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Proposed Rule: Exchange and Insurance Market Standards for 2015 and Beyond

Proposed Navigator and Marketplace Standards

This proposed rule from the Centers for Medicare and Medicaid Services (CMS) includes standards for Health Insurance Marketplaces as well as protections and standards for Navigators and other consumer assistance personnel.



Visualizing Health Policy: What Americans Pay for Health Insurance Under the ACA

Website  from

The March 2014 Visualizing Health Policy infographic shows examples of what Americans will pay for health insurance under the Affordable Care Act, using different scenarios for 40-year-old individuals living in different parts of the country.



Proposed Standards for Navigators and Consumer Assistance Counselors: Preemption of Certain State Navigator Regulatory Laws

A brief from Health Reform GPS

Many states have created policies regulating the activities of navigators created by the Affordable Care Act. On March 17, 2014, HHS released a proposed rule in public view form that addresses a variety of issues including Exchanges, Navigators and Non-Navigator consumer assistance personnel. This brief explains and provides context for the proposed rule.



Marketplace Comparison Worksheet

Form the Center on Budget and Policy Priorities

This worksheet, from the Center on Budget and Policy Priorities' Beyond the Basics project, can help consumers compare Marketplace plans considering costs and their individual needs.



Basic Health Program Final Regulations

A brief from Health Reform GPS

On March 7, 2014, the Centers for Medicare and Medicaid Services (CMS) published final regulations implementing the Affordable Care Act's Basic Health Program (BHP) market option. The BHP is an optional program for states to provide protections for people who may "churn" between Medicaid and the Marketplaces. This brief explains the final regulations from CMS.



Medicaid and Marketplace Eligibility Changes Will Occur Often In All States; Policy Changes Can Ease Impact

Under the Affordable Care Act (ACA), changes in income and family circumstances are likely to produce frequent transitions in eligibility for Medicaid and health insurance Marketplace coverage for low- and middle-income adults. This Health Affairs article provides state-by-state estimates of potential eligibility changes ("churning") if all states expanded Medicaid under health reform, and identifies predictors of rates of churning within states.



Profiles of Medicaid Outreach and Enrollment Strategies: Using Text Messages to Reach and Enroll Uninsured Individuals into Medicaid and CHIP

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The 2014 Affordable Care Act (ACA) health coverage expansions provide millions of uninsured Americans a new coverage option through Medicaid or Health Insurance Marketplaces. However, effective outreach, enrollment, and retention efforts are essential for ensuring that these new coverage opportunities translate into increased coverage. To provide greater insight into the potential role of text messaging as an outreach vehicle, this brief focuses on the use of standard cell phones and smartphones for text messages and internet access and illustrates how one text messaging initiative, Text4baby, a free, personalized maternal child health education text messaging service for pregnant women and new mothers, is helping eligible pregnant women and their families connect to health coverage.



CMS Bulletin on Premium Subsidies and Cost-Sharing Reductions in 2014 Due to Exceptional Circumstances

A brief from Health Reform GPS

The Affordable Care Act (ACA) provides premium tax credits (PTCs) and cost sharing reduction assistance (CSRs) to help individuals defray the cost of enrolling in qualified health plans (QHPs) provided by insurance issuers and purchased through the Health Insurance Marketplace. Technical problems, however, have plagued many state Marketplaces as well as the Federally-facilitated marketplace during the initial 2014 open enrollment period, resulting in a potential for lost enrollment opportunities. This brief from Health Reform GPS explains the allowances CMS will make in eligibility determinations for those who faced technical difficulties applying for coverage.



The ACA in California: Briefing and Panel Discussion

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In the first of many events to highlight Affordable Care Act (ACA) implementation in the states and on the front lines across the country, the Kaiser Family Foundation partnered with the Blue Shield of California Foundation to examine ACA implementation in California (CA) at a briefing and panel discussion. State and county officials, experts and advocates discussed the latest developments and lessons learned about the ACA implementation in California, a state with seven million uninsured people, which is expanding its Medicaid program and running a state Marketplace.



Rehabilitation and Habilitation Services and Devices

A Fact Sheet from the National Disability Navigator Resource Collaborative

This fourth fact sheet in the NDNRC series is intended to help Navigators answer specific questions that people with disabilities might ask about rehabilitation and habilitation services and devices benefits when they are considering buying health insurance through the Marketplace



CMS 2015 Draft Letter to Issuers in the Federally Facilitated Marketplace: Network Adequacy and Inclusion of Essential Community Providers

Summary and Analysis from Health Reform GPS

On February 4, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a Draft Letter to Issuers in the Federally-facilitated Marketplace (FFM). Comments were due by February 25, to be followed by a revised letter. This update from Health Reform GPS reviews key provisions of the Letter and identifies key issues to watch in the final revised letter.



New Tool from Community Catalyst to Assess and Improve Medicaid Managed Long-Term Services and Supports

A new tool from Community Catalyst can help advocates promote more consumer-focused Medicaid managed long-term services and supports by making it easier to identify weaknesses and promote better practices.



Medicaid Accountable Care Organizations: Program Characteristics in Leading Edge States

The need to foster integrated care delivery and address social determinants of health has led to the development of accountable care organizations (ACOs) in Medicaid. With support from The Commonwealth Fund, the Center for Health Care Strategies (CHCS) has been working with leading-edge states to accelerate ACO program implementation. The following matrix presents key features and requirements for ACO programs in seven of the states participating in the Medicaid ACO Learning Collaborative: Colorado, Maine, Massachusetts, Minnesota, New Jersey, Oregon, and Vermont.



Visualizing Health Policy: Physicians and Medicare

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This month�s Visualizing Health Policy takes a look at physicians and Medicare, including information about Medicare�s payment formula for physicians and about access to health care for people covered by Medicare.



Arkansas Medicaid Fight All About the Math

A Conversation with Governor Mike Beebe

In this conversation with Health Affairs and Kaiser Health News, Arkansas Gov. Mike Beebe says his strategy to win over state lawmakers skeptical about continuing the state's Medicaid expansion is to show them the money.

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