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Aetna’s weekly healthcare update 1/6/2014

Health Reform Weekly

A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country.


Week of January 6, 2014

When the Obama administration announced last week that Obamacare enrollments had reached about 2.1 million, it was both a sign of how far Affordable Care Act (ACA) implementation has come and how far it still has to go.  The enrollment numbers signal significant progress has been made since the fumbled launch of the website in October. But the enrollment numbers are still well short of the 3.3 million number set by the Congressional Budget Office (CBO) as the benchmark for a successful start – numbers the administration said were “never our target.”

What remains clear, however, is that as of January 1, 2014 the most significant changes under the ACA have now taken effect. The health benefits marketplace has been
dramatically changed, from the way individuals and those working for small employers obtain their coverage to new rules, such as the individual mandate and a prohibition on pre-existing condition exclusions.  The rules may continue to evolve as the administration addresses issues related to the bumpy rollout of Obamacare, but the new marketplace has arrived.


The Centers for Medicare & Medicaid Services (CMS) announced last week that it has awarded more than $307 million in performance bonuses to 23 states for improving access to children’s health coverage and successfully enrolling eligible children in Medicaid. The performance bonuses were authorized under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). This is the fifth and final year of performance bonus awards.  The bonuses help states by offsetting the costs of insuring the lowest income children and encouraging them to adopt sustainable improvements in their children’s health coverage programs. The amount of a state’s bonus corresponds to the increase in children’s Medicaid enrollment over a specified target. CMS touted recent Census data that show the uninsured rates for children declined from 8.6 percent in 2009 to 7.5 percent in 2011.