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.

via the Centers for Medicare & Medicaid Services (CMS):

  • In October 2023, 87,289,666 individuals were enrolled in Medicaid and CHIP, a decrease of 1,160,543 individuals (1.3%) from September 2023.
    • 80,227,593 individuals were enrolled in Medicaid in October 2023, a decrease of 1,210,160 individuals (1.5%) from September 2023.
    • 7,062,073 individuals were enrolled in CHIP in October 2023, an increase of 49,617 individuals (0.7%) from September 2023.
  • As of October 2023, enrollment in Medicaid and CHIP has decreased by 6,561,074 individuals (7.0%) 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 6,489,844 individuals (7.5%).
    • CHIP enrollment has decreased by 71,230 individuals (1.0%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,975,671 individuals (32.4%) to 93,850,740.
    • Medicaid enrollment increased by 22,637,644 individuals (35.3%).
    • CHIP enrollment increased by 338,027 individuals (5.0%).

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.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of October 2023:

Hmmm...via Covered California:

Covered California announced today that it will give consumers until Feb. 9 to sign up for coverage in 2024.

“We’ve seen record-breaking enrollment nationally, and Covered California is surging with heightened demand,” said Covered California Executive Director Jessica Altman. “We want any Californian who needs health insurance to have the opportunity to get covered for the rest of 2024, and extending the open-enrollment period will ensure they have the time they need.”

In addition to the increased demand, consumers looking to enroll in recent days may have encountered challenges reaching Covered California representatives over the phone, and many this week have experienced longer than expected wait times. This was due in part to a disruption to Covered California’s service center, which was temporarily taken offline in immediate response to a cybersecurity incident affecting a third-party vendor that supports its phone lines.

via Pennie, Pennsylvania's state-based ACA exchange:

  • The record number of Pennsylvanians is an increase of over 150,000 – 56 percent – since Pennie launched in 2020.

Harrisburg, PA – Today, Pennie – PA's official health insurance marketplace – announced that a record nearly 435,000 Pennsylvanians are now covered with affordable, high-quality health coverage through Pennie. This represents a 17% increase compared to this time last year, far exceeding the average annual increase of 1%. Marketplace enrollment has increased by over 150,000 in the four years since Pennsylvania took over ownership and operations from the federal marketplace (healthcare.gov) – a 56% increase.  

via the Massachusetts Health Connector:

Massachusetts Health Connector ends busiest Open Enrollment in a decade with more than 72,000 new enrollments

Marketplace enrollment increases dramatically by 40 percent in the last year

BOSTON – More than 72,000 people enrolled in new health insurance plans with the Massachusetts Health Connector during Open Enrollment 2024, which ended on January 23. This is the largest number of new enrollments in a decade, continuing a rapid increase in overall Health Connector enrollment, which has surged by 40 percent in the last year.

Note: as the next paragraph states, the 40% increase refers to total effectuated enrollment as of today versus total effectuated enrollment as of February 2023. When you include total QHPs and divide it last open enrollment periods total QHPs, which is my and CMS's standard methodology, it's a 30% year over year increase. I've been informed that there are an additional 7,713 enrollees who haven't actually paid their first premium yet.

Well if nothing else at least I get to use the speech to text tool on my Mac for the first time. I found out the hard way this morning that if you're going to punch a wall in frustration, at the very least make sure not to hit a wall stud in the process.

That's right, I managed to dislocate my finger and fracture my knuckle. Or possibly the other way around.

In any event, I may require surgery; I have an appointment with an orthopedic surgeon this week; and either way typing is going to be very difficult and I'm going to have to rely on a lot of voice activation for the next few weeks.

As a result, while I'll still be posting, the entries will likely be shorter than usual and less frequent for a while. Typing actually isn't too bad thanks to speech to text, but using apps like Excel, Photoshop etc. Is gonna be a real pain for a bit.

Thanks for your understanding.

via the Centers for Medicare & Medicaid Services (CMS):

CMS Announces Data RFI to Improve Data Sharing and Enhance Competition 

On December 7, the Biden-Harris Administration announced new actions to promote competition in health care, including increasing transparency in the Medicare Advantage (MA) insurance market and strengthening MA programmatic data. Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is continuing momentum in this area by releasing a Request for Information (RFI) to solicit feedback from the public on how best to enhance MA data capabilities and increase public transparency.

Among the most celebrated & ballyhooed provisions of the ACA are the Guaranteed Issue and Community Rating rules:

...Prohibits a health plan ("health plan” under this subtitle excludes any “grandfathered health plan” as defined in section 1251) from: (1) imposing any preexisting condition exclusion; or (2) discriminating on the basis of any health status-related factor. Allows premium rates to vary only by individual or family coverage, rating area, age, or tobacco use.

Requires health plans in a state to: (1) accept every employer and individual in the state that applies for coverage; and (2) renew or continue coverage at the option of the plan sponsor or the individual, as applicable.

Prohibits a health plan from establishing individual eligibility rules based on health status-related factors, including medical condition, claims experience, receipt of health care, medical history, genetic information, and evidence of insurability.

Connecticut

An interesting article via Jamil Ragland of CT News Junkie:

Six Democratic lawmakers went on the offensive today against what they believe is a better alternative to Association Health Plans.

(Note: The phasing of this lede is confusing...it makes it sound like the lawmakers oppose the better alternative, which the article makes clear is not the case.)

Association Health Plans, which are not currently allowed in Connecticut, would allow small businesses to form a group and purchase health insurance in bulk. However, that health insurance doesn’t come with the protections of the Patient and Affordable Care Act. 

It's been quite awhile since I've written about the "Ass" part of #ShortAssPlans; here's a few basics via Robert Pear of the New York Times:

Pages

Advertisement