Three states have successfully transitioned away from the federal healthcare.gov ACA exchange to operate on their own-state run marketplace.
On October 4, Maine, New Mexico, and Kentucky completed the transition to their own state-based ACA health exchange, making the new total of state-run ACA exchanges 18, including Washington D.C.
Maine will facilitate its ACA marketplace through the new coverme.gov website. Maine-based independent health policy consultant, Mitchell Stein said “The state has more control and will be better able to personalize the outreach efforts… Assuming everything works as intended, the website should be very transparent for the end user, but they will be buying the same plans.”
Similar to Maine, New Mexico also launched a new ACA exchange website called bewellnm.com. The exchange houses a number of resources to assist state residents in accessing affordable care. The new state-based exchange will offer plans from five insurers, providing more options than most of the rest of the country, according to a post by healthinsurance.org.
Unlike Maine and New Mexico, Kentucky’s path towards a state-run exchange is rather cyclical. Governor Andy Beshear has reopened the highly successful kynect.ky.gov platform, first introduced in 2017 by his father and previous governor, Steve Beshear.
The Richmond Register says the platform will act as a one-stop-shop for Kentucky residents to apply for Medicaid and “other resources, including the Supplemental Nutrition Assistance Program (formerly food stamps) and family and child-care assistance programs.”
The state will be offering a variety of Anthem health plans across Kentucky’s 120 counties. For the first time, Kentucky residents will also be allowed to purchase vision plans through the new state-run ACA health exchange.
Regarding the success of the three states’ transition to a state-based ACA health exchange, Health and Human Resources Secretary (HHS) Xavier Becerra, said “Hundreds of thousands of people in Kentucky, Maine, and New Mexico now have coverage options that can be localized through the State-based Marketplace. The Biden-Harris Administration continues to support states across the country working to ensure people have quality, affordable coverage.”
All three states will operate on their own exchanges for the 2022 plan year. Open enrollment will begin on November 1, the same as the federal period.
Meanwhile, federal open enrollment is gearing up to be one of the most successful in the history of the ACA. Not only will the period be 30 days long, but it will also have substantially more resources available for outreach efforts and educating individuals on healthcare options. More insurers are expanding for the 2022 ACA plan year as well, which will no doubt provide greater access to affordable coverage.
Recent polls show that the healthcare law is growing in favorability amongst Americans and for the first time in a long time, the future of the ACA looks good.
As the ACA continues to receive growing support, employers should take caution regarding the healthcare law’s Employer Mandate responsibilities — they’re not going anywhere, in fact, they’re growing in complexity.
Under the ACA’s Employer Mandate, employers with 50 or more full-time employees and full-time equivalent employees are Applicable Large Employers (ALEs) and must:
- Offer Minimum Essential Coverage (MEC) to at least 95% of their full-time employees (and their dependents) whereby such coverage meets Minimum Value (MV); and
- Ensure that the coverage for the full-time employee is affordable based on one of the IRS-approved methods for calculating affordability.
Organizations not taking their ACA Employer Mandate obligations seriously should reassess their position, as the IRS has recently made clear its plans for increased enforcement. To get an idea of where you stand regarding ACA compliance and potential IRS penalty exposure, download the 2021 ACA Essential Guide for Employers.
For assistance preparing for the upcoming ACA reporting season, download the new Employer’s Guide to Coding ACA Form 1095-C.
We’re committed to helping companies reduce risk, avoid penalties, and achieve 100% ACA compliance. For questions about the ACA contact us here.