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Nearly 2.2 million Americans selected plans in the Health Insurance Marketplace from October through December
Thirty percent of those who selected plans were under age 35
Nearly 2.2 million people have selected plans from the state and federal marketplaces by Dec. 28, 2013 (the end of third reporting period for open enrollment), Health and Human Services Secretary Kathleen Sebelius announced today.
A new HHS report provides the first demographic information about enrollees. December alone accounted for nearly 1.8 million enrollees in state and federal marketplaces. Enrollment in the federal Marketplace in December was seven-fold greater than the combined total for October and November – and eight-fold greater for young adults ages 18 to 34.
“Americans are finding quality affordable coverage in the Marketplace, and best of all, because coverage began on New Year’s Day, the promise and hope of the Affordable Care Act is now a reality,” Secretary Sebelius said. “Our outreach efforts have ramped up, so whether it’s through public service announcements, events, our champions or other means, we are doing all we can to find, inform and enroll those who can benefit from the Marketplace. There is still plenty of time for you and your family to sign up in a private plan of your choice, so visit HealthCare.gov to learn more and sign up now.”
Key findings from today’s report include:
- Nearly 2.2 million (2,153,421) people selected Marketplace plans from Oct. 1 through Dec. 28, 2013
- These signups in the state and federal marketplaces represent a nearly five-fold increase from October-November, including nearly 1.8 million (1,788,739) people who selected a plan in December (compared with the previous two-month cumulative total of 364,682 through Nov. 30, 2013).
- Of the almost 2.2. million:
- 54 percent are female and 46 percent are male;
- 30 percent are age 34 and under;
- 24 percent are between the ages of 18 and 34, and;
- 60 percent selected a Silver plan, while 20 percent selected a Bronze plan; and
- 79 percent selected a plan with Financial Assistance.
Today’s report also details state-by-state information where available. In some cases, only partial datasets were available for state marketplaces.
The report features cumulative data for the three-month period because some people apply, shop, and select a plan across monthly reporting periods. Enrollment is measured as those who selected a plan.
To read the report visit: http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf
To hear stories of Americans enrolling in the Marketplace visit: http://www.hhs.gov/healthcare/facts/mystory/index.html
By Kathleen Sebelius, Secretary of Health and Human Services
Today we released our most detailed report to date about the results of the first reporting period of open enrollment in the Health Insurance Marketplace. The numbers show that interest in the Health Insurance Marketplace remains strong and the promise of quality, affordable coverage is becoming a reality for hundreds of thousands of Americans.
Between October 1 and November 2, 2013, 106,185 individuals selected plans from the Marketplace and another 975,407 applied and received an eligibility determination, but have not yet selected a plan. An additional 396,261 were determined eligible for Medicaid or the Children’s Health Insurance Program (CHIP). In total, 502,446 Americans will be positioned to have health coverage starting in 2014.
As we’ve seen in Massachusetts’s efforts to expand coverage, I expect the number of newly insured to grow substantially throughout the open enrollment period. Our efforts to improve HealthCare.gov will be critical to driving new enrollments and meeting consumer demand.
As a further indication of high consumer interest, web traffic and call center volume also continues to be very heavy. During the first reporting period, there have been over 26 million unique visitors to Marketplace websites and over 3.1 million calls to the call centers.
While we know there is still a lot of work to do to make sure every American that wants access to affordable coverage can have it, there are many encouraging takeaways from today’s report.
For the full text of the report, “Health Insurance Marketplace: November Enrollment Report,” please visit: http://aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/rpt_enrollment.pdf
Nevada has a state supported exchange, meaning we don’t need to use the national website. We can go to our own exchange website. If you don’t have employer provided insurance and will need to enroll for insurance, VISIT THE NEVADA HEALTH LINK NOW TO APPLY today.
By Salim Zymet, Digital Advisor, Department of Health and Human Services
Enrolling just a day after the Health Insurance Marketplace opened, Daniel, a 22 year old from Orlando, Florida, is one of the millions of Americans eligible for affordable health coverage through the Health Insurance Marketplace.
Daniel says he’s “thrilled” to get coverage at the price he got it, and is relieved to be covered:
“I already had health insurance, but I just wanted to see if I could do a little bit better on the marketplace, and I did. I was able to pick a much higher quality plan, and because of my income as a student, I’ll only pay about 70 bucks a month for health insurance.”
To compare plans in your area, weigh your options, and get enrolled for coverage beginning January 1st, apply on HealthCare.gov by December 15th.
There are 4 basic ways consumers can apply for and enroll in Marketplace coverage:
- Online at HealthCare.gov;
- Over the phone by calling the 24/7 customer service center (1-800-318-2596, TTY 1-855-889-4325);
- Working with a trained person in your local community (Find Local Help); or by
- Submitting a paper application through the call center or downloading a copy at marketplace.cms.gov.
Every 4 years, HHS updates its strategic plan, which describes its work to address complex, multifaceted, and ever-evolving health and human service issues. Under the Government Performance and Results Modernization Act, Federal agencies are required to consult with the Congress and to solicit and consider the views of external parties. We welcome your input on the draft HHS Strategic Plan for FY 2014-2018. The comment period will close on October 15, 2013. Comments can be submitted from the website, or in several ways:
Fax: (202) 690-8252
U.S. Department of Health and Human Services
Office of the Assistant Secretary for Planning and Evaluation
Strategic Planning Team
Attn: Strategic Plan Comments
200 Independence Avenue, SW, Room 446F.8
Washington, DC 20201
- Goal 1: Strengthen Health Care
- Goal 2: Advance Scientific Knowledge and Innovation
- Goal 3: Advance the Health, Safety, and Well-Being of the American People
- Goal 4: Ensure Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs
- Appendix A: Organizational Chart
- Appendix B: Operating and Staff Divisions and Their Functions
Today, the Department of Health and Human Services (HHS) issued a memo clarifying that all beneficiaries in private Medicare plans have access to equal coverage when it comes to care in a nursing home where their spouse lives. This is the first guidance issued by HHS in response to the recent Supreme Court ruling, which held section 3 of the Defense of Marriage Act unconstitutional.
“HHS is working swiftly to implement the Supreme Court’s decision and maximize federal recognition of same-sex spouses in HHS programs,” said HHS Secretary Kathleen Sebelius. “Today’s announcement is the first of many steps that we will be taking over the coming months to clarify the effects of the Supreme Court’s decision and to ensure that gay and lesbian married couples are treated equally under the law.”
“Today, Medicare is ensuring that all beneficiaries will have equal access to coverage in a nursing home where their spouse lives, regardless of their sexual orientation,” said Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner. “Prior to this, a beneficiary in a same-sex marriage enrolled in a Medicare Advantage plan did not have equal access to such coverage and, as a result, could have faced time away from his or her spouse or higher costs because of the way that marriage was defined for this purpose.”
Under current law, Medicare beneficiaries enrolled in a Medicare Advantage plan are entitled to care in, among certain other skilled nursing facilities (SNFs), the SNF where their spouse resides (assuming that they have met the conditions for SNF coverage in the first place, and the SNF has agreed to the payment amounts and other terms that apply to a plan network SNF). Seniors with Medicare Advantage previously may have faced the choice of receiving coverage in a nursing home away from their same-sex spouse, or dis-enrolling from the Medicare Advantage plan which would have meant paying more out-of-pocket for care in the same nursing home as their same-sex spouse.
Today’s guidance clarifies that this guarantee of coverage applies equally to all married couples. The guidance specifically clarifies that this guarantee of coverage applies equally to couples who are in a legally recognized same-sex marriage, regardless of where they live.
— by Kathleen Sebelius, Secretary of Health and Human Services
The Affordable Care Act (ACA) prohibits some of the worst insurance industry practices that have kept affordable health coverage out of reach for millions of Americans. It provides families and individuals with new protections against discriminatory rates due to pre-existing conditions, holds insurance companies accountable for how they spend your premium dollars, and prevents insurance companies from raising your insurance premium rates without accountability or transparency.
For more than a decade before the ACA health insurance premiums had risen rapidly, straining the pocketbooks of American families and businesses. Oftentimes, insurance companies were able to raise rates without explanation to consumers or public justification of their actions.
One of the provisions of the ACA is that insurance companies must now reveal the percentage of premium dollars they actually spend on health care and how much they spend on administration (e.g., salaries and marketing. Prior to ACA, this type of information was a closely held secret and insurance companies pocketed a good percentage of your premium dollars. With ACA in place, that’s no longer the case. If an insurance company spends less than 80% of premiums on medical care and quality (or less than 85% in the large employer, large group market), it must rebate the portion of premium dollars that exceeded this limit. This 80/20 rule is commonly known as the Medical Loss Ratio (MLR) rule
Rate Review in Action
The ACA brought an unprecedented level of scrutiny and transparency to health insurance rate increases by requiring insurance companies in every state to publicly justify their actions if they want to raise rates by 10% or more. Insurance companies are required to provide easy to understand information to their customers about their reasons for significant rate increases, and any unreasonable rate increases are posted online.
And it’s working. A new report released today shows that the health care law is helping to moderate premium hikes. Since this rule was implemented, the number of requests for insurance premium increases of 10% or more has dropped dramatically, from 75% to 14%. The average premium increase for all rates in 2012 was 30% below what it was in 2010. And available data suggest that this slowdown in rate increases has continued into 2013.
Moreover, when an insurer does decide to increase rates, consumers are seeing lower rate increases than what the insurers initially requested. In the review of rate requests for 10% or more, over 50% resulted in customers receiving either a lower rate increase than requested or no increase at all.
States have received $250 million in Health Insurance Rate Review Grants to help strengthen and improve their rate review processes thanks to the Affordable Care Act. Of the 44 states that received rate review grants, 40 have reported enhancements to their rate review websites. These website enhancements include searchable rate filings, new public comment options, live streaming of rate hearings, and plain language explanations of rate review and rate filings.
The Effective Rate Review program is one of many in the health care law aimed at protecting consumers. The rate review program works in conjunction with the 80/20 rule, which requires insurance companies to generally spend 80% of premiums on health care or provide rebates to their customers. Insurance companies that did not meet the 80/20 rule have provided nearly 13 million Americans with more than $1.1 billion in rebates. Americans receiving the rebate will benefit from an average rebate of $151 per household.
Additionally, today we issued a final rule that implements five key consumer protections from the Affordable Care Act, including protection against denial of health coverage because of a pre-existing condition. This rule makes the health insurance market work better for individuals, families and small businesses, and it also increases the transparency brought to rate increases by directing insurance companies in every state to file all of their rate increase requests.
For more information about the Affordable Care Act, visit http://www.healthcare.gov/index.html.
- Insurance Analysts: Obamacare to Increase Out-of-Pocket Premium Costs, Despite Lavish Subsidies (Forbes, 1/12/2013)
- Proof That Obamacare ‘Rate Shock’ Is An Ugly Insurance Company Deception (Forbes, 3/26/2013)
- Obamacare to Hike Some, Lower Other Individual Health Premiums: Sebelius (Insurance Journal, 3/27/2013)
- Some health insurance premium hikes reduced (Orange County Register, 3/7/2013)
- Insurance Companies Warn of Premium Hikes (Hispanic Business.com, 3/22/2013)
- The Hidden Cost of A Pre-Existing Condition Exclusion in the PPACA (Benefits@Work, 3/24/2013)
The Department of Health and Human Services (HHS) has finalized its regulations on a key element of health reform, the essential health benefits package. These regulations are an important step forward for expanding access to mental-health and addictions treatment in the U.S., because they require a broad range of plans to cover behavioral health services and to do so at parity with medical/surgical services. According to a new report, this means that over 62 million Americans will gain access to insurance coverage that meets parity standards. This includes 27 million uninsured Americans plus 35.5 million who have coverage that either does not cover MH/SUD or is not required to cover them at parity. Beginning in 2014, the essential benefits package will become the minimum standard of coverage that most insurance plans must meet, including plans sold on the exchanges, individual and small group plans, and Medicaid expansion plans.
Other highlights of the regulation are:
- The proposed rule includes language to assure non-discrimination in plan design, a major issue for people with chronic conditions. The rule prohibits cost-sharing structures, utilization management techniques and benefit designs that discriminate against beneficiaries based on race, age, disability status, health status, quality of life, having high health-care needs, or other characteristics. States must monitor and identify discriminatory benefit designs.
- The definition of essential benefits includes both the required preventive services outlined in the ACA as well as any state-mandated benefits (for example, autism coverage mandates) that were in effect prior to December 31, 2011.
However, HHS also left up to states’ discretion several other important decisions, including the definition of habilitative (= rehabilitation) benefits, establishment of non-discrimination standards in plan design, and the enforcement of benefit substitutions within categories. It also adopted a prescription drug policy that requires plans to cover at least one drug in every category and class of the U.S. Pharmacopoeia, an approach that could allow states to offer coverage that does not include the full range of psychiatric medications.
Given the recent report of blatant patient dumping by Southern Nevada Adult Mental Health Services, I for one am not sure leaving it up to “State” discretion to expand on and flesh out the remaining standards is all that good of an idea.
Other Available Substance Abuse & Mental Health Services Admin Reports at HHS
- OAS Methodology Reports - “[These reports address] various methodological issues concerning OAS data collection systems including: statistical techniques and theories, survey methods, sample design, survey instrument design, and objective evaluations of the reliability of collected data.”
- NSDUH Reports on Substance Abuse and Mental Health - “SAMHSA’s National Survey on Drug Use and Health (NSDUH) is the primary source of information on the prevalence, patterns, and consequences of drug and alcohol use and abuse in the general U.S. civilian non institutionalized population, age 12 and older.”
- Youth and Substance Use - These NSDUH reports discuss youth substance abuse.
- Parental, Peer and School Influences - These reports analyze information regarding parental, peer and school influences on drug abuse from the National Surveys on Drug Use & Health by SAMHSA.
- Analytic Series and Other Special Reports - “The Analytic Series addresses special topics relating to alcohol, tobacco, drug abuse, and mental health.”
- Mental Health Reports - These reports analyze information regarding mental health issues as related to drug abuse from the National Surveys on Drug Use & Health by SAMHSA.
- Violence, Suicide, & Risky Behaviors Reports - These reports provide data on suicide attempts, suicides, violence and risky behaviors as related to and influenced by drug use; data was provided by SAMHSA’s National Survey on Drug Use and Health and SAMHSA’s Drug Abuse Warning Network (DAWN).
- Reports on Depression - These reports provide information regarding depression, or related activity, and its connection to substance abuse as reported by NSDUH.
- Mental Health by Racial & Ethnic Group - These reports discuss mental health as it relates to racial and ethnic groupings.
- Homeless Reports - These reports, provided by DASIS, have information regarding homelessness admissions and substance abuse treatment.
- Katrina/Rita Areas: Substance Use and Mental Health - “[These reports present data] on substance use and mental health problems before and after Hurricanes Katrina and Rita”
- Youth & Mental Health Issues Reports - These reports provide information on mental health and substance use among youths.
- Serious Psychological Distress - These reports provide information about people suffering from serious psychological distress, its affects on mental illness and the connections that it has to substance abuse.
- Cities/Counties/Metropolitan Areas - These reports provide information regarding substance use in specific geographic areas.