Medicaid

On his first day in office, Donald Trump issued dozens of Executive Orders. Some of these are mostly symbolic; some won't have any effect without legislative action; some are blatantly unconstitutional & are already being challenged in court. Many, however, are terrifying and will have horrific consequences for thousands or potentially millions of Americans and non-Americans alike.

I already noted that one such order would withdraw the United States from the World Health Organization, which we curently provide 20% of the funding for.

Along with issuing his own new ones, Trump has also already rescinded over 60 XOs issued by President Biden. In this post I'm going to focus on three of them which pertain specifically to healthcare policy.

Again, all three of the following have now been RESCINDED BY DONALD TRUMP:

Many voices including mine have been warning of this for months, so it shouldn't come as a surprise to anyone, but here it is regardless: Last week Politico got ahold of a "menu" of draconian cuts to a wide variety of federal programs, mostly regarding healthcare policy, which House Republicans plan on implementing with their new trifecta:

The early list of potential spending offsets obtained by POLITICO includes changes to Medicare and ending Biden administration climate programs, along with slashing welfare and “reimagining” the Affordable Care Act.

The biggest program on the hit list, however, is Medicaid, which would make up nearly half of the $5 TRILLION in budget cuts Republicans have in mind in order to pay for...massive tax cuts for corporations & the wealthy, of course.

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

October 2024 Key Findings

Medicaid and CHIP Enrollment

• In October 2024, 79.3 million individuals were enrolled in Medicaid and CHIP.
  • 72.1 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
  • 41.7 million adults were enrolled in Medicaid, and there were 37.6 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

• In October 2024, Medicaid, CHIP, Human Services agencies, and State-based Marketplaces received 2.6 million applications, or 2 percent more applications, as compared to September 2024.
• The number of applications received has increased by 20 percent since October 2023 and increased by 66 percent since October 2022.

Total Medicaid/CHIP enrollment in October 2024 still dropped very slightly from September...by just 55,000 people.

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

September 2024 Key Findings

Medicaid and CHIP Enrollment

• In September 2024, 79.4 million individuals were enrolled in Medicaid and CHIP.
  • 72.2 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
  • 41.7 million adults were enrolled in Medicaid, and there were 37.6 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

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

Under the Inflation Reduction Act, some people with Medicare will pay less for some Part B drugs because the drug’s price increased faster than the rate of inflation.

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today announced that some Medicare enrollees will pay less for 64 drugs available through Medicare Part B. The drugs will have a lowered Part B coinsurance rate from January 1, 2025 – March 31, 2025, since drug companies raised prices for each of these 64 drugs faster than the rate of inflation. Over 853,000 people with Medicare use these drugs annually to treat conditions such as cancer, osteoporosis, and substance use disorder. Since April 1, 2023, people with Medicare have seen savings on over 120 drugs thanks to Inflation Reduction Act’s Medicare Prescription Drug Inflation Rebate Program.

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

August 2024 Key Findings

Medicaid and CHIP Enrollment

• In August 2024, 79.4 million individuals were enrolled in Medicaid and CHIP.
  • 72.3 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
  • 41.8 million adults were enrolled in Medicaid, and there were 37.6 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

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

Biden-Harris Administration Announces Medicare Advantage and Medicare Part D Prescription Drug Proposals that Aim to Improve Care and Access for Enrollees

Today, the Centers for Medicare & Medicaid Services (CMS) is proposing actions in the Medicare Advantage (MA) and Medicare Part D prescription drug programs to continue to strengthen protections and access to care for people with Medicare. The Contract Year (CY) 2026 MA and Part D proposed rule aims to hold MA and Part D plans more accountable for delivering high-quality coverage so that people with Medicare are connected to the care they need when they need it.

Yep, my wife & I screwed up royally. Yes, I know: I'm "The ACA Guy" and yes, it's incredibly embarrassing to tell this story, but I'm doing so in the hopes of helping others avoid making the same mistake.

It's been several years since we enrolled in an ACA policy ourselves via HealthCare.Gov, since we were enrolled in my wife's student plan up until recently (she returned to college to get her master's degree). The last few times we were able to enroll or renew our policies without any issues, so we assumed it wouldn't be an issue this time.

However, there seem to have been a few changes to some of the questions during the application process, and one of them threw us for a loop.

In the household income section of the application process, Healthcare.Gov asks both how much you expect to earn this month specifically (November 2024) as well as how much you expect to earn for all of 2025.

It was the first of these questions which is what caused the problem for us.

You see, both my wife and I are self-employed, which means we have highly variable incomes--we may earn $10,000 one month but not earn anything the next.

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

• In July 2024, 79,560,396 individuals were enrolled in Medicaid and CHIP, a decrease of 403,074 individuals (0.5%) from June 2024.
  • 72,429,055 individuals were enrolled in Medicaid in July 2024, a decrease of 441,475 individuals (0.6%) from June 2024.
  • 7,131,341 individuals were enrolled in CHIP in July 2024, an increase of 38,401 individuals (0.5%) from June 2024.

• As of July 2024, enrollment in Medicaid and CHIP has decreased by 14,455,287 individuals (15.4%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
  • Medicaid enrollment has decreased by 14,440,102 individuals (16.6%).
  • CHIP enrollment has decreased by 15,185 individuals (0.2%).

• Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,109,188 individuals (32.6%) to 94,015,683.
  • Medicaid enrollment increased by 22,819,861 individuals (35.6%).
  • CHIP enrollment increased by 289,327 individuals (4.2%).

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

• In June 2024, 79,963,470 individuals were enrolled in Medicaid and CHIP, a decrease of 851,310 individuals (1.1%) from May 2024.
  • 72,870,530 individuals were enrolled in Medicaid in June 2024, a decrease of 838,377 individuals (1.1%) from May 2024.
  • 7,092,940 individuals were enrolled in CHIP in June 2024, a decrease of 12,933 individuals (0.2%) from May 2024.

• As of June 2024, enrollment in Medicaid and CHIP has decreased by 13,943,010 individuals (14.8%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
  • Medicaid enrollment has decreased by 13,860,029 individuals (16.0%).
  • CHIP enrollment has decreased by 82,981 individuals (1.2%).

• Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,999,985 individuals (32.4%) to 93,906,480.
  • Medicaid enrollment increased by 22,681,263 individuals (35.4%).
  • CHIP enrollment increased by 318,722 individuals (4.6%).