Charles Gaba's blog

via CoverME.gov, Maine's state-based ACA exchange:

KEY TAKEAWAYS

Open Enrollment (OE) for 2024 marked the third year Maine operated a state-based marketplace through CoverME.gov, after transitioning from a federally facilitated marketplace model.1 CoverME.gov is operated by the Office of the Health Insurance Marketplace at the Department of Health and Human Services. The structure of the state-based marketplace provides greater control and flexibility, in terms of operational components such as special enrollment periods, customization of the shopping experience, and marketing and outreach. This allows the marketplace to better meet and respond to the needs of Maine residents.

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), announced Utah’s extension of comprehensive coverage for postpartum individuals for a full 12 months through Medicaid and the Children’s Health Insurance Program (CHIP).

I'll be honest: While I've seen several headlines about this crisis over the past couple of weeks I really don't know enough about it to add any commentary, so for now I'll just repost the official statement from the Health & Human Services Dept:

HHS Statement Regarding the Cyberattack on Change Healthcare

The U.S. Department of Health and Human Services (HHS) is aware that Change Healthcare – a unit of UnitedHealth Group (UHG) – was impacted by a cybersecurity incident in late February. HHS recognizes the impact this attack has had on health care operations across the country. HHS’ first priority is to help coordinate efforts to avoid disruptions to care throughout the health care system.

Ahead of tomorrow evening's State of the Union address...via the White House:

FACT SHEET: President Biden Takes New Steps to Lower Prescription Drug and Health Care Costs, Expand Access to Health Care, and Protect Consumers

The President believes that health care is a right, not a privilege, and since day one, he has delivered health care to millions more Americans while also lowering health care costs. The President continues to build on, strengthen, and protect Medicare, Medicaid, and the Affordable Care Act, signing laws such as the American Rescue Plan Act and the Inflation Reduction Act to lower prescription drug costs and health insurance premiums. Thanks to the President’s efforts, more Americans have health insurance than under any other President, and are better protected against surprise medical bills and junk fees.

via the New Mexico Governor's website:

TRUTH OR CONSEQUENCES – Gov. Michelle Lujan Grisham today signed into law legislation that builds on the administration’s work to make healthcare more affordable and accessible for every New Mexican.

“Delivering quality healthcare to New Mexico’s population requires a tailored approach that takes into account rural communities, New Mexicans benefiting from Medicaid, and the tens of thousands of public employees in our state,” said Gov. Lujan Grisham. “These are bills that are going to positively impact a vast swath of New Mexicans.”

The governor signed these important healthcare bills during a ceremony at Sierra Vista Hospital in Truth or Consequences.

As an aside, I was a bit confused about the name of the city so I looked it up. Huh.

New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves 1.2 million New Yorkers, or over 4x as many residents as ACA exchange plans do.

Whenever I write about BHPs I always throw in a simple explainer about what it is, with an assist from Louise Norris:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

It's been a whopping nine months since the last time I wrote anything about the seemingly never-ending Braidwood v. Becerra lawsuit which threatens to not only end many of the ACA's zero-cost preventative services, but which could also throw all sorts of regulatory authority into turmoil depending on what precedents it sets.

Over at CHIRblog, Sabrina Corlette has a refresher on this case and what's at stake:

On March 30, 2023, a federal district court judge issued a sweeping ruling, enjoining the government from enforcing Affordable Care Act (ACA) requirements that health plans cover and waive cost-sharing for high-value preventive services. This decision, which wipes out the guarantee of benefits that Americans have taken for granted for 13 years, now takes immediate effect.

New York State of Health

via NY State of Health:

Enrollment Remains Open Across All Marketplace Programs for Duration of Public Health Emergency Unwind

Albany, N.Y. (February 28, 2024) – Representatives from NY State of Health, the state’s official health plan Marketplace, will make an appearance at job fairs across the State beginning next month to inform New Yorkers about their options for quality, affordable health insurance. Certified enrollment assistants will be available to help uninsured job seekers find a plan that fits their budget and health needs and guide existing enrollees through the new renewal process to keep their coverage current.

Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of November 2023:

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

  • In November 2023, 85,815,827 individuals were enrolled in Medicaid and CHIP, a decrease of 1,503,283 individuals (1.7%) from October 2023.
    • 78,710,401 individuals were enrolled in Medicaid in November 2023, a decrease of 1,523,107 individuals (1.9%) from October 2023.
    • 7,105,426 individuals were enrolled in CHIP in November 2023, an increase of 19,824 individuals (0.3%) from October 2023.
  • As of November 2023, enrollment in Medicaid and CHIP has decreased by 8,034,913 individuals (8.6%) 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 8,007,036 individuals (9.2%).
    • CHIP enrollment has decreased by 27,877 individuals (0.4%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,975,671 individuals (32.4%) to 93,850,740.
    • Medicaid enrollment increased by 22,637,644 individuals (35.3%).
      • CHIP enrollment increased by 338,027 individuals (5.0%).

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