In this article Open enrollment start dates would be standardized in state exchanges Special enrollment period effective dates would be standardized It would be easier for states to add to their essential health benefit requirements States would be allowed to add adult dental to essential health benefits The low-income special enrollment period would become permanent Marketplace plans could be terminated retroactively if an enrollee is eligible for backdated Medicare The federal government has proposed a wide range of health insurance rule changes for 2025 and – if approved – they’re likely ..read more

On January 8, Olympic gymnast Mary Lou Retton attracted national attention and an outpouring of support when she appeared on the Today Show, explaining the health scare she faced in the fall of 2023. Retton recounted how she fell gravely ill with a rare form of pneumonia and – because she couldn’t afford health insurance – faced thousands of dollars in hospital bills. The story fortunately has a happy ending: Retton was discharged from the hospital after about a month, and is recovering at home. And her daughters had organized a fundraiser that raised more than $459,000 in contributions. The f ..read more

In this article: The Biden administration’s proposed changes State regulatory flexibility regarding short-term plans Current state limits on duration of short-term The path to current short-term federal rules Since 2018, federal rules have made it possible for consumers in many states to buy short-term, limited-duration insurance (STLDI) and keep that coverage for as long as three years, including renewals and extensions. (States can set their own more stringent rules, which is why these rules don’t apply nationwide.) But a rule proposed by the Biden administration in July 2023 would signif ..read more

In this article How many people have been disenrolled from Medicaid? Most disenrollments due to procedural reasons CMS pauses procedural enrollments in 29 states and DC How many people have transitioned from Medicaid to Marketplace coverage? Subsidies for Medicaid beneficiaries transitioning to coverage on the Marketplace Special enrollment in the Marketplace for those disenrolled What should current enrollees expect as Medicaid redetermination continues? Medicaid disenrollments resumed several months ago (in April, May, June, or July, depending on the state), and the process is proceeding ..read more

The Affordable Care Act (ACA) has faced numerous legal challenges, but has been upheld three times by the Supreme Court. Over the years, the headlines surrounding the possibility of the ACA (aka Obamacare) being overturned have often focused on people with pre-existing conditions who buy their own health insurance. (This is certainly a valid concern, as those individuals would undoubtedly be worse off without the ACA.) But the impact of the ACA goes well beyond securing access to healthcare for people with pre-existing conditions. Who are these Americans, whose lives are better off, thanks to ..read more

South Dakota is the 39th state to expand Medicaid eligibility to cover low-income adults, with coverage that could take effect as early as July 1. Applications were accepted starting June 1, and enrollment continues year-round. What are the new Medicaid eligibility guidelines after expansion? South Dakota’s Medicaid expansion makes coverage available to many low-income adults who weren’t previously eligible and now meet eligibility criteria. This includes adults who: Are under age 65. Have a household income up to 138% of the poverty level. (For a single person, that’s $20,120 in 2023; for a ..read more

Friday Health Plans, which offers coverage in five states, is winding down its business operations. And in at least three of those states, thousands of enrollees need to select new plans in the coming weeks to avoid becoming uninsured. Friday Health Plans of Georgia has been placed into receivership, and its health policies will terminate on July 31, 2023. Friday Health Plans of Oklahoma and Friday Health Plans of North Carolina have also been placed into receivership, with coverage ending on August 31, 2023. Enrollees will need to continue paying their Friday Health Plans premiums through tho ..read more

Jump to Can I reapply for Medicaid after my coverage is terminated? What are my coverage options if I’m losing Medicaid? What if I can’t afford health insurance and don’t qualify for Medicaid? Does it matter what state I’m in? If I’m losing Medicaid eligibility, what happens to my child’s coverage? I’m not sure if I’ll lose my coverage. How do I check Medicaid eligibility? If you’ve received notification that you’re losing Medicaid eligibility, you’re certainly not alone. Millions of Americans will get similar notices in 2023 and 2024, now that states are once again disenrolling people from ..read more

Topics covered in this article Why it’s important to have awareness of the coverage you’re likely to get at different income levels Key income break points that will determine what you pay for coverage How income estimates impact coverage eligibility In case you missed it during a frenzied election season, the annual open enrollment period for ACA marketplace plans (which are  ACA-compliant health coverage) in 2023 kicked off on November 1. You may also have missed that last year, the American Rescue Plan Act made coverage in private plans sold in the ACA marketplace far more affordabl ..read more

Key takeaways ACA open enrollment will look mostly familiar this fall. Open enrollment dates and deadlines for 2023 plans Insurers entering and leaving individual and family markets The ‘family glitch’ fix will help some buyers. How are ACA premiums changing for 2023? You can start doing your plan shopping research now. The tenth annual open enrollment for ACA-compliant individual/family health coverage is just around the corner. It starts November 1, and will continue through January 15 in most states. Millions of Americans will enroll or renew their coverage for 2023 during open enrollmen ..read more