As part of the Biden-Harris Administration’s work to advance health equity and reduce health disparities, the Centers for Medicare & Medicaid Services (CMS) is seeking feedback on topics related to health care access, such as enrolling in and maintaining coverage, accessing health care services and supports, and ensuring adequate provider payment rates to encourage provider availability and quality. This Request for Information (RFI) is one of many actions CMS is taking to develop a more comprehensive access strategy in its Medicaid and CHIP programs.
“We are committed to providing equitable access to quality health care and removing any barriers to quality health care,” said Health and Human Services Secretary Xavier Becerra. “We want to hear directly from stakeholders so we can strengthen our programs for the more than 80 million Americans with Medicaid or CHIP health insurance. Together, by advancing health equity, we can ensure quality health care is within reach for everyone who needs it.”
As I just noted, the end of the official COVID-19 Public Health Emergency, whenever it happens (it's currently scheduled to end as of April 16th but could be extended once again at any point before then) will cause a new problem:
Millions of Americans currently enrolled in Medicaid will likely no longer be legally eligible to remain on the public healthcare program, threatening to cause a massive overload of agencies and potentially leaving many of them stranded without any healthcare coverage at all.
Legislation to help about 300,000 Oregonians on Medicaid to maintain their coverage after the Covid-19 public health emergency ends advanced out of committee on Monday.
What goes up usually goes back down eventually, and that's likely to be the case with Medicaid enrollment as soon as the public health crisis formally ends...whenever that may be.
Well, yesterday Ryan Levi and Dan Gorenstein of of the Tradeoffs healthcare policy podcast posted a new episode which attempts to dig into just when that might be, how many people could be kicked off of the program once that time comes and how to mitigate the fallout (I should note that they actually reference my own estimate in the program notes):
CMS Commits Over $49 Million to Reduce Uninsured Rate Among Children and Boost Medicaid Enrollment Among Parents, Pregnant People
The Centers for Medicare & Medicaid Services (CMS) committed a record $49.4 million to fund organizations that can connect more eligible children, parents, and pregnant individuals to health care coverage through Medicaid and the Children’s Health Insurance Program (CHIP). Awardees—including state/local governments, tribal organizations, federal health safety net organizations, non-profits, schools, and others—will receive up to $1.5 million each for a three-year period to reduce the number of uninsured children by advancing Medicaid/CHIP enrollment and retention.
Not too many changes were made in either market. I get a weighted average increase of 4.6% for individual market plans (MI DIFS puts it at 4.7%), while I get exactly +7.0% for small group plans (MI DIFS puts it at +7.1%).
As I noted in August, the other noteworthy changes are:
They also estimate that another 1.8 million uninsured Americans who are eligible for subsidized ACA exchange plans who would be eligible for Medicaid instead if those state actually did expand Medicaid (and perhaps another 100K in Missouri). That's nearly 4.0 million total...
So, how to crack this nut in these holdout states, all of which are either completely or partially controlled by Republicans who have adamantly refused to expand the program no matter what all these years?
Highlighting Michigan’s increasingly competitive health insurance market, the Michigan Department of Insurance and Financial Services (DIFS) has reported that consumers will have more health plan options from an increased number of insurers on the Health Insurance Marketplace for the upcoming open enrollment period.
“As we look toward the end of the pandemic and beyond, it is critical that Michiganders are able to get the affordable, high quality health coverage they need for themselves and their families,” said DIFS Director Anita Fox. “Consumers will have more options to choose from when shopping for health insurance coverage on the Marketplace during open enrollment later this year.”
HHS Encourages States to Educate Eligible Immigrants about Medicaid Coverage
Today, the US Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin to states’ Medicaid and Children’s Health Insurance Program (CHIP) agencies reaffirming that the 2019 Public Charge Final Rule – “Inadmissibility on Public Charge Grounds” – is no longer in effect and states should encourage their eligible immigrant populations to access public benefits related to health and housing.
Missouri just voted #YesOn2 to expand Medicaid, and now, because of YOUR vote, over 230,000 hardworking people will have access to life-saving healthcare!pic.twitter.com/azHN0GJjEW
— YesOn2: Healthcare for Missouri (@YesOn2MO) August 5, 2020
Republican lawmakers blocked Medicaid expansion funding from reaching the Missouri House floor on Wednesday, posing a setback for the voter-approved plan to increase eligibility for the state health care program.
As I (and others) have written many times, closing the so-called "Medicaid Gap" is one of the trickiest challenges President Biden and Congressional Democrats face when it comes to strengthening and improving the Affordable Care Act.
Once again: Under the ACA, all Americans earning up to 138% of the Federal Poverty Level (FPL)... roughly $17,700/year for a single adult or around $36,500 for a family of four...were supposed to be eligible to join Medicaid regardless of their health status, whether they had kids and so forth.
This was supposed to be the case in all 50 states and the District of Columbia (I'm not sure about Puerto Rico or the other U.S. territories...many ACA provisions never applied to them in the first place).
Unfortunately, one of the major consequences of the NFIB vs. Sebelius Supreme Court Case in 2012 was that expansion of the Medicaid program has to be voluntary on the part of each state.
