MARKET STABILIZATION RULES FINALIZED
Please note: The NDNRC Update is now being released on a biweekly basis. If there is major news regarding the ACA, it will be available in the news section of the NDNRC website and we may run special NDNRC Updates on the in between weeks if warranted.
Last week, CMS finalized regulations which they indicate are designed to stabilize the ACA marketplaces. The final rules establish important dates and guidelines regarding the length of next year’s open enrollment period, verification for Special Enrollment Periods (SEPs) and the role HHS will play in network adequacy rules, to name a few. To read more about these rules, check out our news item which also includes links for the CMS press release and the rules. For a more thorough discussion of the final rules, check out the blog post by Tim Jost on Health Affairs.
One of the concerns we raised in our comment letter was on the new restriction for SEPs in which consumers are prohibited from changing metal levels when enrolling a new dependent during an SEP. Specifically, we raised the issue of a child being born with a disability and the unforeseen medical costs with which the parents may now be faced. While CMS did not change the rule when it was finalized, they did provide another possible solution to this dilemma in their comments. We’ve written more about it in our blog post this week entitled “CMS Provides Guidance on New SEP Rules and Enrolling a Newborn with Special Health Care Needs.”
One of the proposals that Congress was considering as part of the ACA repeal and replace bill was changing the Medicaid program over to a per capita cap. The Commonwealth Fund has a new fact sheet out which explains how the Medicaid per capita caps work and how they would affect Medicaid beneficiaries. To download a copy of this fact sheet, click here.
The University of Washington Healthy Aging Rehabilitation Research Training Center (RRTC) has released a fact sheet for clinicians entitled “Providers Guide to Using Aging Well with the Physical Disability Factsheets.” To download a copy of this fact sheet, click here.
CMS’s Coverage-to-Care initiative has some new resources designed to help consumers better utilize their health insurance. This includes a fact sheet entitled “Manage Your Health Care Costs” and a 60 second video entitled “How to Maximize Your Health Coverage.” Other resources from the Coverage-to-Care initiative can be found on the Coverage-to-Care section of the CMS website. For more information about what people with disabilities need to know about moving from coverage to care, be sure to check out our fact sheet: “Tips for ACA Enrollees: From Coverage to Care – Persons with Disabilities.”
Last week, the Centers for Medicare & Medicaid Services (CMS) released the Eligibility Determinations and Enrollment Report from January 2017. To read the report from CMS, click here. This report can also be found on our Resources & Links page under “Enrollment Statistics.” Prior Medicaid enrollment reports from CMS, are archived on our website here. In addition, the Kaiser Family Foundation has a page with current Medicaid enrollment numbers available here.
While Congress is not actively pursuing ACA Repeal and Replace for now, there have still been discussions that it could reemerge as an issue. The NDNRC has a statement on health reform entitled “Preserve the Protections Provided by the Affordable Care Act” where we call on Congress and the Administration to protect provisions in the ACA which have benefited people with disabilities. The full statement can be found on our website, where it is also available in a PDF download, by clicking here.
Are you looking for local partners to help with outreach to the disability community? The NDNRC has Community Outreach Collaboratives (COCs) which work to increase collaborations in the community, dissemination and outreach efforts and enrollment of people with disabilities in the ACA marketplace. To find a COC, click here.
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