mmpc - National Indian Health Board

are eligible for the waiver (i.e., they would not have to go through the Exchange
application process to determine their eligibility as AI/AN).
i. NPRM on AI/AN cost sharing waiver and how providers/QHPs will be paid by
Federal government for the amount of cost sharing they are not collecting from
AI/AN will be issued in August.
3. New Issues that came up at FFE Tribal Consultation in DC, July 26
a. Partnerships - Administration is encouraging Partnership arrangements with
states and it’s not clear whether Tribes need to be consulting with States or
Feds, or both. More work for Tribes and very confusing.
b. State Exchange Tribal Consultation Policies - States are not being required to
have Tribal Consultation Policy for Exchanges until they submit the package to
be certified (April 2013) – which means Tribes will not necessarily be consulted in
the decisions about Exchanges.
- Example: Essential Health Benefits
c. Indian questions on application - Amy Erhardt is working on the applications
and she said that waiver of cost sharing will only happen if applicant declares
that they want to be considered for an “Insurance Accessibility Program”.
i. The law says all AI are eligible for cost sharing waivers, even if they
don’t want one of the Insurance Accessibility Programs (Medicaid, CHIP,
Advanced Tax Credits).
ii. This is important because we don’t want MAGI calculated for people
who haven’t filed tax returns.
iii. This approached was not challenged in the DC meeting.
iv. New acronym: APTC/CSR (= Advanced Payment of Tax Credits and
Cost Sharing Reductions)
c. Navigators and In Person Assistance - (Holly Whalen is CCIIO point person
on this)
I. Looks like there will be competition for Navigator grants at federal level
– no set aside for Tribes.
ii. A second source of funding that can come from federal establish
grants, but is not identified in the law is “in-person assistance.”
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