Covering Kids & Families of Indiana Newsletter   
October 13, 2022
Marketplace "Family Glitch" Fix
Since the Marketplace and state-based exchanges began offering health insurance, the so-called "family glitch" has been cited as a barrier to affordable coverage. The affordability employer-based coverage, a measure that determines subsidies plan and other cost-savings when there is an offer of employer coverage, was determined solely on the cost of employee-only coverage. Even when family coverage offered by the employer was not affordable to the household, it was not considered in affordability testing.

Today, the U.S. Treasury Department finalized a regulation that changes this affordability test. Beginning with determinations for the 2023 coverage year, affordability of an employer offer of coverage will be based on the cost of family coverage to the household. The U.S. Department of Health and Human Services (HHS) estimated that the change will help about 1 million Americans either gain coverage or see their coverage become more affordable during the 2023 coverage year.
Proposed Medicaid Eligibility & Enrollment Rule
Centers for Medicare and Medicaid Services (CMS) recently released a proposed rule designed to simplify eligibility and coverage attainment under Medicaid and the Children’s Health Insurance Program (CHIP). A few highlights of the proposed rule, noted in a policy watch published by the Kaiser Family Foundation (KFF) include:

  • Uniform requirements would be put in place to ensure applicants have sufficient time to submit required documentation at application, renewal and when changes in circumstances need to be reported.

  • States would be required to check available data sources, conduct outreach using different modalities, and make efforts to obtain current address information before terminating enrollees due to returned mail.

  • Several provisions aim at simplifying the enrollment process and maintaining continuity of coverage for eligible beneficiaries, including children and individuals dually enrolled in Medicare and Medicaid, many of whom are over 65 and/or have a disability.

  • Waiting periods, coverage lockouts for failure to pay premiums, and annual or lifetime caps on benefits for children enrolled in separate CHIP (S-CHIP) programs would be eliminated.

The 60-day comment period for the proposed rule will end on November 7, 2022, and comments on the notice of proposed rulemaking must be submitted to the Federal Register no later than that date. For more information on how to submit comments or to review the rule in its entirety, visit the Federal Register.

The State of Coverage Policy Summit, hosted by Covering Kids & Families of Indiana, is an annual event focusing on recent legislation, key public policies and emerging issues impacting the health coverage and healthcare environment.

Innovations in Eligibility and Enrollment will be the focus of this year's State of Coverage Policy Summit, featuring experts examining new, novel and emerging approaches to improve enrollment in programs like Medicaid, CHIP and HIP. The impact of systemic and process barriers on health equity will also be examined, as well as the role of such programs in reducing disparities. The event will be fully virtual and is scheduled for October 20th from 10:00AM - Noon.

Summit Keynote Speaker:
Jennifer Wagner serves as Director of Medicaid Eligibility and Enrollment with the Center on Budget and Policy Priorities.

Summit Panelists:
Andrew Bradley - Policy Director, Prosperity Indiana
Emily Bryant - Executive Director, Feeding Indiana's Hungry
Erin Macey, Ph.D. - Senior Researcher & Director of Advocacy, Indiana University Maternal & Child Health Initiative
Open Enrollment is Almost Here!
Open enrollment for Marketplace coverage starts November 1st and will continue through January 15, 2023. A recent blog post from the Georgetown University Center on Health Insurance Reforms summarizes new policies and how they impact consumers.

  • Enhanced Premium Tax Credit subsidies were extended through 2025. Families with incomes between 100 -150% federal poverty level (FPL) will have $0 premium options. Families with incomes over 400% FPL will have their premium contribution capped at 8.5% of income.
  • The special enrollment opportunities for families under 150% FPL were extended through 2025.
  • Fixing the Family Glitch will make Marketplace coverage possible for many who find employer coverage unaffordable for family members. This fix was announced this week.
  • Standardized benefit design options are now required. Every product, metal level and geographic market in which insurers offer a “non-standardized” plan, they must also offer a standardized option that shares common features with plans offered by other insurers. The goal is to simplify the plan selection process.
Find a Navigator
The Indiana Department of Insurance updated its “Find a Navigator” webpage. If your website or other materials contain this link, you will want to update them:
HIP Plan Selection
When enrolling in the Healthy Indiana Plan (HIP), new members can choose between four managed care entities (MCEs): Anthem, CareSource, MDwise or MHS. If no health plan is chosen, one is assigned. Members stay with their health plan for that calendar year. Annually, from November 1st – December 15th, members can switch their health plan for the upcoming calendar year by calling 877-GET-HIP-9. If a member wants to keep their health plan, they do not need to take any action.
News from the Indiana School Health Network
A Ten-Year Roadmap to Healthy Schools
The National Healthy Schools Collaborative, a group of nationally recognized organizations that work in health and education, has developed a Ten-Year Roadmap that lays out six steps that need to be taken to increase the number of healthy schools over the next decade. The vision of the National Healthy Schools Collaborative is to coordinate and accelerate multi-sector collaboration needed to empower every school to succeed, every educator to excel, and every child to thrive.
More States Allow Students to Take Mental Health Days
Many states already have measures in place or are considering making changes to the school absentee rules to allow kids to miss school for mental health reasons. Between the rise in youth mental health issues in emergency rooms throughout the pandemic and the advisory U.S. Surgeon General Vivek H. Murthy issued in December of 2021 declaring a mental health crisis for American children, states and school administrations are recognizing mental health issues as a legitimate reason to miss school.
Indiana currently does not explicitly allow for school mental health days. Those interested in legislative action toward this and other school policy matters are encouraged to join the Covering Kids & Families Schools & Early Childhood Policy Subcommittee by emailing Meetings will begin prior to the upcoming legislative session.
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Marketplace Open Enrollment Trainings & Resources

The Centers for Medicare & Medicaid Services (CMS) Learning Opportunities:
  • Stakeholder calls - The kick-off webinar will be on October 20th at 1:00pm. The remaining webinars are monthly during open enrollment.
  • Weekly webinars - Every Wednesday at 2:00pm, these webinars are focused on various issues navigators may experience. You will need to register through the REGTAP technical assistance portal.
  • Assister Readiness Series - Recorded modules cover topics related to helping consumers enroll in Marketplace coverage. 

Beyond the Basics from the Center on Budget and Policy Priorities offers in-depth trainings live and recorded. They also have enrollment resources including an income calculation worksheet and a plan comparison worksheet available in eight languages.

Navigator Resource Guide from the Georgetown University Center on Health Insurance Reform includes FAQs and resources for diverse communities. 
Online & On-Demand Navigator Pre-Certification & Continuing Education Courses
Covering Kids & Families of Indiana invites you to view our online and on-demand Navigator Pre-Certification & Continuing Education Courses. Each course is approved by the Indiana Department of Insurance. The Pre-Certification Course is for those hoping to become a certified Indiana Navigator, and the Continuing Education Course is for current Indiana Navigators. There is no charge for these courses.
Enrollment Trends

Total Membership increased again in August. With 2,106,052 members, there were 24,311, or 1.17%, more members in August 2022 than in July 2022. August was the seventh month in a row where Total Membership was over 2 million. 
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