CBO releases report on bipartisan ACA stabilization plan

On October 25, 2017, the Congressional Budget Office (CBO) released a report on the Bipartisan Health Care Stabilization Act of 2017, which is now under consideration within the Senate Committee on Health, Education, Labor, and Pensions. The new legislation would offer additional flexibility under the state innovation waiver process, appropriate funding for cost-sharing reductions (CSRs), require some insurers to pay rebates on premiums for 2018, allow more individuals to purchase high-deductible plans, and require Federal support for outreach and enrollment activities. [More]

HHS estimates 22 percent increase in 2017 ACA premiums

On October 24, 2016, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Planning and Evaluation (ASPE), issued a report estimating that premiums for health plans offered through health insurance Exchanges will be about 22 percent higher on average for 2017 than they were for 2016. That estimate is based on ASPE’s comparison of 2017 to 2016 premiums for 38 states using the HealthCare.gov (Federal Exchange) website in both years, as well as state-reported premium data made available to ASPE by four states and the District of Columbia, representing 60 percent of consumers enrolled in State-based Exchanges (SBEs). [More]

Current state of CMS quality rating programs

For Marketplace plans, quality is coming to the forefront as Quality Rating System (QRS) and Quality Improvement Strategy (QIS) requirements are rolled out for Qualified Health Plans (QHPs) starting in 2017. In short, pending the approval of proposed regulations, the following changes are coming for 2017:
• CMS will be publicly displaying QHP quality rating information on HealthCare.gov;
• QHP issuers will be allowed to include 2016 QRS and QHP Enrollee Survey results in marketing materials;
• QHP issuers must adhere to guidelines, including the QRS Technical Guidance and User Guide for the 2017 Coverage Year, established by Federal Department of Health and Human Services in consultation with health care quality experts and stakeholders.
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HHS issues 2016 Exchange enrollment data

On November 12, 2015, the U.S. Department of Health and Human Services (HHS) issued data on the first week of the 2016 open enrollment period (November 1, 2015 – November 7, 2015) for qualified health plans (QHPs) under the Affordable Care Act (ACA). This initial “snapshot” shows that 3,180,777 persons visited the Healthcare.gov website, 1,153,270 persons completed their eligibility applications, and 543,098 eligible persons selected a QHP in the first week. [More]

HHS estimates 7.5 percent increase in 2016 Exchange premiums

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) issued a report on October 26, 2015 estimating that the cost of premiums for qualified health plans offered through health insurance Exchanges will be about 7.5 percent higher on average for 2016, compared to 2015 premiums. The HHS projections take into account premium rate filings for 37 states that will be using the HealthCare.gov website for the annual open enrollment period to be launched on November 1, 2015 for coverage beginning January 1, 2016. [More]

HHS-OIG Issues First Report on Exchange Data Security

The U.S. Department of Health and Human Services (HHS), Office of the Inspector General (OIG) issued on September 22, 2014 the first in what will be a series of reports on information security controls in federal and state-based health insurance Exchanges under the Affordable Care Act (ACA). The OIG reviews are based on HHS regulations on administrative, technical, and physical safeguards to safeguard the confidentiality, integrity, and availability of personally identifiable information (PII) obtained and used by Exchanges. The OIG reviews also apply standards developed by the National Institute of Standards and Technology (NIST) which HHS has adopted in instructions to Exchanges about steps necessary to protect PII. [More]

GAO and HHS-OIG Release Reports on Healthcare.Gov

The Government Accountability Office (GAO) and the U.S. Department of Health and Human Services (HHS), Office of the Inspector General (OIG) have released new reports on the implementation of Healthcare.Gov. The GAO’s report, entitled “Contract Planning and Oversight Practices Were Ineffective Given Challenges and Risks,” focused on one contract and two task orders which together accounted for over 40 percent of the $840 million obligated for developing Healthcare.Gov and supporting IT systems through March 2014. The GAO concluded that cost increases and delayed system functionality were due mainly to changing technical requirements and ineffective contractor oversight under cost-plus-fixed-fee contracts. [More]

DHHS Secretary Appoints First HealthCare.gov CEO

U.S. Department of Health and Human Services (DHHS) Secretary Sylvia Secretary Burwell has selected Kevin J. Counihan, who oversaw the successful launch of Connecticut’s health insurance exchange, to be the first CEO of HealthCare.gov. The New York Times has stated that Secretary Burwell made the selection “as part of an effort to improve management of the federal marketplace and to avoid the technological failures that paralyzed its website, HealthCare.gov, last fall.” [More]