HHS/OIG Reports Inconsistencies in Health Insurance Eligibility Data


The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), released a report on July 1, 2014 describing challenges that health insurance Exchanges/Marketplaces faced in resolving inconsistencies between self-attested data in applications to Exchanges versus data that Exchanges accessed through the Federal Data Services Hub. Resolving such inconsistencies is a critical task necessary to verify individuals’ eligibility for advance premium tax credits (APTCs) and cost-sharing reductions (CSRs) under health plans available through the Exchange. [More]

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Categories:Health and Human Services


HHS/CMS Releases Proposed Rules on Exchange Eligibility Redeterminations


The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), published proposed rules in the July 1, 2014 Federal Register on health insurance Exchange/Marketplace eligibility redeterminations and re-enrollments in health plans for 2015 and beyond. The new proposed rules would modify final rules published in 2012. They would allow more flexibility in Federal Exchanges, at HHS’ discretion, and would also allow State-based Exchanges (SBEs) to devise alternative procedures, subject to HHS approval. [More]

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Categories:Health and Human Services


Federal Court Decision Expected Soon in Challenge to Subsidies Provision of ACA


The U.S. Court of Appeals for the D.C. Circuit appears ready to issue a ruling in the case of Halbig v. Burwell, dealing with the issue of whether language in the Affordable Care Act (ACA) concerning subsidies for people in need of financial assistance to purchase health insurance coverage applies only to individuals who purchase private health insurance on STATE-RUN exchanges. The issue arises because Section 36B(b) (A) of the ACA provides, “The monthly premiums for…health plans offered in the individual market within a state…cover the taxpayer…or any dependent of the taxpayer…enrolled in through an Exchange ESTABLISHED BY THE STATE under 1311(1) of the Patient Protection and Affordable Care Act…”. [More]


Child Welfare Finance Reform Introduced in Congress


In the fall of 2013, Annie E. Casey Foundation and Casey Family Programs gathered community stakeholders and experts in the field of finance reform and child protection. Following that introduction of the finance reform discussion with leaders in the field, staff from Casey made a presentation to Congress on October 13, 2013. The finance reform proposal addressed multiple issues related to the discrepancy between child welfare practice and how states are funded or reimbursed under Title IV-E. [More]

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Exercise to Employment: Health & Wellness in TANF WTW


PCG Human Services’ Tony Ong and Deborah Joffe co-wrote an article published in the June 2014 edition of Policy & Practice magazine about PCG’s Live Well San Diego pilot program to integrate health, wellness, and exercise into the welfare-to-work (WTW) job search curriculum as a way to help engage long-term unemployed WTW participants towards employment. [More]

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CMS Announces Availability of Funding to Support Navigators in Federally-Facilitated and State Partnership Marketplaces


On June 10, 2014, CMS announced the opportunity to apply for Navigator grants in federally-facilitated and State Partnership Marketplaces. A total of $60 million will be available in 2014-2015. Navigators are intended to provide unbiased information to consumers about health insurance coverage, the Health Insurance Marketplace, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program (CHIP). [More]


Report Shows ACA Impact on Affordability, Competition, and Choice


The U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation (ASPE) released a report on June 18, 2014 showing the impact of the Affordable Care Act (ACA) on health insurance premium affordability, competition, and consumer choice for individuals who obtained coverage through federally-facilitated and State Partnership Exchanges/Marketplaces in 36 states during the 2013-2014 open enrollment period. On affordability, the report shows that individuals who selected qualified health plans (QHPs) through the Exchanges and received advance premium tax credits (APTCs) owed a net premium liability 76 percent less than the full premium. They owed on average $82 per month to the QHP, after subtracting $264 in APTCs from the $346 per month average full premium, and 46 percent of individuals owed $50 or less after the APTCs. [More]


DHHS Office Issues 10-Year Framework for Achieving Interoperable Health IT


On June 5, 2014, the US Department of Health and Human Services (DHHS) Office of the National Coordinator for Health Information Technology (ONC) released a multi-year plan for achieving an interoperable information technology (IT) infrastructure. [More]

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DHHS Announces Additional Funds to Expand Community Health Center Services


On June 3, 2014, the US Department of Health and Human Services (DHHS) announced an additional $300 million from the Affordable Care Act (ACA) for existing Health Center Program grantees under Section 330 of the Public Health Service Act. The funds are earmarked to help community health centers expand service hours, hire more medical providers, and add oral health, behavioral health, pharmacy, and vision services. [More]

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Reports Show Emerging ACA Impact on Medicaid Enrollments, Hospital Charges, and Payer Mix


The Centers for Medicare and Medicaid Services (CMS) released on June 4, 2014 a report showing that the 26 jurisdictions (25 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by April 2014 saw on average a 15.3 percent increase in Medicaid/CHIP enrollments for April 2014, as compared to their average monthly enrollments in a July – September 2013 baseline period. States which had not implemented Medicaid expansion by April 2014 saw on average a 3.3 percent increase as compared to their 2013 baselines. Total reported Medicaid/CHIP enrollments nation-wide as of April 2014 reached 65,016,775, an increase of 6,050,059 (10.3 percent) as compared to 2013 baselines. [More]

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