Health Insurance Exchanges

Sharing certain insurance exchange functions across states holds promise for cost savings and other benefits to consumers, states and additional stakeholders. This NASHP report highlights findings and next steps from a study supported by the West Virginia Offices of the Insurance Commissioner, which included interviews and an in-person meeting with officials from several states and […]

Read More
  • Several of the Affordable Care Act’s (ACA) key provisions are aimed specifically at children, but much of the law focuses on covering the larger uninsured population of adults without dependent children. As states focus on implementing these ACA coverage programs and other systemic changes by January 1, 2014, it will be important that children’s coverage […]

    Read More
  • Dowload presentation here (PDF) Health insurance exchanges or marketplaces need to be prepared to serve children’s needs as well as adults. The Children’s Health Insurance Program (CHIP), an already established and tested program, offers features that can help states meet ACA exchange requirements while establishing good coverage for children. With support from the David and Lucile […]

    Read More
  • A significant challenge for states in 2014 and beyond is the projected movement of children and their families between being insured and uninsured, or across CHIP, Medicaid, and the marketplace. This movement or “churning” could cause disruptions in care that could be costly for children and their families, decrease the incentive for insurers to invest […]

    Read More
  • According to the Congressional Budget Office, 14 million individuals will be newly eligible for health insurance through Medicaid, CHIP, or the marketplaces in 2014. The entry of millions of newly insured individuals will certainly strain the capacity of an already burdened health provider workforce. Estimates from the American Association of Medical Colleges suggest that by […]

    Read More
    May 7, 2013 | Filed under: Children, Health Insurance Exchanges, Medicaid
  • Children need access to health care benefits and services that support their developmental needs. Medicaid, through the provision of Early Periodic Screening, Diagnostic, and Treatment (EPSDT), provides the most comprehensive age-appropriate pediatric benefits. CHIP plans were also created with the developmental and physical needs of children in mind. The ACA offers states flexibility in designing […]

    Read More
    May 7, 2013 | Filed under: Children, Health Insurance Exchanges, Medicaid
  • Medicaid and CHIP provide affordable coverage options to children in low-income families. To create more affordable coverage options for individuals and families at higher-income levels, the federal government will provide an Advanced Premium Tax Credit (APTC) for individuals and families who purchase marketplace coverage with incomes between 100 and 400 percent FPL and cost-sharing subsidies […]

    Read More
    May 7, 2013 | Filed under: Children, Health Insurance Exchanges
  • The ACA envisions a “no wrong door” eligibility and enrollment system for consumers in each state to efficiently connect to the appropriate coverage option. To reach this vision, the ACA introduces a simplified eligibility methodology, called Modified Adjusted Gross Income (MAGI), and requires a seamless system for enrollment and renewal. Some challenges and considerations for states […]

    Read More
  • Private Sector Coverage: Marketplaces and SHOP

    Health Insurance Marketplaces The ACA created new health insurance marketplaces (also referred to as health insurance exchanges) as a way for consumers to easily compare and purchase available plans based on price, benefits, services, and quality. The ACA required marketplaces to be operating in every state by October 1, 2013. States chose to run a […]

    Read More
    May 7, 2013 | Filed under: Children, Health Insurance Exchanges
  • Paths to Coverage for Kids: Private Sector Coverage

    The Affordable Care Act makes significant changes to the private health insurance market.  The table below, adapted from a University of California Berkeley Labor Center Report, summarizes key ACA provisions affecting the private market.   ACA Standards for Private Sector Plans   Marketplaces Grand-fathered Plans1 Employer-Sponsored Plans Individual Plans No lifetime or annual limits ✔ […]

    Read More