Charles Gaba's blog

I'm a bit late on this one. It was reported a week or so ago but was officially introduced today:

Trump administration finalizing Medicaid block grant plan targeting Obamacare

  • The plan is guaranteed to enrage critics and invite attacks from Democrats in an election year.

The Trump administration is finalizing a plan to let states convert a chunk of Medicaid funding to block grants, even as officials remain divided over how to sell the controversial change to the safety net health program.

CMS Administrator Seema Verma plans to issue a letter soon explaining how states could seek waivers to receive defined payments for adults covered by Obamacare's Medicaid expansion, according to seven people with knowledge of the closely guarded effort. An announcement is tentatively slated for the end of next week, more than one year after Verma and her team began developing the plan.

New York State of Health is doing their best to calm people down as much as possible:

Fact Sheet:: What you Need to Know About the New Federal Public Charge Rule and Health Insurance

Updated 1/29/20

When does the new Public Charge rule go into effect?

  • The Supreme Court decided on January 27, 2020, to allow the rule to take effect.

Does enrolling in free or low-cost health insurance make me a Public Charge?

  • Most health insurance coverage is not a factor in the new Public Charge test. Only federally-funded Medicaid is included, and even for this program there are several exempt groups of people who are excluded under the rule, including pregnant women and children under 21. Additionally, asylees, refugees, and visa holders who are victims of trafficking and other crimes, among others, are entirely exempt from the Public Charge rule.

The following programs are not included in the Public Charge rule:

Last March I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

Last March I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

Hmmm...looks like there was some sort of data breach at AccessHealthCT:

A Small Number Of Access Health CT Consumers Will Receive Mail This Week About Their Personal Information And Should Review Carefully

HARTFORD, Conn. (January 28, 2020)—Approximately 1,100 Access Health CT consumers will be receiving an ORANGE ENVELOPE in the mail this week. It is important that consumers review this information carefully as they will need to take action to enroll in free services being offered to help protect their personal information that may have been compromised in a data breach.

“Access Health CT takes the privacy and security of consumers’ personal information seriously, and it is making this public notice in an abundance of caution,” said Chief Executive Officer of Access Health CT, James Michel. “We apologize for any inconvenience to consumers and we remain steadfast in our commitment to keep our consumers’ best interests as our number one priority.”

I just received the final 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

Here’s where we are:

  • We have 290,105 January enrollments
  • 22,493 February and March enrollments
  • 7,014 plans selected
  • For a total of 319,612

New enrollments currently total 57,044.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for January vs. February or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

Here's what's truly impressive: Massachusetts is the only state to increase their ACA exchange enrollment each and every year for six years running:

This just in from the New York State of Health ACA exchange:

Press Release: New Yorkers Have More Time to Get Covered in 2020: NY State of Health Open Enrollment Deadline Extended to February 7

  • Enroll Now for Affordable, High-Quality Health Coverage in 2020
  • Free, In-Person Enrollment Help is Available: Click Here to Find a NY State of Health Certified Assistor

ALBANY, N.Y. (January 28, 2020) – NY State of Health, the state’s official health plan Marketplace, announced that consumers will have an additional week to enroll in a Qualified Health Plan (QHP) for 2020. The Open Enrollment deadline has been extended until February 7 to give consumers more time to enroll. NY State of Health’s Customer Service Center representatives and in-person assistors are available to help individuals find the best plan for themselves and their families.

Huh. That's unexpected.

Statement from Connect for Health Colorado® Regarding Supreme Court Decision on the Public Charge Rule

Jan. 27, 2020 

Denver – Connect for Health Colorado® Chief Executive Officer Kevin Patterson released the following statement in response to today’s Supreme Court decision on the Public Charge Rule:

“I am disappointed about the overall impact this ruling will have on all of us, but especially on our friends, neighbors and co-workers seeking a permanent residency status. This rule will force people to get health care in more expensive ways and will cause worse health outcomes for Coloradans; exactly the opposite of our mission and the work our state has led to increase access, affordability and choice in health. 

via KIVI Boise:

The number of Idaho residents who have signed up for Medicaid under the state’s voter-approved expanded coverage has passed 60,000.

The Idaho Department of Health and Welfare posted updated numbers Thursday. The agency estimates 91,000 residents meet requirements.

Coverage started January 1, but enrollment is year-round. Those who sign up for Medicaid will be covered for doctor visits that occurred earlier in the same month.

Voters authorized Medicaid expansion in 2018 with an initiative that passed with 61% of the vote after years of inaction by state lawmakers. In 2019, lawmakers added restrictions requiring five waivers from the U.S. Department of Health and Human Services.

Waivers are required when states want to deviate from Medicaid rules. Federal officials have yet to approve any of Idaho’s requested waivers.

If the anticipated 91,000 people do eventually sign up, it would cost Idaho about $400 million, with the federal government paying 90%.

 

Not Joe Biden. Not Pete Buttigieg. Not Amy Klobuchar. Not Michael Bloomberg. Not Tom Steyer. Not Michael Bennet.

Nope. This is none other than Senator Bernie Sanders of Vermont from July 2009, issuing a strong and vigorous argument in favor of adding a Medicare-like Public Option to the U.S. healthcare system to offer a "level playing field" and "fair competition" with private insurance.

I've cued up the video to the relevant starting point, but if it starts at the beginning for some reason, scroll up to 4:55 in. It runs until around 6:13.

Here's the transcript of Bernie during the section in question:

“No one is talking about a government-run healthcare system. No, they’re not. What they’re talking about is a public option that will compete and give people the choice! The choice of whether they want a public plan or a private plan! Why are you afraid of that? If the private plans are so much better, people will go into the private plan. If the public plans are more cost effective, more reasonable, if people prefer a Medicare-type program they’ll go into that. Why are you afraid of the competition?

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