As I (and many others) have been noting for many months now, the official end of the federal Public Health Emergency (PHE), whenever it happens, will presumably bring with it reason to celebrate...but will also likely create a new disaster at the same time:
What goes up usually goes back down eventually, and that's likely to be the case with Medicaid enrollment as soon as the public health crisis formally ends...whenever that may be.
Well, yesterday Ryan Levi and Dan Gorenstein of of the Tradeoffs healthcare policy podcast posted a new episode which attempts to dig into just when that might be, how many people could be kicked off of the program once that time comes and how to mitigate the fallout (I should note that they actually reference my own estimate in the program notes):
The Biden-Harris Administration is announcing that, beginning today, as many as 720,000 pregnant and postpartum people across the United States could be guaranteed Medicaid and Children’s Health Insurance Program (CHIP) coverage for a full 12 months after pregnancy thanks to the American Rescue Plan (ARP). Medicaid covers 42 percent of all births in the nation, and this new option for states to extend Medicaid and CHIP coverage marks the Biden-Harris Administration’s latest effort to address the nation’s crisis in pregnancy-related deaths and maternal morbidity by opening the door to postpartum care for hundreds of thousands of people.
In March 2020, Congress offered states additional Medicaid funding as long as they agreed to keep everyone enrolled in the program for the duration of the federal public health emergency, regardless of their eligibility status. As of January 2021, nearly 10 million had joined Medicaid or the Children’s Health Insurance Program (CHIP) during the pandemic, pushing enrollment to a record high of more than 80 million people. (Some independent analyses put the current total higher, closer to 90 million.)
As part of the Biden-Harris Administration’s work to advance health equity and reduce health disparities, the Centers for Medicare & Medicaid Services (CMS) is seeking feedback on topics related to health care access, such as enrolling in and maintaining coverage, accessing health care services and supports, and ensuring adequate provider payment rates to encourage provider availability and quality. This Request for Information (RFI) is one of many actions CMS is taking to develop a more comprehensive access strategy in its Medicaid and CHIP programs.
“We are committed to providing equitable access to quality health care and removing any barriers to quality health care,” said Health and Human Services Secretary Xavier Becerra. “We want to hear directly from stakeholders so we can strengthen our programs for the more than 80 million Americans with Medicaid or CHIP health insurance. Together, by advancing health equity, we can ensure quality health care is within reach for everyone who needs it.”
As I just noted, the end of the official COVID-19 Public Health Emergency, whenever it happens (it's currently scheduled to end as of April 16th but could be extended once again at any point before then) will cause a new problem:
Millions of Americans currently enrolled in Medicaid will likely no longer be legally eligible to remain on the public healthcare program, threatening to cause a massive overload of agencies and potentially leaving many of them stranded without any healthcare coverage at all.
Legislation to help about 300,000 Oregonians on Medicaid to maintain their coverage after the Covid-19 public health emergency ends advanced out of committee on Monday.
What goes up usually goes back down eventually, and that's likely to be the case with Medicaid enrollment as soon as the public health crisis formally ends...whenever that may be.
Well, yesterday Ryan Levi and Dan Gorenstein of of the Tradeoffs healthcare policy podcast posted a new episode which attempts to dig into just when that might be, how many people could be kicked off of the program once that time comes and how to mitigate the fallout (I should note that they actually reference my own estimate in the program notes):
CMS Commits Over $49 Million to Reduce Uninsured Rate Among Children and Boost Medicaid Enrollment Among Parents, Pregnant People
The Centers for Medicare & Medicaid Services (CMS) committed a record $49.4 million to fund organizations that can connect more eligible children, parents, and pregnant individuals to health care coverage through Medicaid and the Children’s Health Insurance Program (CHIP). Awardees—including state/local governments, tribal organizations, federal health safety net organizations, non-profits, schools, and others—will receive up to $1.5 million each for a three-year period to reduce the number of uninsured children by advancing Medicaid/CHIP enrollment and retention.
Not too many changes were made in either market. I get a weighted average increase of 4.6% for individual market plans (MI DIFS puts it at 4.7%), while I get exactly +7.0% for small group plans (MI DIFS puts it at +7.1%).
As I noted in August, the other noteworthy changes are:
They also estimate that another 1.8 million uninsured Americans who are eligible for subsidized ACA exchange plans who would be eligible for Medicaid instead if those state actually did expand Medicaid (and perhaps another 100K in Missouri). That's nearly 4.0 million total...
So, how to crack this nut in these holdout states, all of which are either completely or partially controlled by Republicans who have adamantly refused to expand the program no matter what all these years?
Highlighting Michigan’s increasingly competitive health insurance market, the Michigan Department of Insurance and Financial Services (DIFS) has reported that consumers will have more health plan options from an increased number of insurers on the Health Insurance Marketplace for the upcoming open enrollment period.
“As we look toward the end of the pandemic and beyond, it is critical that Michiganders are able to get the affordable, high quality health coverage they need for themselves and their families,” said DIFS Director Anita Fox. “Consumers will have more options to choose from when shopping for health insurance coverage on the Marketplace during open enrollment later this year.”
