The association supports provisions that will expand coverage for non–modified adjusted gross income populations and align open enrollment periods across all marketplaces.
view more »CMS Proposes 2025 Notice of Benefit and Payment Parameters
Nov. 20, 2023 ||The proposed rule aligns state and federal marketplace requirements and includes several Medicaid provisions.
view more »CMS Releases Medicaid Unwinding Data
Aug. 1, 2023 ||CMS will release state Medicaid and Children's Health Insurance Program renewal data on a monthly, two-part basis due to data availability.
view more »California Health Exchange Launches Enhanced CSR Program
Aug. 1, 2023 ||Covered California says the program will reduce out-of-pocket costs for more than 600,000 enrollees, eliminate silver plan deductibles, and assist those predicted to lose Medi-Cal coverage.
view more »CMS Finalizes 2024 Notice of Benefit and Payment Parameters
April 28, 2023 ||The rule updates essential community provider requirements for qualified health plans and adds a special enrollment period for those losing Medicaid or CHIP coverage.
view more »CMS Releases Final Open Enrollment National Snapshot
Jan. 30, 2023 ||CMS reports that open enrollment through the health insurance marketplaces for 2023 totals 16.3 million people, a 13 percent increase from 2022.
view more »CMS Proposes 2024 Notice of Benefit and Payment Parameters
Dec. 21, 2022 ||The proposed rule updates essential community provider requirements for qualified health plans and adds a special enrollment period for those disenrolled from Medicaid or CHIP.
view more »CMS Launches New Medicaid, CHIP Renewal Webpage
May 24, 2022 ||The webpage includes renewal instructions for eligible beneficiaries and guidance for ineligible beneficiaries to secure insurance through the marketplaces.
view more »2023 Marketplace Benefit and Payment Parameters Finalized
May 3, 2022 ||The final rule raises the essential community provider threshold from 20 to 35 percent and uses wait time standards to evaluate qualified health plans for network adequacy.
view more »14.5M Americans Enroll in Marketplace Coverage
Jan. 31, 2022 ||An estimated 5.8 million people newly gained coverage during this open enrollment period; 32 percent of consumers using the federal marketplace selected a plan that costs them $10 or less per month. Enrollment remains open through Jan. 31 in five states and the District of Columbia.
view more »Association Comments on Notice of Benefit and Payment Parameters
Jan. 24, 2022 ||In response to the proposed rule for the 2023 plan year, the association urged the Department of Health and Human Services to ensure equitable access, finalize nondiscrimination policies, standardize collection of Z codes, and prorate premiums and advanced premium tax credits.
view more »Proposed Rule on ACA Marketplace for 2022 Plan Year
July 1, 2021 ||The departments of the Treasury and Health and Human Services proposed extending open enrollment in the Affordable Care Act marketplaces, adding a new special enrollment period, expanding navigator responsibilities, and modifying Section 1332 innovation waivers.
view more »Federal Court Vacates Provisions in 2019 Marketplace Rule
March 12, 2021 ||A federal court vacated several policies in the Trump Administration’s 2019 health insurance marketplace rule for violating federal law, including provisions related to review of network adequacy, standardized options, income verification requirements, and reducing medical loss ratio rebates.
view more »CMS Issues Temporary Policy For Marketplace Premium Reductions
Aug. 11, 2020 ||The agency is using its discretion to allow premium credits to support continuity of coverage for individuals and families impacted by the COVID-19 public health emergency and facing difficulties paying premiums.
view more »CMS Finalizes 2021 Marketplace Rule, Letter to Issuers
May 11, 2020 ||CMS issued the 2021 final notice of benefit and payment parameters rule and letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS provides detailed options for issuers to adopt value-based designs for marketplace plans.
view more »CMS issued the 2021 notice of benefit and payment parameters proposed rule and draft letter to issuers updating regulatory and financial standards for plans offered on the health insurance marketplaces. CMS is not proposing any changes to network adequacy standards.
view more »On the Hill: 300 House Lawmakers Urge DSH Cut Delay
May 14, 2019 ||A bipartisan group of 300 House lawmakers sent a letter to leadership calling for a two-year delay of Medicaid disproportionate share hospital cuts. The House will vote on a legislative package to expedite the availability of generic drugs and protect parts of the Affordable Care Act.
view more »On the Hill: Rx Drug Pricing Hearings, ACA Reform Bill
April 15, 2019 ||Hearings focused on rising drug costs and pricing transparency. Sen. Elizabeth Warren (D-MA) reintroduced a measure to bolster consumer protections under the Affordable Care Act. Both chambers will return to legislative business on April 29.
view more »On the Hill: House Vote on Bipartisan Medicaid Package
March 26, 2019 ||The House also will mark up a dozen bills aimed at lowering health care and prescription drug costs. House and Senate committees move forward on work to address surprise billing.
view more »On the Hill: Medicare-for-All Bill Lands in House
March 5, 2019 ||Long-expected "Medicare-for-all" bill formally introduced; Congressional hearings continue to focus on rising health care costs and prescription drug prices.
view more »Vermonters will experience a 23 percent increase in marketplace premiums, while Tennesseans will see a 26 percent decrease; nationally, premiums will decrease 1 percent on average.
view more »CMS Approves Section 1332 Waivers in Wisconsin, Maine
July 30, 2018 ||The waivers allow each state to create a reinsurance program to lower premiums in the individual market; the waivers will take effect in 2019 and are approved through 2023.
view more »DOL Finalizes Changes to Association Health Plans
June 20, 2018 ||The Department of Labor has issued a final rule expanding the definition of "employer" for purposes of establishing association health plans.
view more »CMS Finalizes Health Insurance Marketplace Provisions
April 16, 2018 ||The Centers for Medicare & Medicaid Services noted that the provisions aim to increase flexibility, improve affordability, strengthen program integrity, empower consumers, promote stability, and reduce regulatory burden in the individual and small group marketplaces.
view more »On the Hill: ACA Market Stabilization, Opioid Epidemic
March 5, 2018 ||Congress this week is focused on negotiating legislation to stabilize the Affordable Care Act insurance marketplace and efforts to fight the opioid crisis.
view more »DOL Proposes Rule on Short-Term Insurance Plans
Feb. 23, 2018 ||The proposal extends to one year the maximum length of short-term, limited duration plans — up from three months, as mandated by the Affordable Care Act.
view more »On the Hill: Marketplace Stabilization, Hospital Nonprofit Status
Feb. 20, 2018 ||Republicans from both chambers work on a marketplace stabilization package; Senate Finance Committee Republicans plan to review the Internal Revenue Service's process for designating nonprofit hospitals.
view more »Grants Aim to Increase Flexibility in Health Insurance Markets
Feb. 8, 2018 ||The Centers for Medicare & Medicaid Services is awarding $8.1 million in targeted funding to assess and potentially alter states’ essential health benefits packages.
view more »Association Comments on Draft 2019 Letter to Issuers in the Federally Facilitated Marketplace
Dec. 12, 2017 ||The association emphasized access to essential community providers within qualified health plan networks in its comments on the 2019 draft letter to issuers.
view more »Association Comments on 2019 Marketplace Plan Standards
Nov. 29, 2017 ||The association encouraged the Centers for Medicare & Medicaid Services to ensure that state plans cover essential health benefits and include sufficient access to essential community providers.
view more »CMS Proposes Notice of Benefit and Payment Parameters for 2019 Health Insurance Marketplaces
Nov. 3, 2017 ||The proposed rule would expand the role of states in administering marketplace plans and give states additional flexibility to define essential health benefits.
view more »Statement on Alexander-Murray Bipartisan Health Care Bill
Oct. 23, 2017 ||The end of cost-sharing reduction subsidies poses an imminent threat to those who depend on marketplace plans. America’s Essential Hospitals thanks Sens. Alexander and Murray for their bipartisan leadership to create more certainty in the individual market.
view more »On the Hill: Trump Administration Ends ACA Subsidies
Oct. 16, 2017 ||The Congressional Budget Office estimates premiums will increase 20 percent by 2018 and the uninsured population will increase by 1 million; 19 states and the District of Columbia filed a lawsuit arguing that withholding the payments violates current law.
view more »Statement on Senate Plan to Repeal ACA with Two-Year Delay
July 18, 2017 ||The repeal-and-delay strategy would leave millions of lives in limbo and create uncertainty that would destabilize insurance markets and paralyze hospitals.
view more »CMS Approves Alaska’s Section 1332 Waiver
July 12, 2017 ||This is the second Section 1332 State Innovation Waiver to receive approval; Alaska is pursuing the waiver to stabilize the state's individual health care market.
view more »ACA Led to Improved Care Access for Low-Income Adults
July 7, 2017 ||Researchers examined outcomes in Kentucky, Arkansas, and Texas; they found expanding access to health coverage improved care access and affordability.
view more »On the Hill: Senate Gains Momentum on ACA Repeal
June 13, 2017 ||Senate Republican leaders aim to submit a draft bill to the Congressional Budget Office early this week and vote on the bill before the July Fourth recess.
view more »CMS Seeks Input on Reducing Regulatory Burden of ACA
June 9, 2017 ||CMS aims to eliminate or change outdated, costly, or inconsistent regulations for marketplaces established under the Affordable Care Act.
view more »Association Letter Responds to Market Stabilization Proposed Rule
March 7, 2017 ||America’s Essential Hospitals expressed concerns about proposed changes that could harm the integrity of qualified health plan networks.
view more »CMS Proposes To Amend Standards Relating to Network Adequacy, ECPs
Feb. 21, 2017 ||The proposed rule aims to provide flexibility by targeting network adequacy reviews & inclusion of essential community providers in qualified health plans.
view more »CMS Finalizes Standards To Strengthen ACA Marketplaces
Dec. 20, 2016 ||CMS finalized a proposal to continue the current methodology, which qualified health plans use to satisfy the minimum essential community provider standard.
view more »Association Promoting Open Enrollment During Week of Action
Dec. 12, 2016 ||America's Essential Hospitals is taking part in the Provider and Hospital Week of Action to promote open enrollment for insurance marketplaces under the ACA.
view more »Association Letter Calls for Marketplace Network Adequacy
Dec. 2, 2016 ||America's Essential Hospitals expressed continued concerns about qualified health plan network adequacy in federally facilitated marketplaces.
view more »CMS Releases Draft Letter to 2018 QHP Issuers
Nov. 15, 2016 ||The letter provides operational and technical guidance to issuers of qualified health plans through the federal health insurance marketplace for 2018.
view more »Open Enrollment Kicks Off for ACA Marketplaces
Nov. 1, 2016 ||The open enrollment period runs from Nov. 1 through Jan. 31, 2017. Consumers must enroll by Dec. 15 for coverage that begins Jan. 1, 2017.
view more »CMS Aims to Enroll Young Adults in Marketplace
Oct. 3, 2016 ||CMS will use social video platform Twitch, improve the HealthCare.gov mobile interface, and use #HealthyAdulting to encourage young adults to sign up.
view more »Essential Community Provider Applications Due Oct. 15
Sept. 20, 2016 ||Hospitals eligible for the essential community providers list are participants in the 340B and DSH programs, critical access hospitals, and others.
view more »CMS Proposes New Standards to Strengthen ACA Marketplaces
Sept. 7, 2016 ||Comments on the proposed Notice of Benefit and Payment Parameters for 2018 are due by Oct. 6.
view more »CMS Awards $63M To Support Marketplace Navigators
Sept. 7, 2016 ||The grants to support marketplace navigators come as exchanges gear up for the Nov. 1 start of open enrollment for coverage beginning in 2017.
view more »CMS Seeks Information on Medicare, Medicaid Patient Diversion
Aug. 23, 2016 ||CMS is concerned that some providers might steer Medicare- and Medicaid-eligible patients into individual market plans to get higher payments.
view more »HHS Tightens Health Insurance Marketplace Rules
June 21, 2016 ||Individuals must prove they are eligible to sign up for coverage outside of open enrollment. HHS also proposes amending risk adjustment for insurers.
view more »HHS Finalizes 2017 Guidance for Qualified Health Plan Issuers
March 2, 2016 ||HHS finalizes 2017 Notice of Payment and Benefit Parameters rule and letter to issuers offering qualified health plans on the federally facilitated marketplace.
view more »On the Hill: 340B Round Tables, Mental Health, ACA Co-Ops
Jan. 20, 2016 ||America's Essential Hospitals and two members systems host congressional staff for round-table discussions about how proposed 340B Drug Pricing Program guidance threatens vulnerable patients and essential hospitals.
view more »Association Calls for Greater ECP Inclusion in Marketplaces
Jan. 16, 2016 ||Comments urge CCIIO to require that ACA marketplace plans include willing essential community provider (ECP) hospitals and ensure payment rates support access to care.
view more »On the Hill: Appropriations Debate, Tax Extenders, Medicare DSH
Dec. 9, 2015 ||Congress debates omnibus appropriations measure, considers another stop-gap funding bill, as deadline for government shutdown looms.
view more »HHS Says No Marketplace Qualified Plan Comparable to CHIP
Dec. 9, 2015 ||Out-of-pocket expenses higher in ACA marketplaces and coverage worse for children, especially those with special needs, HHS reports.
view more »CMS, NAIC Issue Health Plan Network Adequacy Requirements
Dec. 2, 2015 ||Proposals would make required and recommended changes to how qualified health plans operate in Affordable Care Act marketplaces.
view more »Network Adequacy Model Law Passes Hurdle Toward Adoption
Nov. 17, 2015 ||Model law would update requirements for insurance carriers in the health insurance marketplaces, particularly regarding provider directories, mental health services, telehealth, and nondiscrimination.
view more »HHS Evaluates Progress Toward Triple Aim
Nov. 9, 2015 ||Report on National Strategy for Quality Improvement in Health Care details progress made toward better care, lower costs, and improved health.
view more »Marketplaces Now Open for Coverage Enrollment
Nov. 3, 2015 ||Open enrollment for ACA marketplaces will last from Nov. 1, 2015, to Jan. 31, 2016, with coverage taking effect as soon as Jan. 1. Previously announced HHS enrollment goals include improving consumer experience, retaining and adding customers.
view more »CMS Proposes BHP Federal Payment Methodology
Oct. 27, 2015 ||The Basic Health Plan methodology would begin Jan. 1, 2017, and is largely unchanged from current methodology. CMS plans to finalize the rule in Feb. 2016. The BHP is an affordable alternative to marketplace coverage.
view more »HHS Extends Nondiscrimination Provisions to Ensure Equity
Sept. 9, 2015 ||The proposed rule extends nondiscrimination provisions to individuals based on sex, sexual orientation, and gender identity. The proposed rule also includes requirements for access for people with disabilities and limited English proficiency.
view more »Narrow Networks Vary by State Marketplaces
Aug. 26, 2015 ||According to a study, 10 states had a high prevalence of networks that were considered narrow in their health insurance marketplaces, while 12 states did not offer any plans with narrow networks.
view more »States Can Waive ACA Provisions with Alternative Coverage Plans
July 29, 2015 ||Plans must be budget-neutral and cover as many people as traditional ACA reforms. With these waivers, states may forgo certain ACA provisions including the marketplaces and individual mandate.
view more »Association Analysis of Supreme Court’s Decision in King v. Burwell
June 30, 2015 ||The Supreme Court ruled in King v. Burwell that the Affordable Care Act makes federal subsidies available to individuals in states that use the federally facilitated marketplace, not just those with a state-based marketplace.
view more »Another Big Deal: Supreme Court Upholds Subsidies
June 25, 2015 ||The U.S. Supreme Court ruled to keep subsidies for health insurance sold via federally run exchanges
view more »Supreme Court Upholds Subsidies in King v. Burwell Case
June 25, 2015 ||Six justices ruled in favor of the Obama administration, arguing that the overall structure and purpose of the ACA supports the interpretation that Congress intended subsidies to be available in both federally facilitated and state-based marketplaces.
view more »Statement on U.S. Supreme Court Decision in King v. Burwell
June 25, 2015 ||Decision maintains access to vital health care services for millions of Americans and supports the hospitals that care for our most vulnerable patients
view more »CBO: ACA Repeal Would Cost 24 Million Americans Health Insurance
June 24, 2015 ||CBO also found that if a full ACA repeal took effect on Jan. 1, 2016, the federal deficit would increase by $137 billion between 2016 and 2025.
view more »Uncompensated Care Survey Deadline Extended to May 6
April 24, 2015 ||America's Essential Hospitals is conducting this member survey to capture the impact of the ACA coverage expansion on essential hospitals.
view more »$67 Million for Marketplace Navigators Available from CMS
April 20, 2015 ||The funding opportunity will support navigators for up to three years in federally facilitated and state partnership health insurance marketplaces.
view more »Future of ACA Subsidies Rests with June Court Ruling
March 10, 2015 ||Ruling against subsidies could send ACA into "death spiral," according to RAND report.
view more »On the Hill: Homeland Security, 340B, HIT, ACA, and SGR
March 3, 2015 ||Congress must pass a homeland security spending bill this week, and health insurance marketplaces are under scrutiny as oral arguments in the King v. Burwell Supreme Court case begin.
view more »Health Insurance Marketplaces a Primary Focus for HHS
March 3, 2015 ||Specifically, HHS will evaluate financial assistance programs, Medicaid expansion, pioneer ACOs, and marketplace payment systems.
view more »CMS Sets 2016 ACA Marketplace Requirements
Feb. 24, 2015 ||Feb. 20 final rule and letter to issuers outline benefit and payment parameters for 2016 health insurance marketplace plans
view more »Basic Health Plan Methodology Final for 2016
Feb. 24, 2015 ||Payment methodology, to start Jan. 1, is largely unchanged from 2015
view more »Marketplaces Enroll More Than 11.4 Million in Coverage
Feb. 18, 2015 ||Plus, more than 3.3 million people who submitted marketplace applications are eligible for Medicaid or CHIP.
view more »Association filed Jan. 28 amicus brief in Supreme Court case supporting insurance subsidies through federally facilitated health insurance marketplace.
view more »What are we doing to demonstrate support for ACA insurance coverage subsidies? We filed and amicas brief for King v. Burwell affirming the position. Here's what we said and why.
view more »Association Calls for ECP Inclusion in Marketplaces
Jan. 13, 2015 ||The association submitted comments to CCIIO and NAIC calling for more robust standards for including ECPs in health insurance marketplaces.
view more »Association Submits Comments on ECP Standards
Jan. 6, 2015 ||America's Essential Hospitals urged HHS to improve ECP standards in the marketplaces to ensure patients have access to quality, affordable health care.
view more »Association Urges MACPAC to Support Four-Year CHIP Extension
Jan. 6, 2015 ||America’s Essential Hospitals urged MACPAC to support a four-year CHIP funding extension and during that time, evaluate the marketplaces' network adequacy, affordability, and covered benefits.
view more »Comment on Proposed Network Adequacy, Insurance Requirements
Dec. 12, 2014 ||CMS, NAIC documents contain important health insurance marketplace provisions, including cost-sharing requirements. Comments due to CMS Dec. 22, to NAIC by Jan. 12, 2015.
view more »Cost-Sharing Assistance Supports Patients, Strengthens Marketplaces, and Promotes the ACA
Nov. 25, 2014 ||New association policy brief describes how cost-sharing assistance by hospitals helps vulnerable patients afford health insurance marketplace coverage and access vital health care services
view more »MACPAC Seeks Public Comment on Coverage for Children
Nov. 17, 2014 ||The commission seeks input on which groups of children would be most affected if CHIP expires and potential policy options through the marketplaces.
view more »Association Urges Full D.C. Court to Uphold Premium Subsidies
Nov. 4, 2014 ||Oral arguments for this case are scheduled to begin Dec. 17.
view more »D.C. Circuit to Rehear Marketplace Subsidies Case
Sept. 8, 2014 ||The full U.S. Court of Appeals for the District of Columbia will rehear Halbig v. Burwell, one of the two cases with conflicting results on whether ACA subsidies are available in the federally facilitated marketplace.
view more »CMS Finalizes Marketplace Redetermination Rules
Sept. 5, 2014 ||Generally, if consumers do nothing, they will be auto-enrolled in the same plan with the same premium tax-credit and other financial assistance as they had in the 2014 plan year.
view more »CMS Issues Guidance on Marketplace Assister Certification
Aug. 18, 2014 ||In preparation for the Nov. 15 start of open enrollment in the health insurance marketplace, CMS issues guidance on certification requirements for navigators, certified application counselors, and others who help consumers with the enrollment process.
view more »States Explore Provider-Based Premium Assistance
Aug. 18, 2014 ||Florida, New York, and Wisconsin consider options to allow hospitals to subsidize insurance premiums for individuals. Financial assistance would increase opportunities for coverage and continuous, coordinated care.
view more »Courts Issue Conflicting Opinions on ACA Premium Tax Credits
July 23, 2014 ||The U.S. Court of Appeals for the DC Circuit has ruled that people who purchase health insurance through the federally facilitated marketplace are ineligible for ACA subsidies. The 4th Circuit Court of Appeals in Virginia released a conflicting opinion hours later.
view more »On the Hill: House GOP to Sue President, Energy and Commerce Holds Health Care Hearings, Markups
July 15, 2014 ||House GOP will move forward with a lawsuit against President Obama on the delay of the employer mandate without congressional approval. Energy and Commerce is marking up a variety of bills and holding hearings on the health insurance marketplaces and anthrax.
view more »Foundation-Supported Premium Assistance Programs
July 9, 2014 ||Guidance for those offering premium assistance to low-income marketplace populations
view more »CMS Proposes New Exchange Redetermination Rules
July 1, 2014 ||CMS outlines three methods for reviewing enrollee coverage eligibility for insurance purchased through the federally facilitated marketplace.
view more »HHS Report Shares Impact of Federal Marketplace Subsidies
June 24, 2014 ||HHS report announces that 87 percent of individuals who purchased health insurance from the federally facilitated marketplace during initial open enrollment have received premium assistance through federal tax credits. The report also shows that 64 percent of individuals enroll in plans with the lowest premiums, despite higher cost-sharing rates.
view more »On the Hill: GOP Leadership Elections, Stalled Appropriations, Hearings on Narrow Networks and MedPAC Report
June 17, 2014 ||The Labor/HHS appropriations bill vote was cancelled due to Republican threats to derail the process over ACA funding. House Majority Leader Cantor's loss has House Republicans vying for his seat. MedPAC shares its biannual report to Congress on Wednesday.
view more »Association Comments on Provider Nondiscrimination
June 17, 2014 ||The association submitted comments to the Departments of Labor, Health and Human Services, and the Treasury regarding their request for information on provider nondiscrimination.
view more »CMS Announces Marketplace Navigator Funding
June 15, 2014 ||CMS announced $60 million in additional grants available to support navigators in federally facilitated and state partnership marketplaces. Letters of intent are due June 30, and complete applications are due July 10.
view more »America’s Essential Hospitals released a policy brief June 2 announcing its support for provider-sponsored premium assistance, which the association believes is a logical extension of members' work and facilitates the availability of affordable health care for all.
view more »Premium Assistance Programs
June 2, 2014 ||America's Essential Hospitals describes how provider-supplemented premium assistance for enrollees in the health insurance marketplaces strengthens the marketplaces and furthers the goals of the Affordable Care Act.
view more »HHS Clarifies Foundations Can Make Payments to QHPs
May 28, 2014 ||HHS reiterates that charitable foundations are not prohibited from making payments on behalf of enrollees in qualified health plans.
view more »CMS Finalizes Marketplace and Insurance Market Standards
May 20, 2014 ||CMS issued a final rule Friday, May 16, on 2015 standards for health insurance marketplaces and the insurance market. Among other provisions, CMS finalized measures for a quality rating system that would require health insurance issuers operating through the marketplaces to collect, validate, and report data on quality metrics for qualified health plans.
view more »The Ways and Means Committee reviewed hospital issues as part of the Medicare Program. Two Louisiana delegates urged CMS to accept nonprofit-provided premium assistance. The Senate Veterans Affairs Committee held a hearing featuring Secretary Shinseki.
view more »Association Comments on Third-Party Premium Assistance Rule
May 13, 2014 ||Comments include requests to allow provider-supplemented premium assistance and cost-sharing for individuals obtaining marketplace coverage and to clarify that QHPs should accept premium and cost-sharing assistance from private, nonprofit foundations.
view more »On the Hill: House Passes Expat ACA Exemption, Reviews Insurance Enrollment, Senate Begins Burwell Hearings
May 6, 2014 ||The expat bill was previously considered but didn't pass due to Democrats fighting against it. The Energy and Commerce Oversight Subcommittee will look at insurance enrollment and the marketplaces from the perspective of insurers. OMB Director Sylvia Burwell will testify before the HELP Committee as she begins her confirmation process to become the next HHS secretary.
view more »CBO Estimates Lower Cost, Higher Coverage from ACA
April 22, 2014 ||CBO estimated 2016 marketplace premiums will be 15 percent less than they were estimated to be in 2009. This should mean the ACA will cost $104 billion less to the federal government over the next decade than previously projected.
view more »Association Comments on Marketplace Quality Rating Standards
April 22, 2014 ||The association said that CMS should implement the QRS in a way that protects consumer access to ECPs in the marketplaces. It also urged CMS to ensure the measures used in the QRS are endorsed by the National Quality Forum and risk adjusted for socioeconomic factors.
view more »Members Took Action on Capitol Hill During our Spring Policy Assembly
April 16, 2014 ||Staff from our members held 100 meetings with their senators and representatives to discuss what defines an essential hospital and the key issues facing essential hospitals. Issues included: protecting essential hospital payments, ensuring essential hospitals are included in marketplace health insurance plan networks, and preserving support for training future clinicians at essential hospitals.
view more »Association Members Hold 100 Meetings with Policymakers
April 8, 2014 ||Association members explained what makes an essential hospital and the key issues facing essential hospitals to their policymakers on the Hill. The event also included reflections from senior Capitol Hill and administration staff and two award ceremonies that recognized members of Congress and congressional staff for their commitment to essential hospitals.
view more »Special Enrollment Period for Marketplace Consumers
April 8, 2014 ||CMS is allowing consumers to enroll in the federally facilitated marketplace under a special enrollment period if they experienced life changes, exceptional circumstances, or technical problems with healthcare.gov. Coverage will be effective for 2014. HHS reported that 7.1 million people enrolled in health insurance through the marketplaces before the March 31 open enrollment deadline.
view more »CMS Proposes Marketplace Quality Standards
March 25, 2014 ||CMS proposes that QHP issuers collect enrollee satisfaction data for certain QHPs. This data will be one of the components used to determine QHP quality ratings. America's Essential Hospitals will submit comments on CMS' proposal for collecting enrollee satisfaction data.
view more »Administration RFI on Provider Nondiscrimination
March 24, 2014 ||Labor, Treasury, and Health and Human Services seek comments on the ACA’s provider nondiscrimination provision. Their request includes information on access, costs, other federal and state laws, and feasibility. Comments are due by June 10.
view more »Health care leaders will discuss efforts to enroll patients in health insurance coverage before March 31. Association President & CEO Bruce Siegel, MD, MPH, along with Vice President Joe Biden, U.S. Department of Health and Human Services Secretary Kathleen Sebelius, and other hospital association leaders will participate in the call.
view more »CMS Releases Rule on QHP Payments by Third Parties
March 19, 2014 ||CMS stated that it encourages QHPs to reject payments from hospitals and other health care providers. The agency did not provide information about premium and cost-sharing payments made on behalf of QHP enrollees by private, nonprofit foundations. America's Essential Hospitals will submit comments to CMS urging the agency to allow such payments from private, nonprofit foundations.
view more »CCIIO Finalizes 2015 QHP Issuer Letter
March 19, 2014 ||For 2015, each qualified health plan (QHP) network must include at least 30 percent (up from 20 percent in 2014) of all available ECPs in its service area to meet network adequacy requirements. CMS is also implementing a reasonable access review standard.
view more »CMS Releases Basic Health Plan Final Rule
March 18, 2014 ||The final rule establishes procedures for enrollment and certification. CMS also released its final methodology for determining federal payments to states establishing a BHP program in 2015.
view more »Intentional Uninsurance: Misguided and Unintentionally Selfish
March 11, 2014 ||Recently, a prominent Member of Congress announced that he would forgo health insurance coverage. While he does so in an effort to protect individual liberty, the ultimate cost of choosing to go insured is borne by the rest of us - taxpayers and the insured alike.
view more »Robust ECP Standards Needed for Marketplace Inclusion
March 5, 2014 ||America’s Essential Hospitals protects access to care among marketplace plans. The association urged CCIIO to ensure an adequate number of ECPs are included in QHP networks. It also asked CCIIO to ensure patients have access to all hospital services in their plan’s network.
view more »Marketplace Enrollment Increases in January
Feb. 19, 2014 ||Nearly 3.3 million people have selected plans through the marketplaces since they opened Oct. 1, 2013. This number represents 45 percent of the 7.3 million people who were eligible to enroll in a marketplace plan. In addition, 3.2 million people who submitted applications through the marketplaces were determined to be eligible for Medicaid or the Children’s Health Insurance Program (CHIP).
view more »CMS Releases New FAQs on QHP Premiums Paid by Third Parties
Feb. 7, 2014 ||These FAQs further clarify the Nov. 4, 2013 FAQ, which stated that the U.S. Department of Health and Human Services encourages issuers to reject premium payments from third parties such as hospitals, other health care providers, and other commercial entities.
view more »Responding to input from America’s Essential Hospitals to strengthen the essential community provider (ECP) requirements, CCIIO notes an enhanced ECP standard. America’s Essential Hospitals is pleased CCIIO recognizes that more protection is needed for ECP patients’ access to care but believes that the requirements should be strengthened further.
view more »CCIIO Releases Draft CY 2015 Letter to Issuers in Federally Facilitated Marketplaces
Feb. 5, 2014 ||Of particular interest to members of America's Essential Hospitals, we are pleased to see CCIIO account for the concerns raised by our member hospitals and enhance its essential community provider standard.
view more »On the Hill: ACA Replacement, Risk Corridors, Waxman to Retire, Surgeon General to Be Confirmed
Feb. 4, 2014 ||Republican House leaders are working on a proposal to replace the Affordable Care Act (ACA). On Wednesday, the House Committee on Oversight and Government Reform will hold a hearing on the risk corridors provision in the ACA. Last week, House Energy and Commerce Ranking Member and Former Chair Henry Waxman (D-CA) announced he would retire at the end of his term this fall.
view more »Shaheen Concerned About Network Adequacy
Jan. 31, 2014 ||Sen. Jeanne Shaheen (D-NH) urged the U.S. Department of Health and Human Services Secretary Kathleen Sebelius in a Jan 29 letter to “closely examine the provider network adequacy standards” for qualified health plans sold through health insurance marketplaces (exchanges).
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