The Massachusetts Health Connector Board of Directors voted on Thursday, May 11, to ensure that health insurance plans used by five million Commonwealth residents to meet the state’s individual mandate continue to deliver high-value preventive services at no cost to consumers. This vote follows a March 2023 decision by a federal District Court in Texas to limit the scope of preventive services covered under the Affordable Care Act.
The proposed regulation amendments guarantee that Massachusetts residents with health insurance plans meeting state Minimum Creditable Coverage (MCC) standards will continue to receive key preventive services like cancer screenings, HIV prevention, and cholesterol-lowering medication without cost-sharing. These proposed regulation amendments protect coverage standards that are current practice in the Commonwealth.
FDA Finalizes Move to Recommend Individual Risk Assessment to Determine Eligibility for Blood Donations
Today, the U.S. Food and Drug Administration finalized recommendations for assessing blood donor eligibility using a set of individual risk-based questions to reduce the risk of transfusion-transmitted HIV. These questions will be the same for every donor, regardless of sexual orientation, sex or gender. Blood establishments may now implement these recommendations by revising their donor history questionnaires and procedures.
This updated policy is based on the best available scientific evidence and is in line with policies in place in countries like the United Kingdom and Canada. It will potentially expand the number of people eligible to donate blood, while also maintaining the appropriate safeguards to protect the safety of the blood supply.
An FDA advisory panel on Wednesday unanimously endorsed making daily birth control pills available over-the-counter for the first time, following two days of deliberations over whether patient misuse could lead to more unintended pregnancies.
Why it matters: If the FDA follows the recommendation and switches HRA Pharma's Opill away from prescription-only use, it could expand the availability of contraception and deepen partisan rifts over reproductive health in the post-Roe landscape.
HRA Pharma, part of consumer products giant Perrigo, expects a final decision from the FDA to come at some point this summer.
Driving the news: In a 17-0 vote, members of two FDA advisory committees decided that patients can properly follow Opill's labeling instructions — including taking the pill at around the same time every day — without consulting with a health provider.
New Opportunity To Enroll Through MNsure for Minnesotans With Unaffordable Job-Based Family Health Insurance
Special enrollment period open through October 31, 2023
ST. PAUL, Minn.—MNsure, Minnesota’s health insurance marketplace, is offering a special enrollment period (SEP) for Minnesotans who are currently enrolled in unaffordable family insurance through an employer with a renewal date other than January 1.
Under a new IRS rule, related household members who are covered by a family member’s employer-sponsored health insurance may be newly eligible to receive advanced premium tax credits through MNsure that lower the cost of private health plans. As a result, some eligible household members may be able to find a better deal on health insurance by shopping for a private plan through MNsure and saving on monthly premiums with a tax credit.
New Jersey Department of Banking and Insurance Establishes Extended Special Enrollment Period at Get Covered New Jersey for Individuals Losing NJ FamilyCare Coverage
TRENTON – New Jersey Department of Banking and Insurance Commissioner Marlene Caride today announced the creation of an extended Special Enrollment Period for individuals who are no longer eligible for NJ FamilyCare and qualify for health insurance through Get Covered New Jersey, the state’s Official Health Insurance Marketplace.
Per federal law, the Department of Human Services is restarting eligibility reviews for NJ FamilyCare as of April 1, which will result in some individuals who are no longer eligible being disenrolled from the program. For those who no longer qualify for NJ FamilyCare because their income is too high, they may be eligible to obtain health coverage through Get Covered New Jersey and may be able to get help paying for premiums.
Oscar Health will exit the California individual ACA insurance market for plan year 2024 as part of a push to make its insurance business profitable.
On a May 9 call with investors, transcribed by Seeking Alpha, Oscar Health CEO Mark Bertolini said the company is exiting underperforming markets to improve its profitability.
"The company has been disciplined in managing its portfolio and improving the sustainability of our margins over time," Mr. Bertolini said.
Oscar Health plans to reenter the California market in the future, Mr. Bertolini said.
Interim CFO Sid Sankaran said the California market represents less than 5 percent of Oscar Health's membership, with around 35,000 members in the state.
This suggests that Oscar has roughly 700,000 ACA exchange enrollees nationally, FWIW.
Shapiro Administration Working With Community Organizations To Help All Pennsylvanians Amid Major Federal Changes To Medicaid Renewals
Reading, PA - Pennsylvania Department of Human Services (DHS) Acting Secretary Dr. Val Arkoosh joined representatives from the Berks Community Health Center and Pennie® today to highlight how the Shapiro Administration, Pennie, and community organizations are collaborating to support Pennsylvanians through federal changes to Medicaid and CHIP renewal requirements so they can protect their health and stay covered.
CMS will beef up its outreach strategy and scale up a pilot program that connected navigators to specific consumers who are not eligible for Medicaid but could enroll in an Affordable Care Act plan through healthcare.gov to help ensure people who lose benefits during the ‘unwinding’ maintain their coverage, according to a slide-deck from a recent webinar.
As part of the effort, healthcare.gov will send those consumers additional reminder letters about enrolling in ACA coverage, with the first batch slated to go out in mid-May, and the assisters will contact those customers shortly afterward.
HHS has estimated that about 2.7 million of the 15 million or so Medicaid beneficiaries expected to lose coverage during the redetermination may be eligible for subsidized coverage through the marketplaces.
...Well, just one day after the Bright Healthcare bombshell news broke, Texas-based health insurance broker Jenny Chumbley Hogue sounded the alarm on another large carrier bailing on Texas next year:
