Speaking of vanishing subsidies- I got a call today from a client who tells me that they were recently kicked off their exchange plan and assigned to Medi-CAL. Spoke with CoveredCA staff, and their explanation is that the poverty level guidelines have changed as of 4/1 and they are automatically disenrolling anyone who no longer qualifies for the exchange based on the new guidelines- no warning letter, no phone call, nothing. Just wake up one day with a cancellation letter and a "Welcome to Medi-CAL" packet. Anyone else experience this either in CA or on the Federal Marketplace? I can't imagine what the person in charge of this directive was thinking
With subsidies based on the second lowest silver plan, it behooves 2 insurers to kind of work together to establish a low base from which to pay subsidies.
That should increase market share pretty fast.
In a few years, when our newly forming insurer has enough assets to go on the public exchanges, that will be one of our moves, for our unique design lowers premiums over time, without medical trend.
We may need to license a separate insurer so that 2 companies can play the game.
Don Levit
That does make sense with new FPL levels for medicaid eligibility.
During OEP each year, you use the prior years FPL. 2014 uses 2013 numbers all year long for subsidy clients.
OEP ended on 4/1, and it's time to start using 2014 FPL numbers I'm sure for new subsidized clients.
It should only affect a select few on the 138% FPL bubble level in a state that expanded medicaid.
And each state may be different for losing kids to CHIP.
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Federal Poverty Guidelines
The new 2014 federal poverty guidelines have been released. The 2013 guidelines are also provided here for reference.
It’s important to note that eligibility for Medicaid and the Children’s Health Insurance Program (CHIP) is now determined by the 2014 guidelines. Eligibility for advance premium tax credits is determined by 2013 federal poverty guidelines.
State-run health insurance marketplaces should update their standards as soon as possible to align with those of the federally facilitated marketplaces. A short explanation of what these changes mean to consumers is here (via Center for Children and Families).
2014 Federal Poverty Guidelines
Federally facilitated marketplaces will use the 2014 guidelines to determine eligibility for Medicaid and CHIP (this is effective February 10, 2014).
- See more at: Federal Poverty Guidelines | Families USA
