via the Centers for Medicare & Medicaid Services (CMS), by email:
Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.
Medicare
As of November 2022, 65,372,781 people are enrolled in Medicare. This is an increase of 136,217 since the last report.
35,114,923 are enrolled in Original Medicare.
30,257,858 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.
Based on current COVID-19 trends, the Department of Health and Human Services is planning for the federal Public Health Emergency for COVID-19 (PHE), declared under Section 319 of the Public Health Service Act, to expire at the end of the day on May 11, 2023. Thanks to the Administration’s whole-of-government approach to combatting the virus, we are in a better place in our response than we were three years ago, and we can transition away from an emergency phase.
I'd never heard of Illinois state Senator Laura Fine before now. I know absolutely nothing else about her besides her being a Democrat who represents IL Senate District 9.
As I noted a few weeks back, the Patient Protection & Affordable Care Act now directly provides healthcare coverage for a stunning 40 million Americans:
...it's very likely that another 50,000 - 100,000 people will be added to the final QHP tally when the dust settles tomorrow (Tuesday, January 31st) evening. Even assuming the same 94% effectuation rate, that will still bring the effectuated QHP total to roughly 15.4 million.
Add to this the 1,217,517 confirmed Basic Health Plan (BHP) enrollees in New York and Minnesota and the subtotal comes to around 16.62 million QHPs + BHPs combined.
Next, we need to add Medicaid Expansion enrollees.
...the MBES reports only run through March 2022, at which point the national ACA expansion total stood at 22,275,433.
We're up to 38.9 million Americans with ACA coverage already, and we're still missing a lot of Medicaid expansion enrollees.
Updated 8/17/23: D'oh! I completely forgot about this development when I started running my state-by-state rate filing analyses this summer. No wonder Humana has disappeared from over a dozen states for 2024!
Update 3/15/23: At the request of Humana's Sales Integrity Dept., I've removed their logo from this blog entry.
Before I start, let me say that I've never been a fan of Medicare Advantage, at least as its currently structured, for a number of reasons. I am not advocating for the Medicare Advantage system--again, as currently structured--to be expanded.
ICYMI: Governor Murphy and Commissioner Caride Announce Record-Breaking 341K People Signed Up for Health Insurance During Open Enrollment Period
Nearly 40% Increase in Sign-Ups Since the Murphy Administration Assumed Operation of the Health Insurance Exchange
Residents with a Qualifying Life Event or Who Meet Certain Income Levels Still Have Options to Get Covered
TRENTON – Governor Phil Murphy and Department of Banking and Insurance Commissioner Marlene Caride today announced that more than 341,000 New Jerseyans signed up for health coverage through Get Covered New Jersey during the Affordable Care Act Open Enrollment Period – a record high in New Jersey.
Over on Twitter, political commentator Krystal Ball made an interesting claim:
A provision in Obamacare allows residents in areas deemed a public health disaster to be covered by Medicare for life. At the very least, East Palestine residents deserve this universal coverage after being exposed to a known carcinogen. https://t.co/ooPYmJ4Y8b
Dear Governor Whitmer, House Speaker Tate, Senate Majority Leader Brinks, House Health Policy Committee Chair Rogers & Senate Health Policy Chair Hertel:
Five years ago, ahead of the 2018 midterm election, I wrote an open letter to all Michigan Democratic legislative candidates with a healthcare policy wish list. It included 26 ways to Protect, Repair & Strengthen the #ACA at the state level, several of which overlapped with the Democratic caucus's "Michigan Health Care Bill of Rights."
Unfortunately, while Democrats made large gains in Michigan in 2018, we didn't quite flip control of either the state House or Senate; it would take another four years to pull that off. Fortunately, that did happen last November, giving Democrats a trifecta in the House, Senate and Governor's office at the same time for the first time in decades, so it's time for me to compile an updated version of my Michigan healthcare policy wish list.
HealthSherpa continues to be the largest private channel for ACA enrollments in the US, insuring over 5 million people for 2023 and growing more than 50% year over year
In its strongest season yet, HealthSherpa has enrolled more than 5 million people in Plan Year 2023 coverage and enrolled HALF of all new Affordable Care Act enrollees in Federally Facilitated Marketplace (FFM) states during Open Enrollment. HealthSherpa now accounts for 35% of all FFM enrollments and volume grew more than 50% year over year, far outpacing the FFM as a whole which grew only 13% (1).
A couple of weeks ago I wrote about how the Georgia state government, which for years has been among the more ACA-hostile GOP states, and which has spent the past several years actively attempting to get out of having any official ACA exchange platform whatsoever, has seemingly done a complete 180 and now supposedly wants to go the other way:
Georgia GOP leaders have proposed a bill that they hope will lead to a state takeover of the health insurance exchange marketplace for Affordable Care Act plans.
...Traditionally a majority of Georgians shop for ACA plans on the federally run marketplace website, healthcare.gov. Eighteen states use their own marketplace website, according to the Kaiser Family Foundation. The key feature of these sites is they allow shoppers to objectively compare their options for price and coverage.
It’s unclear exactly what the state’s replacement would be.
One of the big public health stories last week was that Johns Hopkins University, which has been operating one of the best COVID-19 tracking projects in the country since the pandemic hit U.S. shores, has announced that they're shutting it down next month:
When the pandemic hit, the federal government struggled to publish snapshots of the virus’ spread.
So, academics and journalists quickly filled the void, creating new tools with near real-time estimates of the unfolding pandemic.
Since January 2020, Johns Hopkins University has operated one of the most prominent resources for tracking covid-19 case counts and deaths across the world.
Tax Season is a Health Coverage Enrollment Opportunity
DENVER— The annual Open Enrollment Period for health insurance ended mid-January, but Coloradans who missed the enrollment deadline could still have a special opportunity to sign up for health coverage as a result of the Tax Time Enrollment Program.
The Tax Time Enrollment Program, which launched last year, provides Coloradans the opportunity to check a box on their state tax return to share their information with Connect for Health Colorado and the state Department of Health Care Policy & Financing for the purpose of obtaining health coverage. Through October 2022, approximately 1,700 people used the Tax Time Enrollment Program to enroll in a health insurance plan through Connect for Health Colorado.
RALEIGH, N.C. (AP) — The North Carolina General Assembly began on Tuesday what could become the final push to expand Medicaid to hundreds of thousands of low-income adults in the state with a House measure that quickly advanced through two committees with bipartisan support.
The bill is generally expected to pass the NC House as soon as today...and a different version of the bill is expected to pass the state Senate as well. The issue is the difference between the two versions:
Medicaid expansion will be up for debate once again when the Wyoming Legislature convenes for its 67th session in January.
The legislature’s Joint Revenue Committee voted to advance the Medical Treatment Opportunity Act to the legislative session during a meeting this month.
It’s the same bill the legislature considered during the 2022 session, state staffers said.
The proposed legislation would allow Medicaid expansion to occur in Wyoming as long as the federal contribution to the program remains at 90 percent or higher.
Perhaps the greatest success of the American health care system these last few benighted years is this surprising fact: The uninsured rate has reached a historic low of about 8 percent.
...One [COVID era] policy was likely the single largest factor. Over the past three years, under an emergency pandemic measure, states have stopped double-checking if people who are enrolled in Medicaid are still eligible for its coverage. If you were enrolled in Medicaid in March 2020, or if you became eligible at any point during the pandemic, you have remained eligible the entire time no matter what, even if your income later went up.
But in April, that will end — states will be re-checking every Medicaid enrollee’s eligibility, an enormous administrative undertaking that will put health insurance coverage for millions of Americans at risk.
The Biden administration estimates upward of 15 million people — one-sixth of the roughly 90 million Americans currently receiving Medicaid benefits — could lose coverage, a finding that independent analysts pretty much agree with. Those are coverage losses tantamount to a major economic downturn: By comparison, from 2007 to 2009, amid the worst economic downturn of most Americans’ lifetimes, an estimated 9 million Americans lost their insurance.
There's been a LOT of buzz among healthcare wonks over the past week about major developments happening with the ACA's Basic Health Plan (BHP) programs in both Minnesota and New York State. This article is about Minnesota; I'll post about what's happening in New York separately.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.
As of this writing, 69.2% of the total U.S. population has completed their primary COVID-19 vaccination series (including 94.2% of those 65+), but a mere 15.8% of the total population has also gotten their updated bivalent booster shot. Even among seniors it's only at 40.8% nationally.
A classic tax-season scam is back with a new twist. Clients in New Mexico have reported receiving calls from scammers posing as beWellnm representatives, trying to obtain private and secure information.
BeWellnm, New Mexico’s health insurance exchange, will never call and ask a customer to text or email your bank information, credit card or social security number.
“Customers who received insurance through the exchange will need a 1095-A form – Health Insurance Marketplace Statement – for their taxes. Scammers know this and think they can take advantage, but we are here to protect consumers and offer them free help with their 1095-A form,” said Bruce Gilbert, Chief Executive Officer of beWellnm.
BeWellnm will be providing customers who obtained insurance through the exchange at any point last year with their 1095-A form. You should expect to see if in the mail in the coming weeks. This form is very important and will be filed with your federal taxes to complete Form 8962: Premium Tax Credit.
The end of the maintenance of effort requirement will be the most significant event for exchange stakeholders in 2023, according to various sources who work closely with health insurance exchanges across the country.
...Estimates of how many people could lose Medicaid benefits and have access to other coverage range from about 15 million to 18 million, and of those about 2.5 million could be eligible for exchange coverage according to recent analyses by HHS and the Urban Institute.
This section contains enrollment data through January 15, 2022.
1. Total Plan Selections (net): Count of unique individuals who have selected a Plan Year (PY) 2023 Marketplace medical plan. Count includes all new and re-enrolling consumers (defined in Indicators 2 and 3), regardless of whether the consumer has paid the first month premium. Count does not include plans that were canceled or terminated.: 40,689
Note: Yes, I'm aware that the upcoming "unwinding" of Medicaid via the end of the Public Health Emergency provisions is about to blow this entire project up, but that's kind of the point, to see where things stand as of this moment.
Seven years, two administrations, one federal insurrection and one global pandemic later, I figured it was time to finally update the breakout of what I've since decided to refer to as the Psychedelic Donut.
This Tax Season, PA takes the Path to Pennie™ for Quality, Accessible Health Coverage
This tax season, uninsured Pennsylvanians can enroll in quality, low-cost health coverage through Path to Pennie™. The Pennsylvania Department of Revenue and Pennie have teamed up to allow uninsured tax filers the ability to get covered outside of Open Enrollment. When completing their Pennsylvania state income tax return, individuals can indicate interest in getting covered through Pennie.
Uninsured Pennsylvanians will be able to indicate they are without health insurance through an optional tax form called, REV-1882 ‘Health Insurance Coverage Information Request.’ This form creates a simple and straightforward way for Pennsylvanians to specify that they, their spouse, and/or their dependents do not have health coverage and are interested in learning more about the services provided by Pennie.
I'll write more about President Biden's future healthcare agenda wish list after this evening's State of the Union address (let's face it, not much of it will be accomplished given that the GOP has retaken control of the House of Representatives), but in the meantime here's a nice summary of the major healthcare-related accomplishments of his administration so far, via the White House website:
Covered California Provides New Opportunities for People to Sign Up for Health Insurance Through Special Enrollment
SACRAMENTO, Calif. — Covered California is reminding Californians that they still have an opportunity to sign up for quality health insurance and get financial help to lower the cost of their monthly premiums even though open enrollment ended on Jan. 31. Every year, Covered California allows people who have experienced a significant life event to sign up for coverage during special enrollment.
“Californians can still protect themselves and their families with quality health insurance for the rest of the year, if they have had a major change in their lives,” said Jessica Altman, executive director of Covered California. “If you have recently lost your coverage, gotten married, had a baby, or have been affected by California’s winter storms, visit CoveredCA.com to check out what plans are available to you.”
Consumer Advisory: Former Individual Market Bright Health & Oscar Health Enrollees Have Until March 1 to Choose New Coverage
Special Enrollment Period allows them to still get insurance for 2023.
DENVER - People who had individual health insurance plans (insurance not from an employer) from Bright Health and Oscar Health in 2022 are reminded that they have until the end of February to choose a health plan from another company for 2023 insurance.
Even though the regular open enrollment for individual health insurance plans concluded on January 15, consumers who had their Bright or Oscar coverage finish at the end of December are allowed a 60-day special enrollment period (SEP) because those companies did not offer plans for 2023. This 60-day SEP started on January 1 and will continue until March 1, 2023.
Special enrollment remains open for those who qualify for, but are not enrolled in, Cascade Care Savings
More than 60% of Washington Healthplanfinder customers are in a Cascade Care plan
Washington Health Benefit Exchange (Exchange) released its 2023 Enrollment Preview Report today. Nearly 231,000 customers signed-up for a 2023 qualified health plan through Washington Healthplanfinder, including 37,000 new customers.
“We had our highest net enrollment gain and launched the new Cascade Care Savings during open-enrollment for 2023, resulting in our highest percentage of subsidized customers and highest percentage of plan switching,” Exchange interim CEO Jim Crawford said.
The exact QHP total, according to the preview report, was 230,800, down 3.7% from the 2022 Open Enrollment Period.
Georgia GOP leaders have proposed a bill that they hope will lead to a state takeover of the health insurance exchange marketplace for Affordable Care Act plans.
...Traditionally a majority of Georgians shop for ACA plans on the federally run marketplace website, healthcare.gov. Eighteen states use their own marketplace website, according to the Kaiser Family Foundation. The key feature of these sites is they allow shoppers to objectively compare their options for price and coverage.
It’s unclear exactly what the state’s replacement would be.
As I noted this morning, while the 2023 ACA Open Enrollment Period has now officially ended in all states, there's still a lot of Special Enrollment Period (SEP) exceptions for people who have Qualified Life Experiences (QLEs) such as losing their current coverage, turning 26, moving, getting married/divorced, giving birth and so forth.
There's also year-round enrollment available for members of Native American tribes, as well as those eligible for Medicaid and the Children's Health Insurance Program (CHIP).
Finally, in most states, residents are eligible to enroll year-round as long as their income is below a certain threshold--usually 150% of the Federal Poverty Level (FPL), somewhat higher in some states, including New York, where residents earning. up to 200% FPL can enroll in the Essential Plan year-round.
Last month I noted that the partisan COVID death rate gap, which had been significantly higher in the reddest U.S. counties than the bluest counties every month since July 2020, appeared to be on the verge of finally disappearing entirely:
The initial COVID wave in March - May 2020, of course, devastated Blue America, primarily densely populated (and heavily Democratic) New York and New Jersey, while leaving Red America (mostly sparsely populated, rural Republican counties) relatively unscathed.
This situation quickly began to reverse itself only a few months later. Starting in July 2020--the same month the Vanity Fair expose was published, as it happens--the situation had already reversed itself: The reddest fifth of the U.S. was already experiencing a higher COVID death rate than the bluest fifth...and it has stayed that way ever since.
However, as I keep noting, there's still plenty of people who are eligible to enroll in ACA healthcare coverage during the off-season (thanks to Louise Norris for providing some of the links below):
