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):
Under the Guise of “Health Insurance Stabilization,” Congress Should Not Axe Financial Help for Low-Wage Families
In negotiations over stabilizing the individual health insurance market, lawmakers are considering slashing federal health care assistance for low- and moderate-income consumers by more than $27 billion a year. In dollars terms, this would be a greater blow than completely eliminating, in one stroke, the Low-Income Home Energy Assistance Program, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the Child Care and Development Block Grant, the Community Development Block Grant, and federal grant programs for community-based mental health services and substance abuse prevention and treatment.
Between the lines: This doesn't solve the partisan dispute over abortion language, as it'd bar plans that offer abortion coverage from receiving federal subsidies. But it hints that there's Republican support behind a set of policy changes that could substantially lower premiums ahead of the 2018 elections.
I wrote an extensive piece about the way abortion coverage is currently handled for ACA exchange policies back in October 2017:
