Pennsylvania Association of

Community Health Centers

Supporting Pennsylvania's health centers in increasing access to quality primary health care for all

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Friday, May 04, 2018

May 4, 2018 Outreach and Enrollment News

Survey Shows Some ACA Gains Lost

The coverage gains made under Affordable Care Act (ACA) appear to be slowly eroding, a new study by the Commonwealth Fund shows. The number of uninsured adults between ages 19 and 64 grew by 2.8 percentage points from 2016 to March of this year, the study shows, representing an additional 4 million uninsured American adults in that time period. Read more here.


Error with Exceptional Circumstance SEP Eligibility

The Centers for Medicare & Medicaid Services (CMS) has identified consumers who were wrongly denied access to the Exceptional Circumstance Special Enrollment Period (SEP) and are notifying these consumers of eligibility for another SEP due to the error or misrepresentation of the Marketplace. These consumers will be able to select a 2018 Marketplace plan or make changes to their existing 2018 plan by May 24, 2018. Coverage accessed with this SEP will begin June 1 or July 1, depending on the date the consumer selects their plan.  Consumers who want to get coverage prior to June 1 must file an appeal within 90 days of the date of SEP Eligibility Notice. CMS has identified the population eligible for this SEP within Marketplace systems so that they can be easily identified by the Marketplace Call Center representatives and other CMS officials. Anyone eligible for this SEP will receive a hard copy notice in the mail. CMS will not require any documentation to prove eligibility for this SEP.  See the original guidance.


Short-Term Limited Duration Health Plans

Insurance Commissioner Jessica Altman submitted comments to CMS about the harmful effects of short-term, limited duration health plans. These plans provide temporary health coverage to consumers who have coverage gaps due to unexpected issues or need health care for a brief period. Generally, these plans have low premiums but also very limited coverage. The proposed rule on Short-Term Limited Duration Health Plans issued last year and released on February 20, would not prohibit health insurers from discriminating based on a consumer's medical history and pre-existing conditions because short-term plans are not subject to ACA consumer protections. See Commissioner Altman's comments.

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