage as insurance renewal deadlines rapidly approach. The Governor also issued a public service announcement to get the message out to New Yorkers.

Connecticut

via Access Health CT:

These free, in-person events will take place in Bridgeport, East Hartford, Middletown and Torrington

HARTFORD, Conn. (June 27, 2023) — Access Health CT (AHCT) today announced it will host four free, in-person enrollment fairs in July and August to help HUSKY Health enrollees who have been affected by recent legislation. The events will take place in Bridgeport, East Hartford, Middletown and Torrington. HUSKY Health is Connecticut’s Medicaid program.

Medicaid Unwinding is a term the federal government is using to describe the process of resuming reviewing households for Medicaid eligibility after a three-year hiatus during the Public Health Emergency. The eligibility redetermination process resumed April 1.

Connecticut residents that remain eligible for HUSKY Health will likely be automatically reenrolled; those that need to take action will receive mail with instructions.

Michigan

via the Michigan Dept. of Insurance & Financial Services:

(LANSING, MICH) The Michigan Department of Insurance and Financial Services (DIFS) is reminding consumers that they have the right to appeal a denial of a health insurance claim to DIFS after attempting resolution through the insurer’s appeal process. To assist Michiganders with these appeals, the state has launched a newly updated consumer website that offers more information and answers to frequently asked questions.

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