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Memo to the Biden Administration Transition Team
Memo to the Biden Administration Transition Team From: Trish Riley, National Academy for State Health Policy Executive Director Re: State-based marketplace strategies for insurance market stabilization and improvement Nov. 20, 2020 The National Academy for State Health Policy (NASHP), in close consultation with executives from state-based health insurance marketplaces (SBMs), has developed a list of priority actions that may: ● Lower costs and bring stability to individual and small group health insurance markets; ● Improve access to health insurance coverage; and/or ● Improve consumer experience when purchasing small group or individual market coverage. NASHP is home to the State Health Exchange Leadership Network, a consortium of state leaders and staff dedicated to operation of the SBMs. This list draws upon the experience of SBM leaders who have spent the past decade building and operating successful platforms for the procurement of health insurance coverage. These recommendations reflect NASHP’s collective discussions with SBM leaders, but do not reflect consensus across all SBMs. States value flexibility to design their programs to meet local needs and circumstances. For additional information specific to each state, please see Appendix A, which includes references to comments submitted by SBMs in response to various policy changes. We have also included the contact information for SBM executives who can provide additional information specific to their states. NASHP is ready to provide any additional information that may be helpful as you deliberate critically important issues related to health care coverage. Thank you for your time and consideration. Sincerely, Trish Riley Executive Director National Academy for State Health Policy 2 Monument Square, Suite 910, Portland ME 04101 1233 20th St NW, Suite 303, Washington, DC 20036 Phone: (207) 837-4815 State-Based Marketplace Recommended Areas for Priority Administrative Action in 2021 I. -
1-800-760-5095 Or Listen Via Web
State of Implementation Webinar Series! Call-in to listen: 1-800-760-5095 Or listen via web Follow us on! Twitter for live ! updates:! @statereforum! #Enrollment2014! State of Implementation Webinar Series! Enrollment 1.0: State Reflections ! Call-in #: 1-800-760-5095! on ACA’s First Year and What’s Next! Follow us on Twitter for ! live updates: ! July 22, 2014, 2:00-3:30 p.m. Eastern! @statereforum ! #Enrollment2014! ! Agenda 2:00-2:05 p.m. ! Introduction! •" Anne Gauthier, Director, State Health Exchange Leadership Network and Senior Program Director, National Academy for State Health Policy! 2:05– 2:20 p.m.! Surfacing State Enrollment Experience and Innovation from Year 1 of the ACA! •" Alice Weiss, Director, Enrollment 2014 Project and Program Director, National Academy for State Health Policy! 2:20–3:00 p.m.! Implementation Insights from the States! Moderator: ! •" Anne Gauthier, NASHP! Panelists:! •" Carrie Banahan, Kentucky! •" Christina Goe, Montana! •" Nathan Johnson, Washington! 3:00–3:25 p.m.! Question and Answer! *Use the chat feature to submit your questions! 3:25-3:30 p.m. ! Wrap-up! Surfacing State Enrollment Experience and Innovation From Year 1 of the ACA Alice Weiss! Director, Enrollment 2014 Project! Program Director! National Academy for State Health Policy (NASHP)! Enrollment 2014 ¨" Project Goal: surface state enrollment and retention lessons and promising practices from first year of ACA implementation to promote spread and rapid learning ¨" Two Components: ¤" 1. Research: Key Informant Interviews with 10 States -
The Kentucky Marketplace's Internal Controls Were Generally Effective In
Department of Health and Human Services OFFICE OF INSPECTOR GENERAL THE KENTUCKY MARKETPLACE’S INTERNAL CONTROLS WERE GENERALLY EFFECTIVE IN ENSURING THAT INDIVIDUALS WERE ENROLLED IN QUALIFIED HEALTH PLANS ACCORDING TO FEDERAL REQUIREMENTS Inquiries about this report may be addressed to the Office of Public Affairs at [email protected]. Daniel R. Levinson Inspector General October 2015 A-04-14-08036 Office of Inspector General http://oig.hhs.gov The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, as amended, is to protect the integrity of the Department of Health and Human Services (HHS) programs, as well as the health and welfare of beneficiaries served by those programs. This statutory mission is carried out through a nationwide network of audits, investigations, and inspections conducted by the following operating components: Office of Audit Services The Office of Audit Services (OAS) provides auditing services for HHS, either by conducting audits with its own audit resources or by overseeing audit work done by others. Audits examine the performance of HHS programs and/or its grantees and contractors in carrying out their respective responsibilities and are intended to provide independent assessments of HHS programs and operations. These assessments help reduce waste, abuse, and mismanagement and promote economy and efficiency throughout HHS. Office of Evaluation and Inspections The Office of Evaluation and Inspections (OEI) conducts national evaluations to provide HHS, Congress, and the public with timely, useful, and reliable information on significant issues. These evaluations focus on preventing fraud, waste, or abuse and promoting economy, efficiency, and effectiveness of departmental programs. -
Implementing an Integrated Healthcare System in Kentucky
Implementing an Integrated Healthcare System in Kentucky Kentucky Public Health Leadership Institute Scholars: Leslie Aitken; BBA, CPA Director of Administrative Services; Clark County Health Department Anne Hatton; RN Clinic Nurse Administrator; Clark County Health Department Olivia Whitman; MPH Community Health Development Coordinator; Clark County Health Department Mentor(s): April Harris; M.P.H., CHES Deputy Director/Accreditation and QI Coordinator; Three Rivers District Health Department EXECUTIVE SUMMARY: Currently, the U.S. is ranked 1st in healthcare spending and 26th in life expectancy among OECD countries and life expectancy in Kentucky is below the U.S. national average.1 The Affordable Care Act (ACA), which was signed into law in March of 2010, included comprehensive health insurance reforms aimed at increasing the quality of healthcare services provided and decreasing the cost of healthcare.2,3 In 2014 the rollout of Kynect, Kentucky’s official marketplace for insurance under ACA, resulted in the second largest decrease in the uninsured rate in the country.3 To-date approximately only 11% of Kentuckians are uninsured yet, Kentucky still ranks 44th in the nation in terms of health outcomes.4 The following paper reviews the potential barriers to receiving healthcare, along with the five model types of integrated healthcare systems and the features of each that could alleviate some of those barriers. INTRODUCTION/BACKGROUND: In the United States 17.5% of the Gross Domestic Product (GDP) is spent on healthcare, which is about $3.0 trillion dollars as a nation, and $9,523 per person.5 However, the current life expectancy of an American is, only, approximately 76 years of age for males and 81 years of age for females.1 Currently, the U.S. -
Kentucky Health Cooperative Guide to Using Your Health Insurance Plan
KENTUCKY HEALTH COOPERATIVE, INC. THE WAIT IS OVER! I HAVE HEALTH INSURANCE. NOW WHAT? A Guide to Using Your Health Insurance Plan Brought to You By Kentucky Health Cooperative, Inc. 1-855-687-5942 #KYHC #GetHealthyKy www.mykyhc.org CONGRATULATIONS ON YOUR HEALTH PLAN DECISION! This booklet may provide new information about your health insurance plan. Or, it may serve as a refresher. Either way, we hope you fi nd it helpful. Note: Examples in this guide do not refl ect specifi c plans. If you are a Kentucky Health Cooperative plan member, please contact your agent with questions. Or, you may call Member Services at 1-855-687-5942 for details about costs and features of plans. NOTES ABOUT MY PLAN Year: _______________________________________________________________ Effective Date: ______________________________________________________ Premium Due Date: __________________________________________________ Name/Phone Number, Email Address of Insurance Agent, kynector, or Other Person Who Helped Me: ________________________________________ ____________________________________________________________________ The Name of My Plan Is: _____________________________________________ My Member ID: _____________________________________________________ My Primary Care Provider Is: _________________________________________ Phone number: ______________________________________________________ My Provider’s Website URL: __________________________________________ My Specialists: ______________________________________________________ ____________________________________________________________________ -
Health Insurance Marketplace
TAX YEAR 2021 Health Care Reform Health Insurance Marketplace Norman M. Golden, EA 1900 South Norfolk Street, Suite 218 San Mateo, CA 94403-1172 (650) 212-1040 [email protected] Health Insurance Marketplace • Mental health and substance use disorder services, in- cluding behavioral health treatment (this includes coun- The Health Insurance Marketplace helps uninsured people seling and psychotherapy). find health coverage. When you fill out the Marketplace ap- • Prescription drugs. plication online the website will tell you if you qualify for: • Rehabilitative and habilitative services and devices (ser- • Private health insurance plans. The site will tell you vices and devices to help people with injuries, disabili- whether you qualify for lower costs based on your house- ties, or chronic conditions gain or recover mental and hold size and income. Plans cover essential health ben- physical skills). efits, pre-existing conditions, and preventive care. If you • Laboratory services. do not qualify for lower costs, you can still use the Mar- • Preventive and wellness services and chronic disease ketplace to buy insurance at the standard price. management. • Medicaid and the Children’s Health Insurance Pro- • Pediatric services, including oral and vision care. gram (CHIP). These programs provide coverage to mil- lions of families with limited income. If it looks like you Essential health benefits are minimum requirements for all qualify, the exchange will share information with your Marketplace plans. Specific services covered in each broad state agency and they’ll contact you. Many but not all benefit category can vary based on your state’s require- states have expanded Medicaid to cover more people. -
Subsidized Health Coverage Through Mnsure
INFORMATION BRIEF Research Department Minnesota House of Representatives 600 State Office Building St. Paul, MN 55155 Randall Chun, Legislative Analyst 651-296-8639 Updated: October 2018 Subsidized Health Coverage through MNsure MNsure, the state’s health insurance exchange, was established by the 2013 Legislature as part of implementation of the Affordable Care Act (ACA). Individuals who are not eligible for Medical Assistance (MA) or MinnesotaCare, with incomes that do not exceed specified guidelines, may be eligible for premium tax credits and cost-sharing reductions to purchase health coverage on a subsidized basis through MNsure. This information brief describes eligibility, covered services, enrollee premiums and cost-sharing, and other aspects of subsidized coverage available through MNsure. Contents Availability of Coverage through MNsure ...................................................... 2 Qualified Health Plan Coverage ...................................................................... 3 Subsidies for the Purchase of Qualified Health Plans ..................................... 5 Enrollment Statistics ...................................................................................... 11 Copies of this publication may be obtained by calling 651-296-6753. This document can be made available in alternative formats for people with disabilities by calling 651-296-6753 or the Minnesota State Relay Service at 711 or 1-800-627-3529 (TTY). Many House Research Department publications are also available on the Internet at: www.house.mn/hrd/. House Research Department Updated: October 2018 Subsidized Health Coverage through MNsure Page 2 Availability of Coverage through MNsure Establishment and Role of MNsure MNsure, the state’s health insurance exchange, was established by the 2013 Legislature as part of implementation of the federal Affordable Care Act (ACA). MNsure was established as a state board and is governed by a seven-member board of directors (see Minn. -
Consumer Decisionmaking in the Health Care Marketplace
Research Report Consumer Decisionmaking in the Health Care Marketplace Erin Audrey Taylor, Katherine Grace Carman, Andrea Lopez, Ashley N. Muchow, Parisa Roshan, Christine Eibner C O R P O R A T I O N For more information on this publication, visit www.rand.org/t/rr1567 Library of Congress Cataloging-in-Publication Data is available for this publication. ISBN: 978-0-8330-9505-3 Published by the RAND Corporation, Santa Monica, Calif. © Copyright 2016 RAND Corporation R® is a registered trademark. Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.html. The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org Preface For this report, researchers conducted a literature review to better understand how consumers make choices about health insurance enrollment and to assess how website design can influence choice when consumers select plans online. -
SBM-FP Transition Planning State-Based Marketplace on The
IJC on Health, Welfare, and Family Services October 28, 2020 Cabinet for Health and Family Services Eric Friedlander, Secretary Carrie Banahan, Deputy Secretary 2 . kynect Self Service Portal (SSP) portal was launched on October 5, 2020 . Provides a common platform to access kynect benefits, kynect resources, and kynect health coverage . Redesigned look and feel for increased access and a new mobile design . State Based Exchange was not included in the design of the new kynect SSP 3 Through kynect benefits, residents can check their eligibility and apply for the following Commonwealth’s benefit programs: Food Assistance – Supplemental Nutrition Assistance Program (SNAP) Financial Assistance – Kentucky Transitional Assistance Program (KTAP) Health Assistance – Medicaid/Kentucky Children’s Health Insurance Program (KCHIP) and COVID-19 time-limited coverage Premium Assistance – Kentucky Integrated Health Insurance Premium Payment (KI-HIPP) Program Child Care Assistance – Child Care Assistance Program (CCAP) 4 Through kynect health coverage, residents can check their eligibility, apply for the following Commonwealth’s benefit programs, and find a kynector: Health Assistance – Medicaid/Kentucky Children’s Health Insurance Program (KCHIP) and COVID-19 time-limited coverage Premium Assistance – Kentucky Integrated Health Insurance Premium Payment (KI-HIPP) Program Qualified Health Plan (QHP) Assistance – Through the Kentucky Health Benefit Exchange (KHBE), QHPs may qualify for advance premium tax credits (APTC) and cost sharing reductions (CSR) kynector Assistance – to guide you to the right coverage 5 5 Application Statistics -Daily Averages Impactful Results 50% increase in Intakes from kynect benefits in comparison to the benefind daily average in 2020 23% increase in RACs from kynect benefits in comparison to the benefind daily average in 2020 112% increase Document 5ploads from kynect benefits in comparison to the benefind daily average in 2020 Note – The daily average for .Net SSP is based on usage between Jan – Oct 2020. -
U.S. House of Representatives Committee on Energy and Commerce
U.S. HOUSE OF REPRESENTATIVES COMMITTEE ON ENERGY AND COMMERCE September 25, 2015 TO: Members, Subcommittee on Oversight and Investigations FROM: Committee Majority Staff RE: Hearing entitled “An Overdue Checkup: Examining the ACA's State Insurance Marketplaces.” On September 29, 2015, at 10:00 a.m. in 2123 Rayburn House Office Building, the Subcommittee on Oversight and Investigations will hold a hearing entitled “An Overdue Checkup: Examining the ACA's State Insurance Marketplaces.” Section 1311 of the Affordable Care Act provided funding assistance to the States to help them establish their own health insurance exchanges. The Federal government granted States at least $5.51 billion toward this effort. By law, the State exchanges were supposed to be self- sustaining—that is, have a funding source other than Federal grant dollars—by January 1, 2015. Despite this multi-billion dollar investment, many are struggling to become self-sustaining. The Department of Health and Human Services (HHS) Office of Inspector General (OIG) alerted the Centers for Medicare and Medicaid Services (CMS) that these faltering State exchanges may be using establishment grants to help cover operational costs. With growing maintenance costs and lower than expected enrollment numbers, States are weighing their options, including shutting down their exchanges and migrating to the Federal system. The Subcommittee is conducting oversight to understand the sustainability challenges State exchanges are facing. The hearing also will examine how Federal establishment grant dollars were spent. I. WITNESSES Peter V. Lee, Executive Director, Covered California, State of California; Jim Wadleigh, Jr., Chief Executive Officer, Access Health CT, State of Connecticut; Jeff M. -
Public Education, Outreach and Application Assistance
ACA Implementation—Monitoring and Tracking Public Education, Outreach and Application Assistance December 2014 Stan Dorn The Urban Institute With support from the Robert Wood Johnson Foundation (RWJF), the Urban Institute is undertaking a comprehensive monitoring and tracking project to examine the implementation and effects of the Patient Protection and Affordable Care Act of 2010 (ACA). The project began in May 2011 and will take place over several years. The Urban Institute will document changes to the implementation of national health reform to help states, researchers and policymakers learn from the process as it unfolds. This report is one of a series of papers focusing on particular implementation issues in case study states. Reports that have been prepared as part of this ongoing project can be found at www.rwjf.org and www.healthpolicycenter.org. The quantitative component of the project is producing analyses of the effects of the ACA on coverage, health expenditures, affordability, access and premiums in the states and nationally. For more information about the Robert Wood Johnson Foundation’s work on coverage, visit www.rwjf.org/coverage. EXECUTIVE SUMMARY This analysis of public education and application assistance messages, the ACA’s many complications, and uninsured during the 2014 open enrollment period is based primarily on consumers’ unfamiliarity with basic health insurance concepts, many state-level informants supported limiting • results from the Health Reform Monitoring Survey public education to simple messages that drove consumers (HRMS), a quarterly national survey of the nonelderly to seek more specific information. population; and • interviews in 24 states with diverse informants— However, according to HRMS data, 61 percent of policy-makers, consumer advocacy groups, navigators, surveyed adults who remained uninsured in June 2014 application assisters, insurance brokers and agents— had heard “little” or “nothing” about subsidies to help pay conducted by researchers from the Urban Institute and for marketplace coverage. -
Kynect Benefits Information
Frequently Asked Questions Table of Contents General kynect benefits Information .................................................................................................................................. 4 Q1. What is kynect benefits? .................................................................................................................................. 4 Q2. How do each of the kynect benefits programs assist Kentuckians? .................................................. 4 Q3. Who is using kynect benefits? ........................................................................................................................ 4 Q4. What languages are available in kynect benefits? ................................................................................. 4 Q5. Why was I automatically logged out of kynect benefits? ...................................................................... 4 Q6. What can I access from the kynect benefits footer?................................................................................ 4 Kentucky Online Gateway ....................................................................................................................................................... 5 Q7. What is the Kentucky Online Gateway? ...................................................................................................... 5 Q8. Does every kynect benefits resident need a KOG account? ................................................................... 5 Q9. Can I reset my KOG password?......................................................................................................................