Charles Gaba's blog

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

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

  • In September 2023, 88,414,773 individuals were enrolled in Medicaid and CHIP.
    • 81,408,432 individuals were enrolled in Medicaid in September 2023, a decrease of 1,621,776 individuals (2.0%) from August 2023.
    • 7,006,341 individuals were enrolled in CHIP in September 2023, an increase of 28,391 individuals (0.4%) from August 2023.
  • As of September 2023, enrollment in Medicaid and CHIP has decreased by 5,435,967 individuals 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 5,309,005 individuals (6.1%).
    • CHIP enrollment has decreased by 126,962 individuals (1.8%).
  • 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%).

via U.S. News:

Managing diabetes will be a less expensive proposition for more Americans in 2024.

Sanofi has officially joined Novo Nordisk and Eli Lilly in lowering the cost of insulin to $35 a month for many patients. The three drug makers are also drastically lowering the list prices for their insulin products.

The price-cutting moves were first announced last spring, but some of them didn’t take effect until Jan. 1.

...Over 8 million Americans need insulin to survive, but up to a quarter of those patients haven't been able to afford the medication and have dangerously rationed doses, according to the ADA.

Now, thanks to the Inflation Reduction Act, Medicare enrollees pay no more than $35 a month for their insulin prescriptions.

I tried to come up with a less inflammatory headline. I really did. But in the end this is what it comes down to. Via Eleanor Klibanoff of the Texas Tribune:

Emergency rooms not required to perform life-saving abortions, federal appeals court rules

  • The Biden administration reminded hospitals of their obligation to perform life-saving abortions under the Emergency Medical Treatment and Labor Act after the overturn of Roe v. Wade. Texas sued, arguing it was an overstep that mandated abortions.

Federal regulations do not require emergency rooms to perform life-saving abortions if it would run afoul of state law, a federal appeals court ruled Tuesday.

After the overturn of Roe v. Wade in June 2022, the U.S. Department of Health and Human Services sent hospitals guidance, reminding them of their obligation to offer stabilizing care, including medically necessary abortions, under the Emergency Medical Treatment and Labor Act (EMTALA).

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

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2024. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2024 is December 15, 2023. Consumers who select a plan between December 16, 2023 and January 16, 2024 will have coverage beginning February 1, 2024. 

CoverME.gov Activity Through December 26, 2023

BeWell NM

BeWell NM, New Mexico's state-based ACA exchange, has launched a very handy new Enrollment Data portal which includes plenty of info for a data hound like myself to pore over:

First, the top line numbers (as of 12/28/23):

  • Number of enrolled consumers: 52,651
  • Consumers enrolled in Medical coverage: 51,904
  • Consumers enrolled in Dental coverage: 13,149

While dental coverage is also important, standalone dental plans aren't considered Qualified Health Plans (QHPs); it's the "Medical Coverage" which is the key number here.

Also, the total number above may look confusing, but most of the Medical & Dental coverage enrollees overlap:

  • Medical Only: 39,502
  • Dental Only: 747
  • Medical + Dental: 12,402

For comparison, last year BeWell NM reported enrolling just 38,150 people (including auto-renewals) through December 31st.

This breaks out to:

Via Access Health CT's News/Press Releases page:

Stats as of December 29, 2023

Qualified Health Plans (QHP):

  • QHP Enrollment In 2023 Coverage: 122,656
  • 2024 OE Acquisition Summary: 22,678

Medicaid:

  • Completed applications/redeterminations processed through the integrated eligibility system: 42,619

It's my understanding that "Acquisition Summary" refers to CT residents who are brand-new enrollees (never enrolled via the exchange before).

The 122.6K figure includes auto-renewals being piled on top of the new/active renewal tally.

By comparison, last year Access Health CT reported enrolling 103,380 people through December 30th (one extra day since Nov. 1st fell on a Tuesday last year); this also included auto-renewals:

  • 2023: 103,380 in 60 days (1,723/day)
  • 2024: 122,656 in 59 days (2,079/day)

In other words, Connect's ACA exchange has enrolled 20.7% more people per day so far.

via Covered California:

SACRAMENTO, Calif. — With a key deadline coming up on Dec. 31, Covered California announced that 161,670 people have signed up for 2024 coverage as of Dec. 23 during this open enrollment, marking an 18 percent increase over the same period last year and the highest during this same period in four years.

Another 1,571,559 Californians have renewed their coverage so far.

That's 1,733,229 QHP selections to date. By comparison, last year the combined new+renewal enrollment in CA was 1,676,616 through 12/24, meaning the 2024 Open Enrollment Period is actually running more like 5.3% higher than last year on a per day basis:

via the NJ Dept. of Banking & Insurance:

  • NJ residents must enroll by Dec. 31 for coverage starting Jan. 1
  • 9 in 10 People Who Enroll Qualify for Savings; Many Pay $10 a Month or Less for Health Coverage

TRENTON — New Jersey Department of Banking and Insurance Acting Commissioner Justin Zimmerman today announced that more than 330,000 New Jersey residents signed up for a 2024 health insurance plan through the state’s Official Health Insurance Marketplace, Get Covered New Jersey, in the first five weeks of the Open Enrollment Period that started on November 1, 2023. Total signups have increased compared to the same timeframe last year, as residents continue to take advantage of record levels of financial help available from the State of New Jersey and the federal government and more plan options to choose from. 

Open Enrollment for 2024 health insurance ends January 31st, but residents must enroll in a plan by December 31, 2023 for coverage to take effect on January 1, 2024. 

BeWell NM

BeWell NM, New Mexico's state-based ACA exchange, has launched a very handy new Enrollment Data portal which includes plenty of info for a data hound like myself to pore over:

First, the top line numbers (as of 12/21/23):

  • Number of enrolled consumers: 51,772
  • Consumers enrolled in Medical coverage: 51,042
  • Consumers enrolled in Dental coverage: 12,826

While dental coverage is also important, standalone dental plans aren't considered Qualified Health Plans (QHPs); it's the "Medical Coverage" which is the key number here.

Also, the total number above may look confusing, but most of the Medical & Dental coverage enrollees overlap:

  • Medical Only: 38,946
  • Dental Only: 730
  • Medical + Dental: 12,096

For comparison, last year BeWell NM reported enrolling just 37,892 peple (including auto-renewals) through December 24th.

This breaks out to:

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