As I concluded in the last piece:

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...

Cut to Daniel Chang & Andy Miller in KFF Health News, Today:

I've butted heads with California Democratic Congressman Ro Khanna a few times, most notably nearly four years ago over his misrepresentation of the role private health insurance would play under a theoretical Bernie Sanders-style "Medicare for All" system.

However, I also believe in giving credit where its due, and a new bill introduced by Rep. Khanna (with 29 cosponsors, most of whom seem to be members of the Progressive Caucus, as you'd expect) seems petty damned reasonable to me:

State-Based Universal Health Care Act of 2023

via the North Carolina Dept. of Health & Human Services:

NC Medicaid Expansion Continues to Bring Health Care to More North Carolinians

PRESS RELEASE — As of Feb. 1, 2024, 346,408 newly eligible North Carolinians are enrolled in Medicaid and now have access to comprehensive health care, according to the North Carolina Department of Health and Human Services’ Medicaid Expansion Enrollment Dashboard. NCDHHS released an updated the dashboard today, and it includes enrollment data as of Feb. 1, 2024. This number is more than half of the anticipated 600,000 people who are newly eligible for coverage, expected to enroll in Medicaid expansion over the next two years.

"In the first two months we have already enrolled over half of the eligible people," said NC Health and Human Services Secretary Kody H. Kinsley. "These individuals and families are seeing providers, utilizing preventative and specialty care, and getting life-saving prescriptions."

via Covered California:

La versión en español de este Comunicado puede ser descargada en este enlace.

SACRAMENTO, Calif. — Covered California has opened the application process for its Navigator Program, with up to $33.9 million to be granted over the next three years to community organizations that help individuals and families become aware of and enroll in health insurance, with a focus on diverse and underserved communities.

The application process will run until March 15. For this Navigator Program funding cycle, the total annual budget has nearly doubled, increasing from $6.5 million to up to $11.3 million per year.

“Covered California’s success over the past decade is due in great part to the tremendous Navigator Program grantees that have helped Californians understand their health care options and get the coverage they need,” Executive Director Jessica Altman said. “The increased funding this year is a testament to the effectiveness of this program and will help strengthen our efforts to reach the most vulnerable Californians where they are.”

I've only written about the ACA's Affordability Threshold a few times before, usually regarding the so-called "Family Glitch." As explained by the always brilliant Louise Norris:

We still get calls on a regular basis from people who are shopping for individual insurance because adding dependents to their employer plan is prohibitively expensive. We estimate that roughly 20 percent of the people who contact us are in this situation.

Unfortunately, due to a “glitch” in the ACA, they are not eligible for premium subsidies in the exchange if the amount the employee has to pay for employee-only coverage on the group plan is deemed “affordable” – defined as less than 9.78 percent of household income in 2020.

Not content to let Georgia hog all of the state-sues-feds-over-low-income-healthcare-coverage-policy headlines, the state of Florida has also recently gotten into the act with their own federal lawsuit, this time over the Children's Health Insurance Program, or CHIP. Via Health News Florida:

Gov. Ron DeSantis’ administration has filed suit to challenge a new federal requirement that specifies when children can be removed from the state’s Children’s Health Insurance Program.

...At issue is a Biden administration rule that took effect Jan. 1 requiring states to provide 12 months of continuous eligibility for enrollees ages 18 and younger under Medicaid and CHIP, even if monthly premiums are not paid.

Georgia is one of just ten remaining states which is still holding out on fully expanding Medicaid to all legal residents earning up to 138% of the federal poverty level under the Affordable Care Act. Instead, back in 2019, GOP Georgia Governor Brian Kemp submitted a Section 1115 waiver which included a plan to partially expand Medicaid to some uninsured Georgia residents...except with a work reporting requirement for enrollees attached to it.

The program was called "Georgia Pathways," it was approved by the Trump Administration, and unlike several other states which had work requirement provisions shot down by various judges, Georgia's managed to slip through. It was scheduled to go into effect in 2021 and was supposed to be valid until September 30, 2025 before having to be resubmitted for renewal.

The incoming Biden Administration's HHS Dept. put the kibosh on the work requirement provisions of the program. Georgia successfully challenged the administration and Georgia Pathways went into effect last summer...but is still currently scheduled to sunset next September.

Back in November, I noted that Georgia, one of the ten states STILL refusing to expand Medicaid coverage to hundreds of thousands of low-income residents a decade after they could have done so under the ACA, may finally be coming around...albeit via a rather silly & inefficient method. via the Atlanta Journal-Constitution:

Could Georgia adopt an Arkansas-style Medicaid plan?

Senior Republicans see an opening for a health care overhaul

Key Republicans say they’re open to legislation that would add hundreds of thousands of poor Georgians to the state’s Medicaid rolls — and bring in billions of federal dollars to subsidize it — as part of a compromise to roll back hospital regulations.

New York State of Health

via NY State of Health:

  • Certified Enrollment Assistors Visit Colleges Across New York State
  • New Yorkers Who Enroll by February 15 Will Have Coverage in Place for March 1

ALBANY, N.Y. (February 9, 2024) – NY State of Health, the state’s official health plan Marketplace, today announced an informational college campaign, with events taking place on campuses throughout New York State. Certified enrollment assistors will be visiting schools to talk to students about affordable, quality health insurance through the Marketplace, and help current enrollees renew their coverage. Enrollment for 2024 coverage is currently open for Medicaid, Essential Plan, Child Health Plus, and Qualified Health Plans (QHP). Consumers who enroll by February 15 will have coverage for March 1.

New York State of Health

As I noted last week, while the 2024 ACA Open Enrollment Period ended in most states back on January 15th, and in several more as late as January 31st, there are two remaining states where it's technically still going on: California, which bumped their final Open Enrollment deadline out by an extra 9 days at the last minute on the 31st, and New York, which announced last fall that they're keeping enrollment fully open to anyone all the way out until the end of May, to coincide with the end of the ongoing Medicaid Unwinding process.

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