2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Charles Gaba's blog

Starting today, November 1st, the Seventh Annual ACA Open Enrollment Period is upon us! As I do every year, here's a list of important things to remember when selecting a health insurance policy. Some of these are the same every year and apply nationwide; others are specific to the 2020 enrollment period and/or to particular states.

1. DON'T MISS THE DEADLINE!

California actually launched Open Enrollment for 2020 on October 15th, but for the other 49 states (+DC) it starts on November 1st. The deadline for Open Enrollment is December 15th in most states for coverage starting January 1st, 2020, but eight states which operate their own ACA exchanges have extended deadlines:

Moments ago, Covered California, the nation's largest state-based ACA exchange, released data via a media teleconference regarding the 2020 Open Enrollment Period.

In addition to being the largest ACA exchange after HealthCare.Gov, this info from Covered California is especially significant for the 2020 OEP due to their newly expanded/enhanced premium subsidies.

To recap: Under the ACA, financial subsidies are available to exchange enrollees earning between 100-400% of the Federal Poverty Level (FPL). That's between around $12,500 - $50,000/yr if you're a single adult, or between $25,000 - $100,000/yr for a family of four. Under the standard ACA formula, enrollees in that income range have their premiums capped at no more than around 2.0 - 9.8% of their income, on a sliding scale.

Unfortunately, this means that people earning more than 400% FPL are eligible for no financial assistance at all, a sudden drop-off known as the Subsidy Cliff.

This just in from the New York State of Health ACA exchange:

More Than 200,000 New Yorkers Enroll in a Qualified Health Plan During First Forty-One Days of the 2020 Open Enrollment Period

  • December 15 is the Deadline to Enroll for January 1 Coverage

(ALBANY, N.Y.) December 12, 2019 - NY State of Health, the state’s official health plan Marketplace today announced that as of December 11, more than 200,000 consumers have enrolled in a 2020 Qualified Health Plan (QHP) through NY State of Health, the official health plan Marketplace, outpacing enrollment in a QHP at the same period last year by approximately 7,000 enrollees. Consumers must enroll or renew by December 15 for coverage beginning January 1, 2020.

I haven't written about Utah's batcrap Medicaid expansion program in quite awhile...since last March, in fact. As a reminder, here's where things stood at the time:

Yes, that's right: Not only did they lop 50,000 people out of the loop entirely, the other 90 - 100K enrollees will also be subject to...wait for it...work requirements. Well...sort of; keep reading.

First, it looks like they'll have to apply to at least 48 employers as well. So...what, if they get hired by the first one they still have to apply with 47 more?

Note that it says "and" before the fourth item, not "or"...which means all of them will have to register online, complete a training assessment, apply to at least 48 companies and complete an online training course.

...Oh by the way, one more thing: The minimum wage in Utah is $7.25/hour.

via MNsure, Minnesota's state ACA exchange:

ST. PAUL, Minn.—With the end of MNsure's open enrollment period just under two weeks away, MNsure is reminding private health plan enrollees that there is still time to renew or change their coverage for 2020. Additionally, those who are seeking coverage for 2020 and have not yet submitted an application through MNsure can do so through December 23, 2019.

"We strongly encourage all Minnesotans to come back to MNsure.org and compare plans to ensure they are getting the best deal and the best coverage for their family," said Nate Clark, MNsure CEO. "Financial assistance to lower premium costs is available, and the majority of Minnesotans qualify."

MNsure's open enrollment period runs through December 23, 2019, eight days longer than the federal open enrollment period.

Below is a brief guide to assist Minnesotans with coverage during open enrollment:

In most states, the 2020 Open Enrollment Period deadline is midnight on Sunday, December 15th. In a few states, the deadline is as late as January 31st.

And then there's Idaho. Via Your Health Idaho, the state's ACA exchange:

Deadline to apply for 2020 health insurance is December 16
Your Health Idaho extends hours to support increased interest

BOISE, Idaho – Idahoans seeking 2020 health insurance coverage must complete their application through the state insurance exchange, Your Health Idaho, by Monday, Dec. 16. In anticipation of increased interest and high demand, Your Health Idaho is extending customer support hours through December.

Your Health Idaho will be open Monday through Friday, December 9-20, from 7 a.m. to 8 p.m. MT. Phone lines will also be open Saturday, Dec. 14, and Saturday, Dec. 21, from 10 a.m. to 4 p.m. MT.

This just in via CMS:

Effectuated Enrollment for the First Half of 2019

This report provides average monthly effectuated enrollment and premium data for the individual market Federal and State-Based Exchanges for the first six months of the 2019 plan year. The Centers for Medicare & Medicaid Services (CMS) publishes effectuated enrollment data semiannually to provide a more accurate picture of enrollment trends for the Exchanges than indicated by the number of individuals who simply selected a plan during Open Enrollment. For coverage to be considered effectuated, individuals generally must pay the first month’s premium for the plan.

So last night I whipped up a bit of a fuss on Twitter with my response to an exchange between Pete Buttigieg and Rachel Maddow:

Asked by @maddow about a McKinsey client laying off thousands of insurance company workers — and whether Buttigieg’s work played a role — Buttigieg turns it around and warns that Medicare for All advocates would end every insurance worker’s job.

— Dan Diamond (@ddiamond) December 11, 2019

Maddow: "When you did that cost & overhead assessment for Blue Cross Blue Shield of Michigan, a couple years after that, they laid off like 1,000 people. Was your work part of what led to those layoffs?

Buttigieg: " I doubt it...I don't know what happened after the time that I left, that was in 2007, when they decided to shrink in 2009. Now, what I do know is that there are some voices in the Democratic primary right now who are calling for a policy that would eliminate the job of every single American working at every single insurance company in the country."

The Week 6 HealthCare.Gov Snapshot Report from CMS should be released sometime Wednesday afternoon, covering enrollment in 38 states from Dec. 1st - 7th.

As a reminder, here's what the Week 5 report looked like (for Nov. 1st - 30th):

There are two major things to account for when comparing the two years: First, there's a day missing due to Nov. 1st falling on a Friday instead of a Thursday this year. This likely accounts for around ~120,000 of the difference. Secondly, Nevada split off from HC.gov this year, which accounts for around ~19,000 of the gap the first 3 weeks. In addition, a small portion of the difference is likely due to Idaho and Maine expanding Medicaid; exchange enrollees earning between 100-138% FPL should be tranferred over to Medicaid instead.

via the New Hampshire Insurance Dept by email:

Deadline is Approaching for Open Enrollment Sign-ups

CONCORD, NH – New Hampshire residents should be aware that the deadline to enroll in individual health insurance for 2020 is this Sunday, December 15. After this date, the only way people can enroll in an individual insurance plan is if they qualify for a special enrollment period, typically during the 60 days following certain qualifying life events. Enrollees must pay the first monthly premium by the insurance company’s due date before 2020 coverage can take effect on January 1.

"Now is the time for New Hampshire residents who need individual coverage to enroll in a health plan for next year," said Insurance Commissioner John Elias. "Only if someone has a qualifying life event such as getting married or having a baby can they change their plan during the year. If consumers still have questions about what plan is best for their needs, they should reach out to an insurance agent or an enrollment assister for help understanding their options."

On the one hand, this isn't nearly as big of a technical disaster as the HealthCare.Gov launch was in 2013, I admit.

On the other hand, only 8 million people enrolled in ACA exchange plans in the first 2013-2014 Open Enrollment Period, whereas nearly 60 million are enrolled in Medicare.

via the House Energy & Commerce Committee via email:

Bipartisan House Leaders Raise Medicare Plan Finder Concerns

  • Committee Leaders Urge CMS to Open Special Enrollment Period for Beneficiaries Who Used Plan Finder to Make Enrollment Decisions

Washington, D.C. – Bipartisan House health leaders sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma expressing concerns over reports that the Medicare Plan Finder was confusing, generated incorrect results, and inadvertently led beneficiaries to select plans with lower premiums but higher overall costs.

via the Massachusetts Health Connector:

Massachusetts Health Connector Open Enrollment Continues through January 23, Offering High-Quality and Affordable Coverage to Residents

BOSTON – December 9, 2019 – Open Enrollment for health insurance through the Massachusetts Health Connector continues through January 23, 2020, providing residents time to find affordable coverage that delivers a wide range of benefits to make it easier and less costly to get health care.

Uninsured residents have until December 23 to apply, pick a plan and make a payment in order to have coverage starting January 1, and they have until January 23 to apply for coverage starting February 1. In contrast, Open Enrollment in other states served through the federal marketplace ends as early as December 15.

Covered California and the Challenged Athletes Foundation Team Up to Promote Open Enrollment and the Dec. 15 Deadline for Coverage During All of 2020

  • While Covered California’s Open Enrollment period runs through Jan. 31, 2020, consumers must enroll by the end of Dec. 15 to have their coverage begin on Jan. 1.
  • Covered California is teaming up with the Challenged Athletes Foundation, to host a Holiday Boot Camp to promote the importance of health, fitness and the open enrollment period. 
  • The Boot Camp will be led by Paralympian, 2019 Parapan Gold Medalist and World Record Holder Scout Bassett and Nike Master Trainer Betina Gozo.
  • Californians who choose to go without coverage could face a penalty when they file their 2020 taxes.

Covered California continued its statewide open enrollment campaign by teaming up with the Challenged Athletes Foundation in San Diego for its Holiday Boot Camp on Tuesday. The event comes as Covered California alerts consumers about a critical upcoming deadline. Consumers must sign up by Dec. 15 if they want their coverage to start on Jan. 1.

For three years running, thanks to a combination of the way the ACA's premiums subsidy formula works and the Silver Loading workaround, several million low-income people are eligible for fully ACA-compliant healthcare policies which end up costing them NOTHING in premiums after federal tax credits are applied.

Here's why: Under the ACA's subsidy formula, if you earn between 100% - 400% of the Federal Poverty Line ($12,490 - $49,960/yr if you're single), you're eligible for subsidies which bring the cost of the benchmark Silver ACA plan down to between 2.06 - 9.78% of your income, on a sliding scale.

If you earn less than 200% FPL (just under $25,000), you also qualify for heavy cost sharing reduction assistance as well...but only if you enroll in a Silver plan.

So, let's suppose you earn exactly $25,000/yr (just over 200% FPL). At that income, you'd qualify for subsidies bringing the benchmark Silver down to 6.5% of your income, or $135/month. If the benchmark plan costs, $600 at full price, you'd therefore be eligible for $465/month.

 

Tuesday, December 10th, is gonna be a pretty big day for federal healthcare policy, especially in the U.S. House of Representatives.

For one thing, it's my understanding that the big Prescription Drug Bill (H.R. 3, the Lower Drug Costs Now Act) is scheduled for a floor vote on Tuesday, although it's possible that it'll be bumped until later in the week given the grumbling by the Congressional Progressive Caucus.

For another, the House Energy & Commerce Committee is holding what I'm assuming are all-day hearings on not one, not two, but nine different Universal Coverage bills, including the Big Ones: Medicare for All and Medicare for America:

HEARING ON "PROPOSALS TO ACHIEVE UNIVERSAL HEALTH CARE COVERAGE"

Date: Tuesday, December 10, 2019 - 10:30am

Pages