Guam

Yesterday I noted that the big year-end federal omnibus spending bill includes provisions which allow states to start kicking people off of Medicaid who are only eligible thanks to the COVID-19 public health emergency bills passed in 2020 & 2021..but it at least does so in a fairly responsible way by phasing out the extra federal matching funds gradually over a 9-month period, to prevent states from dumping everyone all at once.

The omnibus bill also includes other important positive Medicaid provisions such as letting children who are eligible for the program stay on it for at least 12 months regardless of  household income changes, and letting states offer 12 months of postpartum Medicaid/CHIP coverage to newborn children & their mothers on a permanent basis instead of the current 5-year limit.

As I noted way back in October (seriously, I made a note of it at the bottom of the spreadsheet the very first week), the ACA situation in Guam, American Samoa, Puerto Rico, the U.S. Virgin Islands and the Northern Mariana Islands is, to put it mildly, kind of screwed up. Due to some massive oversights, they were stuck with some of the ACA's provisions (no denials for pre-existing conditions, having to accept everyone, etc.), but didn't get the other key provisions (no exchanges, no subsidies). As a result, it's been a bit of a mess.

Thankfully, the problem has been "solved", although not quite the way the Obama administration intended:

Guam and the four other American territories got some good news this week: they will no longer be held hostage by a byzantine set of Obamacare rules and regulations.

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