Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


PPACA Enrollment Issues

The U.S. Department of Health and Human Services (HHS) indicated that the next Patient Protection and Affordable Care Act (PPACA) open enrollment period is unlikely to be extended and will begin November 15, 2014 and end on February 15, 2015. States operating their own exchanges, including Minnesota, are urging participating health insurers to disclose the premium rates for the plans they intend to offer before the start up date in an effort to assist individuals in the enrollment process. In the meantime, it is estimated by some organizations that up to 7 million adults, about 2.7 million who are uninsured, may be eligible for enrollment before the open enrollment period begins as a result of the “qualifying life event” rules allowing for special enrollment periods during the year. The increase in rates projected by a number of insurers will likely become fodder in the political debates over the PPACA leading up to the November elections. The increase in premiums may invoke a debate over legislative changes that would allow insurers to offer more affordable coverage with an actuarial value of 50% or so (that might be designated “copper” coverage). To assist consumers in the enrollment process, the Centers for Medicare and Medicaid Services (CMS) issued additional guidance on the training of “navigators” and “consumer assistance personnel” in order to become eligible to help in the upcoming enrollment season. Navigators would have to complete about 20 hours of training on such issues as: immigration and eligibility; re-enrollment; determining household income levels for premium assistance; and premium tax eligibility for individuals subject to domestic abuse.

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