CMS

CMS Publishes FAQs to Ensure Individuals, Issuers and States have Clear Information on Coverage Benefits for COVID-19

Today, the Centers for Medicare & Medicaid Services (CMS) is posting Frequently Asked Questions (FAQs) on Essential Health Benefits (EHB) Coverage in response to the 2019 Novel Coronavirus (COVID-19) outbreak. This action is part of the broader, ongoing effort by the White House Coronavirus Task Force to ensure that all Americans – particularly those at high-risk of complications from the COVID-19 virus – have access to the health benefits that can help keep them healthy while helping to contain the spread of this disease.

“Amid a serious outbreak like this one, Americans understandably crave the security and peace of mind that comes from understanding exactly how they will be covered.” said CMS Administrator Seema Verma. “Today’s guidance aims to give it to them. Working closely with states and issuers around the country, the Trump Administration will continue to provide pertinent information to strengthen the nation’s response and keep Americans informed.”

(h/t @CarenaAK via Twitter)

The hits just keep on coming for CMS Administrator Seema Verma:

Medicare chief asked taxpayers to cover stolen jewelry

A top Trump health appointee sought to have taxpayers reimburse her for the costs of jewelry, clothing and other possessions, including a $5,900 Ivanka Trump-brand pendant, that were stolen while in her luggage during a work-related trip, according to documents obtained by POLITICO.

Seema Verma, who runs the Centers for Medicare and Medicaid Services, filed a $47,000 claim for lost property on Aug. 20, 2018, after her bags were stolen while she was giving a speech in San Francisco the prior month. The property was not insured, Verma wrote in her filing to the Health and Human Services department.

The federal health department ultimately reimbursed Verma $2,852.40 for her claim, a CMS spokesperson said.

Yesterday, the Centers for Medicare & Medicaid released several important data-heavy reports, featuring a lot of month-by-month, state-by-state and year-by-year ACA enrollment data. There's a lot of data to dig into, so I'm breaking this into several posts.

First up: Average monthly effectuated enrollments. It's important to understand the difference between someone selecting a Qualified Health Plan (QHP) from one of the ACA exchanges during the Open Enrollment Period and someone actually being enrolled in an effectuated policy...that is, just because you sign your family up for a policy on HealthCare.Gov (or a state-based exchange), you aren't considered effectuated until you actually pay for the policy.

Hot off the heels of the Week 4 HC.gov Snapshot Report, CMS has also released another important ACA exchange enrollment report:

Effectuated Enrollment for the First Half of 2018

This report provides average effectuated enrollment and premium data for the Federal and State-Based Exchanges for the first six months of the 2018 plan year. The Centers for Medicare & Medicaid Services (CMS) publishes effectuated enrollment data semiannually to provide a more accurate picture of enrollment trends for the Exchanges than indicated by the number of individuals who simply selected a plan during Open Enrollment. For coverage to be considered effectuated, individuals generally must pay their premium for the given month.

A few days ago, the Centers for Medicare & Medicaid released three important new reports on the 2018 Open Enrollment Period and trends in the individual market. There's a lot of data to go over, so I'm breaking my analysis into several smaller posts for easier readability.

Overview • Part One • Part Two • Part Three • Part Four

• February 2018 Effectuation snapshot report
• Subsidized/Unsubsidized Enrollment Trend Report
• Exchange Trends Report

Now we move onto the second report released by CMS this week: The "Subsidized/Unsubsidized Enrollment Trend Report". If you set aside the anti-ACA digs from the Trump Administration, there's some fascinating data to be found, including what they claim to be one of the Holy Grails of the ACA individual market: Supposedly accurate data on the number of off-exchange ACA-compliant enrollees across the first four years of the ACA exchanges! Yes, I know, it's exciting, heady stuff.

NOTE: My broadband connection has been experiencing a lot of problems lately; I have a service guy on his way out today for the fourth time in the past two weeks, but this means I'll likely be offline for a few hours, so this post will be incomplete for awhile.

Yesterday, the Centers for Medicare & Medicaid released three important new reports. I did an initial write-up about their overall findings yesterday; today I'm taking a deeper look at the actual reports themselves.

First up, the February 2018 Effectuation snapshot report:

Over the past few weeks,I've posted partial 2018 Open Enrollment Period demographic data from Connecticut, Idaho, Maryland, New York and Washington State. Still missing are final wrap-up reports from the other 7 state-based exchanges...as well as The Big One: The official report from the Assistant Secretary for Planning and Evaluation (ASPE).

The 2014 ASPE report was released on May 1st, 2014...just 17 days after the first, tumultuous 2014 Open Enrollment Period ended (only 12 days, really, since the report actually ran through April 19th, 2014 even though the "overtime" period technically ended on April 15th).

This just in...I used to track the monthly Medicaid/CHIP reports pretty religiously, but the total numbers have actually stayed fairly stable month to month for the past year or so (mainly because the states which expanded Medicaid under the ACA have mostly "maxed out" by now). This should start changing in Maine later this year as they voted to expand the program via ballot initiative last November, and Virginia may end up expanding Medicaid to up to 400,000 people there as well later this year.

In the meantime, here's where things stood as of the end of 2017, according to CMS:

Highlights from the December 2017 Report

Medicaid and CHIP Total Enrollment

Note: Ironically, I had to make a slight correction myself below--for some reason I originally had "Alleigh" down as "Allison".

Flashback to May 24, 2017:

From Alleigh Marre, HHS Dept. National Spokesperson, less than an hour ago (h/t Kimberly Leonard for the heads up):

"Even Charles Gaba, the author of ACAsignups.net admits in his analysis, “The simple truth is: Yes, full-price, unsubsidized premiums for individual market healthcare policies probably have doubled since 2013…” His analysis of the report drives home that Obamacare’s one-size-fits all mandates and regulations have driven up prices for all."

Here's the actual quote she's referring to:

OK, first of all, here's the actual press release from CMS about it:

CMS announces new policy guidance for states to test community engagement for able-bodied adults
Will support states helping Medicaid beneficiaries improve well-being and achieve self-sufficiency

CMS today announced new guidance that will support state efforts to improve Medicaid enrollee health outcomes by incentivizing community engagement among able-bodied, working-age Medicaid beneficiaries. The policy responds to numerous state requests to test programs through Medicaid demonstration projects under which work or participation in other community engagement activities – including skills training, education, job search, volunteering or caregiving – would be a condition for Medicaid eligibility for able-bodied, working-age adults. This would exclude individuals eligible for Medicaid due to a disability, elderly beneficiaries, children, and pregnant women.

In other words, work requirements for Medicaid expansion enrollees are now officially on the table.