Medicaid

Yesterday I noted that the big year-end federal omnibus spending bill includes provisions which allow states to start kicking people off of Medicaid who are only eligible thanks to the COVID-19 public health emergency bills passed in 2020 & 2021..but it at least does so in a fairly responsible way by phasing out the extra federal matching funds gradually over a 9-month period, to prevent states from dumping everyone all at once.

The omnibus bill also includes other important positive Medicaid provisions such as letting children who are eligible for the program stay on it for at least 12 months regardless of  household income changes, and letting states offer 12 months of postpartum Medicaid/CHIP coverage to newborn children & their mothers on a permanent basis instead of the current 5-year limit.

As I (and many others) have been noting for over a year now, the official end of the federal Public Health Emergency (PHE), whenever it happens, will presumably bring with it reason to celebrate...but will also likely create a new disaster at the same time:

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):

Wyoming

With South Dakota becoming the latest holdout state to finally expand Medicaid to adults earning up to 138% of the Federal Poverty Level (FPL) under the Affordable Care Act last month, there's now just 11 states remaining which still haven't done so.

The smallest of these, which is also the smallest state in the country, is Wyoming, which has had a long & storied history when it comes to Medicaid expansion fakeouts. The "Equality State" legislature has considered expanding Medicaid to the roughly 19,000 residents who would become newly eligible for the program eight times since the ACA was signed into law in 2010, only to see approval of it fail at one stage or another every time.

 Well, according to this article by Katie Roenigk at "County 10" in Fremont County, Wyoming, it looks like the 9th time may be the charm:

November 29th, 2022, via the Centers for Medicare & Medicaid Services:

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.

As of August 2022, 64,942,984 people are enrolled in Medicare. This is an increase of 111,278 since the last report.

  • 34,939,872 are enrolled in Original Medicare.
  • 30,003,112 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage. 
  • ...As of August 2022, 90,550,412 people are enrolled in Medicaid and CHIP. This is an increase of 587,411 since the last report.
  • 83,494,001 are enrolled in Medicaid
  • 7,056,411 are enrolled in CHIP

As I noted at the time:

CMS Logo

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 August 2022, 64,942,984 people are enrolled in Medicare. This is an increase of 111,278 since the last report.

  • 34,939,872 are enrolled in Original Medicare.

  • 30,003,112 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage. 

  • 50,443,950 are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage. 

South Dakotans Decide Healthcare

 

Back in January 2021, I. noted that:

...over the past few years, the voters of some of those states have decided to take it upon themselves to force their legislators/governors to expand Medicaid anyway, via statewide ballot initiative campaigns:

CMS Logo

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 July 2022, 64,831,706 people are enrolled in Medicare. This is an increase of 149,601 since the last report. 

CMS Logo

via the Centers for Medicare & Medicaid Services:

Biden-Harris Administration Announces More than Half of All States Have Expanded Access to 12 Months of Medicaid and CHIP Postpartum Coverage

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced that more than half of all states have expanded access to 12 months of Medicaid and Children’s Health Insurance Program (CHIP) coverage after pregnancy. Georgia and Pennsylvania are the 25th and 26th states to be approved for the extended coverage, made possible by provisions in the American Rescue Plan (ARP), signed into law by President Biden in March of 2021. This announcement marks critical progress in the implementation of the Biden-Harris Administration’s Maternal Health Blueprint, a comprehensive strategy aimed at improving maternal health, particularly in underserved communities.

Arizona

via the Centers for Medicare & Medicaid Services (CMS):

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved Medicaid section 1115 demonstration initiatives in Arizona that will help the state take aim at health-related social needs. Like recently approved demonstrations in Oregon and Massachusetts, Arizona’s demonstration will test innovative interventions that target critical drivers of health outcomes, including housing insecurity.                     

“Everyone deserves the chance to receive the care they need to live safe and healthy lives,” said HHS Secretary Xavier Becerra. “We are proud to work with Arizona in this groundbreaking effort. We will continue doing all we can to strengthen Medicaid, and urge states to follow Arizona’s lead.”

Medicaid

As I (and many others) have been noting for many months now, the official end of the federal Public Health Emergency (PHE), whenever it happens, will presumably bring with it reason to celebrate...but will also likely create a new disaster at the same time:

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):

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