Medicaid

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

The Centers for Medicare & Medicaid Services’ (CMS’) final rule will make it easier for millions of eligible people to enroll in and retain their Medicare Savings Program (MSP) coverage. The final rule reduces red tape and simplifies Medicare Savings Program enrollment, helping millions of seniors and people with disabilities afford coverage. The final rule follows President Biden’s executive orders in January 2021, December 2021, and April 2022, directing federal agencies to take action to expand affordable, quality health coverage.

Mississippi is one of the ten states where ACA Medicaid expansion still hasn't gone through a full decade after it could have (well...eleven if you include North Carolina, where the Republican-controlled legislature is currently holding it hostage).

A few years ago, Medicaid expansion in Mississippi looked like it might actually happen: While the states GOP Governor and Republican supermajority-controlled state legislature opposed it, in May 2021 there was a strong grassroots effort to put a statewide initiative on the ballot to push it through regardless, exactly how it happened in other deep red states like Utah, Nebraska, Idaho and South Dakota.

Unfortunately, just a few weeks later, the Mississippi Supreme Court crushed that effort:

Back in March, after years of failed and stalled attempts to get it passed, the North Carolina legislature finally pushed ACA Medicaid expansion over the line to be signed into law by Democratic Governor Roy Cooper.

As for when the program would actually go into effect, however...that's been something of a mystery for awhile now. Apparently the wording of the legislation ties it in with it being included in the general state budget, which hasn't happened yet. As a result, no one seems to be sure when the healthcare expansion program for up to ~600,000 North Carolina residents will actually launch.

Back in July, the Health & Human Services Dept. took an optimistic stance, preparing for the possibility of the program kicking off starting on October 1st of this year. Unfortunately, that was based on the assumption that the GOP-controlled state legislature would actually pass the general budget required for it to happen by September 1st.

It's now September 18th. Where do things stand?

Yesterday the U.S. Census Bureau published new reports on Income, Poverty and Health Insurance Coverage in the United States as of 2022. Obviously all three of these are extremely important and interact closely with each other, but given that my focus is healthcare policy, I'm going to stick with the health insurance coverage portion.

According to the 2023 Current Population Survey Annual Social & Economic Supplement (CPS ASEC):

...92.1% of the U.S. population had health insurance coverage for all or part of 2022 (compared to 91.7% in 2021). An estimated 25.9 million or 7.9% of people did not have health insurance at any point during 2022, according to the 2023 Current Population Survey Annual Social and Economic Supplement (CPS ASEC). That compares to 27.2 million or 8.3% of people who did not have health insurance at any point during 2021.

It's been about five months since I last posted about the status of Oregon's pending Basic Health Plan program:

As reported by Megan Messerly of Politico in 2022:

In Oregon, Democrats passed a bill in March to establish a basic health program, the details of which are being ironed out by a task force that began meeting this week. In Kentucky, Republicans approved $4.5 million in state funds this spring to set up a basic health program, which was signed into law by the state’s Democratic governor. An estimated 85,000 Oregonians and at least 37,000 Kentuckians will be eligible to enroll in the plans as soon as next year.

Medicaid Unwinding

I haven't checked in on how many Americans have lost Medicaid or CHIP coverage due to the ongoing Medicaid Unwinding process playing out nationally since the end of July. Fortunately, KFF (formerly the Kaiser Family Foundation) has been diligently tracking the data, and it continues to be extremely depressing and concerning.

At the time, "only" 3.77 million people had been confirmed to have lost coverage purely due to procedural/red tape reasons (as opposed to others who lost coverage after being determined ineligible any longer).

KFF's data is now pretty comprehensive (it includes nearly every state plus DC), and it's bad if not worse than many healthcare advocates feared as the numbers have continued to grow dramatically:

Over at Inside Health Policy, Dorothy Mills-Gregg has decided to check in on "Georgia Pathways," the Peach State's new program which partially expands Medicaid to residents earning up to 100% of the Federal Poverty Level (FPL), but with a rather significant string attached: Work reporting requirements:

As noted by Madeline Guth of the Kaiser Family Foundation last year:

...in spite of nearly every state which tried to (or succeeded in) implement Medicaid work requirements having their programs shut down by the courts, one state's work/reporting managed to survive: Georgia. As explained in the Kaiser article:

Michigan

Last Tuesday I noted that a package of bills designed to codify various ACA protections into state law here in Michigan (most of which are low-hanging fruit of my own healthcare wish list which I posted back in February) had managed to make it halfway through the legislative process: Five of them have passed the Michigan House, but not the Senate; the other three have passed the Michigan Senate...but not the House. I applauded the state legislature for pushing these bills halfway through and encouraged them to get the other half of the job done.

I was therefore highly amused and pleased to see MI Governor Gretchen Whitmer call for doing that the very next day in her "What's Next" address:

Over at Inside Health Policy, Amy Lotven has an excellent scoop from a new CMS report which was hiding in plain sight:

New CMS data, quietly released in late August, show about 178,000 consumers chose a qualified health plan (QHP) through a state or federal exchanges after losing Medicaid and CHIP coverage in the first two months of the Medicaid unwinding. Those sign-ups through the end of May are more than three times the 54,000 enrollments that CMS reported in July, which reflected only the April numbers.

Earlier today I noted that according to the most recent Medicare enrollment report from the Centers for Medicare & Medicaid Services (CMS), Medicare Advantage enrollment--in which a private insurance carrier is paid by the federal government to administer Medicare benefits, and which differs in some important ways from "traditional" or "Fee for Service" Medicare--is on the verge of overtaking traditional Medicare in terms of total enrollment.

As of May 2023, 48.5% of all Medicare enrollees were covered via a Medicare Advantage plan, a percentage which has been steadily increasing over the years (it was only at 35.5% as of 2019).

While I mention this every time I post about the latest Medicare enrollment report, it's been some time since I've checked on the traditional vs. privately administered variants of Medicaid enrollees. For a long time I've been under the impression that roughly 70% of Medicaid enrollment was handled via Managed Care Organizations (MCOs):

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