Tuesday, September 27, 2016

CMS Bolsters Outreach To Young Adults As Open Enrollment Nears

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On September 27, the Centers for Medicare and Medicaid Services announced a new campaign to enroll young adults in the health insurance marketplaces. The announcement was released as part of the White House Millennial Outreach and Enrollment Summit.

Young adults have seen the sharpest drop in uninsured rates since the enactment of the Affordable Care Act (ACA) in 2010, yet millions remain uninsured. Nine out of 10 marketplace-eligible young adults without health insurance have incomes that would make them eligible for tax credits, thus they should find marketplace coverage affordable. As young adults tend to be healthy and use little medical care, enrolling them in the marketplaces is an essential step toward stabilizing the marketplace risk pools. Thus, CMS and other federal agencies and private partners are undertaking a major outreach effort to enroll young adults in marketplace coverage for 2017.

This effort has several components. First, the outreach effort will use online platforms that cater to young adults. Specifically, it intends to use Twitch, a gamer social video platform and community. According to the press release, this effort will feature:

HealthCare.gov pre-roll before videos, a homepage takeover, and ongoing efforts with streamers on Twitch to amplify our message throughout Open Enrollment.

For those of you who, like me, cannot fully grasp the intricacies of this statement, it's worth noting that 10 million daily active users, many of them 18-36 year olds, currently spend 106 minutes per-day, per-person on Twitch.

CMS intends to improve its functionality on mobile devices, which one-in-five millennials use exclusively for internet access. It will offer an end-to-end mobile shopping experience, including the ability to comparison shop on a phone or tablet with intuitive navigation and a streamlined interface to compare plans.

CMS is also launching a coordinated social media outreach campaign to young adults under the umbrella #HealthyAdulting. CMS is partnering with nearly two dozen youth, ethnic, medical, disability, women's, and religious groups to conduct outreach campaigns using digital platforms used by young adults, including Facebook, Twitter, and Tumblr to encourage young people to enroll in marketplace coverage. Partnering organizations will host Twitter, Facebook, and Tumblr events potentially reaching hundreds of thousands of their young adult followers.

Finally, CMS is targeting individuals whose coverage will soon end and those who were not covered last year. They are collaborating with the Department of Defense to reach out to service members who are transitioning out of military health coverage. Likewise, they are also working with state Medicaid and CHIP programs to contact individuals losing Medicaid or CHIP coverage (about half of whom are aged 18-34) to encourage them to enroll in marketplace coverage. As announced earlier, the Internal Revenue Service is also contacting individuals who paid the shared responsibility fee or claimed an exemption for 2015 to encourage them to enroll in marketplace coverage. About 45 percent of taxpayers who paid the fee or claimed an exemption in 2015 were under age 35.

Hawai'i Completes 1332 Waiver

On September 26, CMS notified Hawai'i that its application for a 1332 waiver was complete. Section 1332 of the ACA allows HHS (and the IRS) to waive or modify certain ACA requirements to encourage state innovation as long as proposed state programs meet the coverage and affordability goals of the ACA.

Hawai'i asks that it be excused from operating a Small Business Health Options (SHOP) marketplace program and that small group health plans in the state not be required to offer a silver level plan. Hawai'i's Prepaid Health Care Act has long required small businesses to offer even more generous health plans, thus these provisions are unnecessary.

HHS now has 180 days to approve or disapprove Hawai'i's proposal. It is requesting public comments by October 26, 2016.



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