Medicaid

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):

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

In May 2023, 93,815,749 individuals were enrolled in Medicaid and CHIP.

  • 86,783,676 individuals were enrolled in Medicaid in May 2023, a decrease of 279,373 individuals (-0.3%) from April 2023.
  • 7,032,073 individuals were enrolled in CHIP in May 2023, a decrease of 41,687 individuals (0.6%) from April 2023
  • As of May 2023, enrollment in Medicaid and CHIP has decreased by 61,085 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 increased by 69,102 individuals (0.1%).
    • CHIP enrollment has decreased by 130,187 individuals (1.8%)
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,001,765 individuals (32.5%) to 93,876,834.
    • Medicaid enrollment increased by 22,634,781 individuals (35.3%).
    • CHIP enrollment increased by 366,984 individuals (5.4%)
Connecticut

via Access Health CT:

These free, in-person events will take place in Litchfield, New Britain, Vernon and Willimantic

HARTFORD, Conn. (Aug. 30, 2023) — Access Health CT (AHCT) can help eligible Connecticut residents enroll in HUSKY Health, the state’s Medicaid program, and Qualified Health Plans. To help residents understand the types of health coverage available to them, AHCT will host free, in-person enrollment fairs in September and October. Many HUSKY Health clients have been affected by “Medicaid Unwinding,” a term the federal government is using to describe the process of resuming reviewing households for Medicaid eligibility after a three-year break during the Public Health Emergency. The eligibility redetermination process resumed April 1 and HUSKY clients will be notified when it is their turn to enroll.

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

CMS Takes Action to Protect Health Care Coverage for Children and Families

  • States must assess and fix their systems so eligible children and families can stay covered. 

Today, and as part of its ongoing work to make sure all Americans have access to health care coverage, the Centers for Medicare & Medicaid Services (CMS) sent a letter to all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands requiring them to determine whether they have an eligibility systems issue that could cause people, especially children, to be disenrolled from Medicaid or the Children’s Health Insurance Program (CHIP) even if they are still eligible for coverage, and requiring them to immediately act to correct the problem and reinstate coverage.

via Nevada Health Link:

  • Medicaid recipients deemed ineligible for coverage may be eligible for financial assistance and are encouraged to contact Nevada Health Link to avoid a lapse in health coverage

CARSON CITY, Nev. – As the redetermination process associated with the unwinding of the Public Health Emergency continues, Nevada Health Link, Nevada’s health insurance marketplace, is continuing to work diligently to streamline the enrollment process for individuals and households whose increased income no longer qualifies them for Medicaid coverage.

via New York State of Health:

  • 2023-24 Enacted Budget Invests in Health Equity by Adopting Key Evidence-Based Interventions to Better Care for New York Parents and Newborns

ALBANY, N.Y. (August 24, 2023) – The New York State Department of Health announced several key initiatives aimed at improving maternal and newborn health. Enacted as part of the 2023-24 New York State Budget, the state is committing to multiple Medicaid investments that will expand access to prenatal and postnatal care and support better birth outcomes. This announcement is released on the heels of the State’s adoption of the federal option to extend Medicaid and Child Health Plus (CHPlus) postpartum coverage from 60 days to a full year following pregnancy.

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