2018 MIDTERM ELECTION

Time: D H M S

Good News: The April CMS report is out! Bad News: Marlon Marshall is fully of Hooey

Hat Tip To: 
Esther Ferington

Check out what just showed up in my in box this afternoon:

HHS Blog: Medicaid Enrollment Shows Continued Growth in April

Medicaid Enrollment Shows Continued Growth in April

By Cindy Mann, Deputy Administrator of the Centers for Medicare & Medicaid Services and Director of the Centers for Medicaid and CHIP Services

Medicaid enrollment continues to increase all across the country, especially in those states that have expanded their Medicaid programs under the Affordable Care Act.

As of the end of April, 6 million more individuals were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) as compared to the period before the initial open enrollment under the Affordable Care Act started. That includes 1.1 million additional people enrolled in April as compared to March in the 48 states that reported data for both April and March.

And, as we’ve seen for months, growth was more pronounced in states that adopted the Medicaid expansion: Enrollment in those states rose by 15.3 percent compared to the average enrollment from July through September 2013 while states that have not expanded reported only a 3.3 percent increase in enrollment during that same time period.

Because of the Affordable Care Act, many consumers now have access to new, affordable, private health insurance options in the Health Insurance Marketplace, while many others are now eligible for their state’s Medicaid programs. These gains are made possible by collaboration between CMS and the states that operate these programs.

The Affordable Care Act provides states with new opportunities to expand their Medicaid programs to meet the needs of more uninsured residents. In states that expanded Medicaid, most individuals with incomes up to 133 percent of the Federal Poverty Level, or $15,521 for an individual and $31,721 for a family of four, are eligible for coverage.

And under the Affordable Care Act, coverage for newly eligible adult beneficiaries is fully paid for during the first three years by the federal government, and is never less than 90 percent for the years following. In addition, increased coverage reduces hospitals’ uncompensated care, lowers “cost shifting” to businesses that see higher health insurance premiums, as some of the costs of caring for the uninsured are passed on to them, and strengthens local economies.

While the open enrollment period has ended for the federal or state Health Insurance Marketplaces, consumers may apply for Medicaid and CHIP coverage year round. People are eligible for coverage at any time if they qualify.

There's a link to the actual report itself above; it has the same level of detail, the same state-by-state breakdown, the same individual state footnotes as all of the previous CMS reports on Medicaid/CHIP enrollments.

So, what's missing? Easy.

Apparently the CMS Medicaid/CHIP reports, which are far harder to compile than exchange QHP reports, are continuing, which is a good thing, and I'll be plugging that data into the Medicaid spreadsheet later on today, with a follow-up post on the results.

Yet the private QHP enrollment reports, which are easier to put together (you can scrap the detailed demographic breakdown stuff if absolutely necessary) have been discontinued indefinitely for no apparent reason.

That brings me to this other story out of the Huffington Post (h/t to Esther F.):

Obama Keeps Foot On The Gas For Health Care Enrollment

WASHINGTON -- As President Barack Obama took to the podium on April 17 to announce that eight million people had signed up for private health coverage through the Affordable Care Act, a sense of finality hit the White House briefing room.

Six and a half months had passed since the start of Obamacare's implementation. A technological crisis had produced a political one. And the experience that followed had been both emotionally draining and professionally vexing. That it ended with the administration exceeding expectations made it seem like the ideal time to stop and take a breath -- and perhaps even celebrate. A few days later, the White House's health care team did just that over drinks and snacks.

But for others inside the administration, the end of the open enrollment period in mid-April provided no break at all. If anything, the race to get Americans health care coverage had just begun.

"Outreach is never over," said Marlon Marshall, the deputy director of the White House office of Public Engagement. "We've always continued."

...The Congressional Budget Office originally estimated that 7 million people would sign up for private insurance plans via the exchanges during the calendar year of 2014, a goal the administration has already hit. But if you want a formal accounting of how many people sign up for insurance during the special enrollment period alone, good luck. Monthly enrollment numbers won't be made available between now and November. Asked why, Marshall would only say that there isn't enough incoming information about who is signing up for plans -- an odd explanation for a self-professed data-driven White House.

Are you friggin' kidding me???

For six months they had no problem issuing detailed reports (ok, not quite as detailed as some wanted, but still pretty detailed) about the 8 million+ people who enrolled in QHPs...but NOW they're claiming that "there isn't enough incoming information about who is signing up"???

What the hell is THAT?

Did their database suddenly become glitchier than it was back in October (when they were still able to at least give state-by-state numbers for the 20K or so who did enroll)?

Come on, Mr. Marshall. I've never heard of you before, but any healthcare reporter who's been covering the ACA exchanges since last fall KNOWS what a huge crock of horse dung that is.

As I noted in my follow-up "open letter" to the HHS Dept., many people assume that the discontinuation of the reports was purely a political policy decision...but that doesn't make much sense either:

In addition, aside from the "can't/won't keep paying" crowd, none of those other reasons for leaving the exchange QHPs reflects negatively on the ACA in any way! If someone gains a job with benefits, good for them! Their exchange QHP tided them over for a few months while they improved their lot. If they age into Medicare, again, that's two different "Big Government" programs working exactly the way they're supposed to. The same holds true if their situation goes negative and they find themselves on Medicaid. And if they do happen to pass away, at least their ACA QHP gave them a fighting chance at medical care that they otherwise might not have had.

In other words, even if there is a significant amount of attrition, the administration still has plenty to be proud of with the first year's enrollment numbers. I find it difficult to believe that this is enough to cause HHS to scrap the reports.

The only silver lining here is that the "...won't be made available between now and November" part at least suggests that the monthly enrollment reports will be back for the 2nd open enrollment period, anyway (which was kind of fuzzy earlier).

Color me grumpy.