State-Based Exchanges

Back in February, I wrote about how the state of Georgia, in an eyebrow-raising move, announced that they were moving from the federal ACA exchange (HealthCare.Gov) onto their own state-based ACA exchange.

While numerous other states have already done the same thing (and several more are in the process of doing so as well), Georgia's move to their own enrollment platform was especially noteworthy for two reasons:

First, because it represents as complete 180-degree policy turn from their prior attempts (over the course of several years) to eliminate any formal ACA exchange (federal or state-based) in favor of outsourcing it to private insurance carriers & 3rd-party web brokers.

Secondly, because of the timeframe involved:

Back in February, I wrote about how the state of Georgia, in an eyebrow-raising move, announced that they were moving from the federal ACA exchange (HealthCare.Gov) onto their own state-based ACA exchange.

While numerous other states have already done the same thing (and several more are in the process of doing so as well), Georgia's move to their own enrollment platform was especially noteworthy for two reasons:

First, because it represents as complete 180-degree turn from their prior attempts (over the course of several years) to eliminate any formal ACA exchange (federal or state-based) in favor of outsourcing it to private insurance carriers & 3rd-party web brokers.

Secondly, because of the timeframe involved:

I wrote about Illinois House Bill 579 back in March:

...With the recent trend of more & more states (most recently including Georgia) splitting off from the Federally Facilitated Marketplace (FFM) hosted via HealthCare.Gov, it's hardly surprising...but it's still a pretty big deal, especially given that Illinois is the 6th largest U.S. state by population. Via Amy Lotven of Inside Health Policy:

Illinois’ Department of Insurance would be authorized to operate a state-based exchange, starting in plan year 2026, under legislation introduced late Thursday by the Illinois Democratic House Majority Leader Robyn Gabel. Sources earlier this week told IHP they had heard state officials were working with lawmakers on exchange legislation and the bill could be unveiled by this week.

In February, I wrote about how the state of Georgia, in an eyebrow-raising move, announced that they were moving from the federal ACA exchange (HealthCare.Gov) onto their own state-based ACA exchange.

While numerous other states have already done the same thing (and several more are in the process of doing so as well), Georgia's move to their own enrollment platform was especially noteworthy for two reasons:

First, because it represents as complete 180-degree turn from their prior attempts (over the course of several years) to eliminate any formal ACA exchange (federal or state-based) in favor of outsourcing it to private insurance carriers & 3rd-party web brokers.

Secondly, because of the timeframe involved:

4/01/23: See important update at bottom.

Back in early February, I wrote:

If this was any other state besides Georgia--even any other GOP-controlled state--I'd say good for them since it would presumably just mean that they were the latest state to move to their own state-based exchange (which is how the ACA was originally envisioned anyway).

This would give them the ability to hook the SBM into their state databases for auto-enrolling residents receiving SNAP benefits/etc into $0-premium coverage, or to integrate supplemental subsidies as nearly a dozen states do today, and so forth. There's several upsides to moving to an SBM, up to & including reducing the user fees (although those have been significantly reduced on the federal exchange in recent years anyway).

I had heard that this was in the works, and with the recent trend of more & more states (most recently including Georgia) splitting off from the Federally Facilitated Marketplace (FFM) hosted via HealthCare.Gov, it's hardly surprising...but it's still a pretty big deal, especially given that Illinois is the 6th largest U.S. state by population. Via Amy Lotven of Inside Health Policy:

Illinois’ Department of Insurance would be authorized to operate a state-based exchange, starting in plan year 2026, under legislation introduced late Thursday by the Illinois Democratic House Majority Leader Robyn Gabel. Sources earlier this week told IHP they had heard state officials were working with lawmakers on exchange legislation and the bill could be unveiled by this week.

It's particularly embarrassing for me to not have had this development on my radar seeing how I'm a life-long Michigander who also personally knows at least two of the state legislators onboard. Regardless, this is pretty exciting news from a healthcare policy wonk perspective:

The Michigan Legislature is considering joining the 18 other states that have established state-run health insurance marketplaces through HB 6112. Having an exchange run by the state instead of the federal government, supporters of the bill say, will save Michiganders money by leaving the “rigid and inflexible” federal market for a Michigan-tailored market that can be more responsive and potentially lower premiums. The bill is still in the early days of the legislative process, awaiting a vote from the House Health Policy Committee.

Sure enough, from last week:

via the New Jersey Dept. of Banking & Insurance:

NJ DOBI Announces Grant Opportunity for Navigators to Assist New Jerseyans With Health Insurance Enrollment

• Open Enrollment Period at Get Covered New Jersey Begins November 1, 2021

TRENTON – The New Jersey Department of Banking and Insurance today announced it is now accepting applications for community organizations to serve as Navigators to assist residents with health insurance enrollment for the upcoming Open Enrollment Period and during 2022. The department is making available a total of $4 million in grant funding for Navigators, in an effort to ensure enrollment assistance is available in the community for residents seeking coverage through Get Covered New Jersey, the state’s official health insurance marketplace, during the Open Enrollment Period that starts November 1, 2021 and through the year.

I'm gonna be posting mea culpas for a few days for missing important ACA-related announcements over the past few weeks.

This press release from the New Jersey Dept. of Banking & Insurance came out a few days ago but it's still relevant since NJ is one of a handful of states which have extended their 2021 "No Excuse Needed" Special Enrollment Period out beyond August 15th:

Murphy Administration Officials Encourage Residents Without Health Insurance, Who Received Unemployment Benefits in 2021, to Get Covered

TRENTON – New Jersey Department of Banking and Insurance Commissioner Marlene Caride issued the following statement on the U.S. Supreme Court decision today upholding the Affordable Care Act by a 7-2 vote: 

“Today’s Supreme Court decision is a victory for millions of Americans and New Jerseyans who have access to quality, affordable health insurance as a result of the Affordable Care Act.

“Under Governor Murphy’s leadership, New Jersey has led the way in increasing access to health insurance based on the guiding principle that health care is a fundamental right. New Jersey launched its own state-based health insurance exchange, Get Covered New Jersey, and provided state-level subsidies to increase access and affordability of health coverage and care for our residents, and enrollment increased by nearly 10 percent during our first Open Enrollment Period. Nearly 40,000 residents have signed up for health insurance during the Special Enrollment Period opened by the state on February 1 in response to COVID-19.