January 8, 2015 update: Tax filing requirements. On January 8, 2014, HHS Secretary Burwell and Treasury Secretary Lew issued a joint statement regarding new tax filing requirements that are in effect under the Affordable Care Act for 2014 taxes. Individuals who did not have qualifying health coverage for all or part of 2014 will have to file a form 8965 and either qualify for an exemption or pay a tax penalty. Individuals who received advance premium tax credits should receive a 1095A from their marketplace and will need to file a form 8962 to reconcile the tax credits they were due and the credits they actually received.
The press release links to an IRS publication, as well as an HHS website and two HHS flyers on ACA tax issues. HHS will be reaching out to individuals who have received premium tax credits for 2014 with further information and is working with tax preparers during the tax filing season.
Latest enrollment figures. On January 7, CMS released its enrollment report for week 7 of the 2015 open enrollment period. Not surprisingly, because it was a holiday week with no enrollment deadlines, only 102,896 individuals selected a plan (although 246,543 submitted an application and nearly 2 million visited the healthcare.gov website). Total plan selections through the federal marketplaces now total nearly 6.6 million.
Medicaid/CHIP coordination with exchange coverage. One the goals of the Affordable Care Act was to create a seamless relationship between Medicaid and CHIP, which would cover the lowest-income Americans, and premium tax credits through the marketplaces, which would assist moderate-income Americans. Working families often transition between one form of coverage and another as their income changes, but consumers have experienced some difficulties making the transition. In particular, individuals who are enrolled in a qualified health plan have had difficulty terminating that coverage when they are found eligible for Medicaid or CHIP, thus exposing them to having to pay back premium tax credits that they were not entitled to and to pay premiums for coverage that they do not need and cannot afford. Consumers have also experienced problems when the marketplace assesses them to be eligible for Medicaid or CHIP, and thus ineligible for premium tax credits, but the state Medicaid agency determines that they are ineligible for Medicaid or CHIP.
On December 30, 2014, CMS released a guidance providing directions for handling these situations. The guidance provides step-by-step instructions to be followed by qualified health plan enrollees when they or some members of their family are assessed or determined by the marketplace to be eligible for Medicaid or CHIP. Individuals assessed by the marketplace to be eligible for Medicaid or CHIP may either terminate qualified health plan coverage at that time or wait until they receive a definite eligibility determination from the state Medicaid agency. The guidance also provides instructions for individuals to follow, if they terminate QHP coverage upon being assessed as eligible by the marketplace but are then determined ineligible for Medicaid or CHIP by the state Medicaid agency, that will permit them to reenroll in QHP coverage and receive retroactive coverage through a special enrollment period.
Original post. On December 30, 2014, the Centers for Medicare and Medicaid Services released several reports on enrollment numbers covering the second marketplace enrollment period to date. It released its first monthly ASPE (Assistant Secretary for Planning and Evaluation) report covering October 15 to November 15, 2014. (press release here ) The ASPE report for the first time includes some — very incomplete — information on enrollment in the state-operated exchanges.
CMS simultaneously released a snapshot report covering enrollment in the Federally Facilitated Marketplace (FFM) for the sixth week of open enrollment.
The bottom line is that the reports confirm what we all knew already: The first month of open enrollment is going much better than the early months of open enrollment last year. As of December 26, 6,490,492 individuals had selected a plan through the FFM. Only 96,446 selected a plan in Week 6, compared to 3.9 million in week 5, emphasizing again the importance of the December 15 deadline for January 1 coverage in driving enrollment. Read the rest of this entry »