Eligibility and Enrollment

How do premiums and maximum out-of-pocket costs vary across bronze, silver, gold, platinum, and catastrophic plans available in 2016 through HealthCare.gov?

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  • Eligibility Levels for Coverage of Pregnant Women in Medicaid and CHIP
    Maps

    This map set provides eligibility levels for states’ coverage of services for pregnant women under Medicaid (Title XIX of the Social Security Act) and Children’s Health Insurance Program (Title XXI of the Social Security Act) in 2015. Please see the accompanying chart for eligibility levels for states’ coverage in 2013, 2014, and 2015. Coverage levels for  2014 […]

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  • State Health Policy Blog

    Federal funding for the Children’s Health Insurance Program (CHIP) is currently set to end in September 2017, and states need to be prepared for the possibility that Congress will not act to extend the funding. Medicaid expansion CHIP programs are required through the Affordable Care Act’s (ACA) maintenance of effort (MOE) provision to maintain eligibility […]

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  • Without Congressional action, federal funding for the Children’s Health Insurance Program (CHIP) is due to end in September 2017. The National Academy for State Health Policy (NASHP) created this infographic to highlight the main policy and operational issues that would need to be considered and addressed in states with separate CHIP programs if future federal funding […]

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  • With the ACA’s introduction of open enrollment periods for health coverage programs, the time was right for innovative outreach models to reach new populations. Retail enrollment centers (also called “pop-up retail shops”) were one outreach and enrollment tool developed by states that has shown early promising results. In the first two years of ACA open […]

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  • This map tracks enrollment data from state marketplaces, the federal marketplace and Medicaid/CHIP agencies for individuals and families enrolling in Qualified Health Plans (QHPs) and Medicaid/CHIP.{1} The map also provides state-by-state estimates for those eligible for marketplace and Medicaid/CHIP coverage from Kaiser Family Foundation and Urban Institute analyses. Like all State Refor(u)m research, this chart is […]

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  • The Children’s Health Insurance Program (CHIP) serves as an important source of coverage for adult pregnant women who are ineligible for Medicaid because of their income level or immigration status. As a result of the Affordable Care Act (ACA), these and other low and moderate-income pregnant women may now have access to additional options for […]

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    June 3, 2016 | Filed under: Eligibility and Enrollment, Programs
  • The Affordable Care Act created new opportunities for health centers and primary care associations (PCA) to play a leading role in supporting outreach and enrollment into new and expanded health coverage programs.  Health centers and PCAs received new funding, sometimes from multiple state and federal entities, new training and tools, and a new mandate to find and […]

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    October 30, 2015 | Filed under: Eligibility and Enrollment, Kentucky, Montana
  • Publications

    The Patient Protection and Affordable Care Act (ACA) included new eligibility and enrollment requirements, which have presented states with significant implementation opportunities and challenges. Although states had choices about whether to host a health insurance exchange or expand Medicaid, the ACA required all states to make major changes to Medicaid eligibility policy, including adding mandatory […]

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    July 21, 2015 | Filed under: Eligibility and Enrollment, Publications
  • Publications

    In this new issue brief, NASHP identifies considerations and policy options for states pending the outcome of King v. Burwell. A pro-King decision might end federal subsidies provided to individuals in the 34 states that used the Federally-Facilitated Marketplace to enroll in health insurance coverage, impacting about 7.3 million people. Although the outcome of the case is uncertain, states may want to […]

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    March 17, 2015 | Filed under: Eligibility and Enrollment, Publications, State Exchanges