HHS Expands Access to Affordable Health Insurance

WASHINGTON — The U.S. Department of Health and Human Services (HHS) announced today it is implementing important measures to expand access to more affordable catastrophic health coverage through HHS’ new hardship exemption guidance. This guidance streamlines access to more affordable catastrophic coverage for consumers who are ineligible for advance payments of the premium tax credit (APTC) or cost-sharing reductions (CSRs).

Through these efforts, more Americans will be able to qualify for catastrophic health coverage based on need, beginning November 1^st with the start of open enrollment. Catastrophic plans generally have lower monthly premiums, are designed to protect consumers from very high medical costs in the event of serious illness or injury, and are required to cover three primary care visits pre-deductible. Consumers under the age of 30

Judge Partially Blocks Final Rule Affecting ACA Enrollment, Costs

A federal judge has temporarily blocked implementation of key provisions of a Trump administration rule that would impact enrollment and consumer costs in Affordable Care Act (ACA) health insurance marketplaces.

The final rule would tighten enrollment verification processes, adjust payment formulas, and change premium structures for the marketplaces. The Trump administration has said the changes would improve program integrity and reduce waste, fraud, and abuse.

The plaintiffs in a lawsuit challenging the rule, City of Columbus v. Kennedy, sought an emergency stay of eight of the rule’s provisions. On Friday, August 22, a federal district court judge in Maryland granted a nationwide stay barring the implementation of six of the provisions (the judge’s order states that the stay affects seven provisions, but this is apparently an

CMS Launches Nationwide Push to Remove Ineligible Medicaid Enrollees, Uphold Citizenship Requirements

The Centers for Medicare & Medicaid Services (CMS) today launched an oversight initiative to ensure that enrollees in Medicaid and the Children’s Health Insurance Program (CHIP) are U.S. citizens, U.S. nationals, or have a satisfactory immigration status. CMS will begin providing states with monthly enrollment reports identifying individuals whose citizenship or immigration status could not be confirmed through federal databases, including the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program.

States are responsible for reviewing cases, verifying the citizenship or immigration status of identified individuals, requesting additional documentation if needed, and taking appropriate actions when necessary, including adjusting coverage or enforcing non-citizen eligibility rules. CMS is sending the first set of reports to states today, with all states