In December 2023, 85,094,448 individuals were enrolled in Medicaid and CHIP, a decrease of 785,863 individuals (0.9%) from November 2023
77,913,798 individuals were enrolled in Medicaid in December 2023, a decrease of 786,068 individuals (1.0%) from November 2023.
7,180,650 individuals were enrolled in CHIP in December 2023, an increase of 205 individuals (0.0%) from November 2023.
As of December 2023, enrollment in Medicaid and CHIP has decreased by 8,773,558 individuals (9.3%) 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 8,816,761 individuals (10.2%).
CHIP enrollment has increased by 43,203 individuals (0.6%).
Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,992,937 individuals (32.4%) to 93,868,006.
Medicaid enrollment increased by 22,6350,766 individuals (35.3%).
CHIP enrollment increased by 342,171 individuals (5.0%).
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.
Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.
I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...
...As I noted, however, in all three [states] it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper.
Of course, as one Alabama-based advocate put it...
Well, it looks like Ms. Adams may end up being disappointed...
BREAKING: The Mississippi House just passed Medicaid expansion by a 96-20 vote.
That's more than enough to overcome a veto from Gov. Tate Reeves.
It now heads to the Senate.
Today I want to address the question of Actuarial Value (AV)...that is, what percent of medical expenses (in aggregate) a given healthcare policy actually pays for. As a quick reminder, ACA policies are generally broken into four AV categories, labeled by metal levels: Bronze, Silver, Gold and Platinum, which generally cover roughly 60%, 70%, 80% or 90% of enrollees in-network medical expenses per year (there's a fifth category in front of Bronze called Catastrophic plans, but these have limited eligibility and hardly anyone enrolls in them anyway).
President Biden Announces New Landmark Rule to Protect Americans from Junk Health Insurance
Latest action to deliver better health care and prevent consumers from getting ripped off
Today, the Biden-Harris Administration is taking a major step to crack down on junk health insurance for American families and consumers and deliver better health. As the President has said, people hate being played for suckers and the current practice of offering low-quality insurance that people pay into, but then provides no coverage when people need it, is a bait and switch. That’s why the Biden-Harris Administration is issuing a final rule that protects consumers from junk health insurance and makes sure Americans aren’t scammed into low-quality coverage that leaves consumers on the hook for thousands of dollars in medical bills or denies life-saving care right before treatment. The President is committed to building on the promise of the Affordable Care Act and its critical consumer protections that ensure meaningful coverage for people’s health care needs.
Welp. With last weeks news that House Republicans have decided to once again go to war with the Affordable Care Act if they gain a federal trifecta this November, it's time once again to take a look at just how many of their constituents are at risk of losing their healthcare coverage entirely or, at best, facing massive premium increases (which in most cases would have the same effect by making their coverage cost far more than they could possibly afford).
Alongside this weekends release of the final, official 2024 ACA Open Enrollment Period (OEP) data, The Centers for Medicare & Medicaid Services (CMS) has also pulled together estimates of how many residents of each Congressional District selected ACA exchange plans during the 2024 OEP:
New Jersey Department of Banking and Insurance Acting Commissioner Justin Zimmerman today announced an expanded Special Enrollment Period for individuals who are no longer eligible for NJ FamilyCare and qualify for health insurance through Get Covered New Jersey, the state’s Official Health Insurance Marketplace. The expanded Special Enrollment Period will be available to anyone who lost NJ FamilyCare coverage due to resumption of eligibility reviews regardless of the date they lost coverage. Previously, individuals had 120 days to enroll after their NJ FamilyCare coverage ended.
As required by federal law, the Department of Human Services restarted eligibility reviews for NJ FamilyCare on April 1, 2023. Those who no longer qualify for NJ FamilyCare because their income is too high may be eligible to obtain health coverage through Get Covered New Jersey and may be able to get help paying for premiums.
This is, of course, extremely important since household income is one of the most critical factors in calculating how much financial assistance enrollees receive (or if they're eligible for Advance Premium Tax Credits (ATPC) at all).
If you've ever wondered why healthcare wonks (myself included) almost never even bring up the ACA's Catastrophic Level plans and why the only time I ever discuss Platinum Plans is in the context of high-CSR enrollees being eligible for "Secret Platinum" plans (labeled as Silver), this table should explain why.
Next up: Age brackets, gender, racial/ethnic groups and urban/rural communities. I'm also throwing in the stand-alone Dental Plan table here for the heck of it since I don't know where else to include it.
I don't have a ton to say about any of these, really. It's always interesting to me to see that 1.7% of ACA exchange enrollees are 65 or older. Not sure why they aren't on Medicare but I'm sure there are logical reasons.
Now it's time to move on to the actual demographic breakout of the 2024 Open Enrollment Period (OEP) Qualified Health Plan (QHP) enrollees.
First up is breaking out new enrollees vs. existing enrollees who either actively re-enroll in an exchange plan for another year or who passively allow themselves to be automatically renewed into their current plan (or to be "mapped" to a similar plan if the current one is no longer available).
The table below has the data for both Qualified Health Plans (QHPs) in all 50 states + DC as well as Basic Health Plan (BHP) enrollment in Minnesota and New York only, compared to the 2023 OEP.
Under the RSC Health Care Task Force plan, protections pertaining to guaranteed issue and the prohibition on coverage exclusions would be retailored to reward continuous coverage and promote portability in the individual marketplace.
"RETAILORED." DANGER WILL ROBINSON.
Scratch Guaranteed Issue.
Additionally, to provide Americans with options that fit their individualized needs, each state would again be allowed to determine the minimum attributes and cost-sharing parameters of plans to best meet the needs of their own citizens. In no case, however, would carriers be able to rescind, increase rates, or refuse to renew one’s health insurance simply because a person developed a condition after enrollment.
Since Donald Trump was defeated in the 2020 Presidential election, most people seemed to be under the impression that the Republican Party's decade-long obsession with tearing down President Obama's signature legislative accomplishment, the Patient Protection & Affordable Care Act, was finally over.
Healthcare journalist extraordinaire Jonathan Cohn even pulled the trigger on publishing his definitive history of the ACA, The Ten Year War...although honestly, there was still one remaining major legal loose end to tie up which wouldn't happen until about eight months later.
DENVER – On Monday, Connect for Health Colorado’s Board of Directors took a support position for Senate Bill 24-093, Continuity of Health-Care Coverage Change. This bill would help Coloradans who are no longer eligible for Health First Colorado (Colorado’s Medicaid program) or the Child Health Plan Plus (CHP+) program who have serious medical conditions more easily transition to individual market coverage and continue coverage of necessary medical treatments during the transition period. Connect for Health Colorado released the following statement:
Open Enrollment (OE) for 2024 marked the third year Maine operated a state-based marketplace through CoverME.gov, after transitioning from a federally facilitated marketplace model.1 CoverME.gov is operated by the Office of the Health Insurance Marketplace at the Department of Health and Human Services. The structure of the state-based marketplace provides greater control and flexibility, in terms of operational components such as special enrollment periods, customization of the shopping experience, and marketing and outreach. This allows the marketplace to better meet and respond to the needs of Maine residents.
Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced Utah’s extension of comprehensive coverage for postpartum individuals for a full 12 months through Medicaid and the Children’s Health Insurance Program (CHIP).
I'll be honest: While I've seen several headlines about this crisis over the past couple of weeks I really don't know enough about it to add any commentary, so for now I'll just repost the official statement from the Health & Human Services Dept:
HHS Statement Regarding the Cyberattack on Change Healthcare
The U.S. Department of Health and Human Services (HHS) is aware that Change Healthcare – a unit of UnitedHealth Group (UHG) – was impacted by a cybersecurity incident in late February. HHS recognizes the impact this attack has had on health care operations across the country. HHS’ first priority is to help coordinate efforts to avoid disruptions to care throughout the health care system.
FACT SHEET: President Biden Takes New Steps to Lower Prescription Drug and Health Care Costs, Expand Access to Health Care, and Protect Consumers
The President believes that health care is a right, not a privilege, and since day one, he has delivered health care to millions more Americans while also lowering health care costs. The President continues to build on, strengthen, and protect Medicare, Medicaid, and the Affordable Care Act, signing laws such as the American Rescue Plan Act and the Inflation Reduction Act to lower prescription drug costs and health insurance premiums. Thanks to the President’s efforts, more Americans have health insurance than under any other President, and are better protected against surprise medical bills and junk fees.
TRUTH OR CONSEQUENCES – Gov. Michelle Lujan Grisham today signed into law legislation that builds on the administration’s work to make healthcare more affordable and accessible for every New Mexican.
“Delivering quality healthcare to New Mexico’s population requires a tailored approach that takes into account rural communities, New Mexicans benefiting from Medicaid, and the tens of thousands of public employees in our state,” said Gov. Lujan Grisham. “These are bills that are going to positively impact a vast swath of New Mexicans.”
The governor signed these important healthcare bills during a ceremony at Sierra Vista Hospital in Truth or Consequences.
As an aside, I was a bit confused about the name of the city so I looked it up. Huh.
New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves 1.2 million New Yorkers, or over 4x as many residents as ACA exchange plans do.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
It's been a whopping nine months since the last time I wrote anything about the seemingly never-ending Braidwood v. Becerra lawsuit which threatens to not only end many of the ACA's zero-cost preventative services, but which could also throw all sorts of regulatory authority into turmoil depending on what precedents it sets.
On March 30, 2023, a federal district court judge issued a sweeping ruling, enjoining the government from enforcing Affordable Care Act (ACA) requirements that health plans cover and waive cost-sharing for high-value preventive services. This decision, which wipes out the guarantee of benefits that Americans have taken for granted for 13 years, now takes immediate effect.
Enrollment Remains Open Across All Marketplace Programs for Duration of Public Health Emergency Unwind
Albany, N.Y. (February 28, 2024) – Representatives from NY State of Health, the state’s official health plan Marketplace, will make an appearance at job fairs across the State beginning next month to inform New Yorkers about their options for quality, affordable health insurance. Certified enrollment assistants will be available to help uninsured job seekers find a plan that fits their budget and health needs and guide existing enrollees through the new renewal process to keep their coverage current.
