Open Enrollment Begins
New Medicaid HCBS Advocacy Tool
Home and Community-Based Services (HCBS) will need to be defended in every state this coming year as states balance their Medicaid budgets. Advocates can stay current on the most recent developments impacting HCBS in their state through a new resource from the Hirsh Health Law and Policy Program at George Washington University and the Human Services Research Institute.
The MAP-It: HCBS Policy Map project allows you to follow proposed and implemented Medicaid changes in every state. This map features an accessible user guide to help people gather the information they need from this resource to take action in their state. These resources are part of the HCBS Impacts Tracker Project, and aim to support community and state advocacy to increase and protect access to HCBS.
ACA Marketplace Open Enrollment Begins
This marks the first week that people nationwide can sign up for health insurance on the ACA Marketplace. Affordability is just one area that consumers might be thinking about heading into the enrollment season. Some people who used to receive subsidies are no longer eligible. This includes any individual making over $63,840 annually, or families of four with incomes at $132,000 per year. Make sure to review some of the recent changes that shoppers need to know, compiled by KFF, and remind people to use the Health Insurance Marketplace Calculator to estimate anticipated subsidies and monthly premiums for the year. You can refresh on some Frequently Asked Questions about the ACA Marketplace, including:
- What are premium tax credits and how do they work?
- How much can I earn and qualify for premium tax credits in the Marketplace?
- What income is counted in determining my eligibility for premium tax credits?
- Who is eligible for Marketplace premium tax credits?
- Can I buy health insurance outside of the Marketplace that meets all ACA consumer protection standards?
- What happens if I want to quit a Marketplace health plan during the year?
The Commonwealth Fund tracked rates of uninsurance and access to care over the last three years in a new report. This will be a challenging year for people enrolling in insurance, as insurers are exiting the Marketplace. There will be increased premiums as well, though many people should still expect to receive subsidies to keep costs down. KFF outlined some of the major trends impacting this enrollment season.
Medicaid Work Requirements Update
Medicaid Work Requirements will be in effect starting January 1, 2027. For people with disabilities and chronic conditions, seeking an exemption from the work requirements will be important for maintaining coverage and continuity of care. Thanks to a recent court case, it will now be easier for many people to get the exemption they need.
CMS guidance on the “medical frailty” exemption to work requirements had originally restricted this exemption to people who could prove their inability to work. A federal judge has now blocked that rule. This means that people will be able to claim the exemption based on whether they have certain medical needs, including:
- Blindness or disability
- Substance use disorder
- Disabling mental disorder
- Physical, intellectual, or developmental disability that significantly impairs their ability to perform one or more activities of daily living
- Serious or complex medical condition
We will be following the status of this court case in the weeks ahead, and plan to share updates as we have more information on what’s next.
The NDNRC Newsletter is published weekly. Archives of our weekly updates are available on the NDNRC website. This newsletter is supported by the American Association on Health and Disability (AAHD). Sign up to become an AAHD member today to support ongoing projects like this.