Since 2013, Navigators have helped Americans understand their health insurance options and facilitated their enrollment in health insurance coverage through the Federally-facilitated Marketplace (FFM). As trusted community partners, their mission focuses on assisting the uninsured and other underserved communities. Navigators serve an important role in connecting communities to health coverage, including communities that historically have experienced lower access to health coverage and greater disparities in health outcomes. Entities and individuals cannot serve as Navigators without receiving federal cooperative agreement funding, authorized in the Affordable Care Act, to perform Navigator duties.
The Inflation Reduction Act of 2022 was signed into law on August 16, 2022. The new law provides meaningful financial relief for millions of people with Medicare by improving access to affordable treatments and strengthening the Medicare Program both now and in the long run. The law makes improvements to Medicare by expanding benefits, lowering drug costs, keeping prescription drug premiums stable, and improving the strength of the Medicare program. The law also extends enhanced financial help to purchase HealthCare.gov and state-based Marketplace plans and expands access to Advisory Committee on Immunization Practices (ACIP) recommended vaccines for adults with Medicaid coverage.
Last month the Centers for Medicaid & Medicaid Services (CMS) director of the Center for Consumer Information & Insurance Oversight (CCIIO...yeah, those names & acronyms just roll off the tongue, don't they?) informed the state of Georgia that they're gonna have to wait one more year before launching their own fully state-based ACA exchange (SBE) platform.
There were several reasons given for the 1-year delay, but many of them stemmed from the fact that Georgia was attempting to skip the "Federally-Facilitated" SBE phase which every other state which has made the transition to their own full state-based platform has undergone for at least one year.
While nearly 16.4 million Americans selected Qualified Health Plans (QHPs) via the federal and state ACA exchanges/marketplaces during the official 2023 Open Enrollment Period (along with an additional 1.2 million signing up for a Basic Health Plan (BHP) program in New York & Minnesota, which CMS continues to inexplicably treat as an afterthought in such reports), not all of them actually pay their first monthly premium (for January) for various reasons:
In April 2023, 94,151,768 individuals were enrolled in Medicaid and CHIP.
87,062,629 individuals were enrolled in Medicaid in April 2023, an increase of 348,055 individuals from March 2023.
7,089,139 individuals were enrolled in CHIP in April 2023, a decrease of 73,121 individuals from March 2023.
Since February 2020, enrollment in Medicaid and CHIP has increased by 23,276,699 individuals (32.8%).
Medicaid enrollment has increased by 22,982,836 individuals (35.9%).
CHIP enrollment has increased by 293,863 individuals (4.3%).
Medicaid enrollment likely increased due to the COVID-19 PHE and Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA), which started in March 2020 and ended on March 31, 2023.
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)
The Centers for Medicare & Medicaid Services’ (CMS) Office of the Actuary released projections of National Health Expenditures (NHE) and health insurance enrollment for the years 2022-2031. The report contains expected impacts from the Inflation Reduction Act (IRA), including that people with Medicare prescription drug coverage (Part D) are projected to experience lower out-of-pocket spending on prescription drugs for 2024 and beyond as several provisions from the law begin to take effect.
In February 2023, 93,373,794 individuals were enrolled in Medicaid and CHIP.
86,174,094 individuals were enrolled in Medicaid in January 2023, an increase of 291,095 individuals from January 2023.
7,199,700 individuals were enrolled in CHIP in February 2023, an increase of 111,838 individuals from January 2023.
Since February 2020, enrollment in Medicaid and CHIP has increased by 22,723,554 individuals (32.2%).
Medicaid enrollment has increased by 22,369,004 individuals (35.1%).
CHIP enrollment has increased by 354,550 individuals (5.2%).
The Medicaid enrollment increases are likely driven by COVID-19 and the continuous enrollment condition in the Families First Coronavirus Response Act (FFCRA).
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.
