Medicaid

via the Centers for Medicare & Medicaid Services:

Based on current COVID-19 trends, the Department of Health and Human Services is planning for the federal Public Health Emergency for COVID-19 (PHE), declared under Section 319 of the Public Health Service Act, to expire at the end of the day on May 11, 2023. Thanks to the Administration’s whole-of-government approach to combatting the virus, we are in a better place in our response than we were three years ago, and we can transition away from an emergency phase.

As I noted a few weeks back, the Patient Protection & Affordable Care Act now directly provides healthcare coverage for a stunning 40 million Americans:

...it's very likely that another 50,000 - 100,000 people will be added to the final QHP tally when the dust settles tomorrow (Tuesday, January 31st) evening. Even assuming the same 94% effectuation rate, that will still bring the effectuated QHP total to roughly 15.4 million.

Add to this the 1,217,517 confirmed Basic Health Plan (BHP) enrollees in New York and Minnesota and the subtotal comes to around 16.62 million QHPs + BHPs combined.

Next, we need to add Medicaid Expansion enrollees.

...the MBES reports only run through March 2022, at which point the national ACA expansion total stood at 22,275,433.

We're up to 38.9 million Americans with ACA coverage already, and we're still missing a lot of Medicaid expansion enrollees.

UPDATE 2/27/23: Looks like the bill has made it past the first hurdle:

#hb400 #medicaidforward passed in the House Health and Human Services Committee with a 7 to 3 vote! #nmleg #nmpol #hb400

— New Mexico RCRC (@nmrcrc) February 27, 2023

While ACA Medicaid expansion just died for a 9th time in Wyoming, it may finally be on the verge of actually happening in a much larger state. Via Gary Robertson of the Associated Press:

RALEIGH, N.C. (AP) — The North Carolina General Assembly began on Tuesday what could become the final push to expand Medicaid to hundreds of thousands of low-income adults in the state with a House measure that quickly advanced through two committees with bipartisan support.

The bill is generally expected to pass the NC House as soon as today...and a different version of the bill is expected to pass the state Senate as well. The issue is the difference between the two versions:

Back in December, the state with the smallest population in the country, Wyoming, looked like it might finally carry the ACA Medicaid expansion football into the end zone:

‘Let’s just get this done’: Wyoming Legislature to consider Medicaid expansion again in 2023

Medicaid expansion will be up for debate once again when the Wyoming Legislature convenes for its 67th session in January.

The legislature’s Joint Revenue Committee voted to advance the Medical Treatment Opportunity Act to the legislative session during a meeting this month.

It’s the same bill the legislature considered during the 2022 session, state staffers said.

The proposed legislation would allow Medicaid expansion to occur in Wyoming as long as the federal contribution to the program remains at 90 percent or higher.

Over at Vox, Dylan Scott has an excellent overview of the pending Medicaid Unwinding debacle about to unfold across the country:

Perhaps the greatest success of the American health care system these last few benighted years is this surprising fact: The uninsured rate has reached a historic low of about 8 percent.

...One [COVID era] policy was likely the single largest factor. Over the past three years, under an emergency pandemic measure, states have stopped double-checking if people who are enrolled in Medicaid are still eligible for its coverage. If you were enrolled in Medicaid in March 2020, or if you became eligible at any point during the pandemic, you have remained eligible the entire time no matter what, even if your income later went up.

But in April, that will end — states will be re-checking every Medicaid enrollee’s eligibility, an enormous administrative undertaking that will put health insurance coverage for millions of Americans at risk.

The Biden administration estimates upward of 15 million people — one-sixth of the roughly 90 million Americans currently receiving Medicaid benefits — could lose coverage, a finding that independent analysts pretty much agree with. Those are coverage losses tantamount to a major economic downturn: By comparison, from 2007 to 2009, amid the worst economic downturn of most Americans’ lifetimes, an estimated 9 million Americans lost their insurance.

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

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.

Medicare

via the Centers for Medicare & Medicaid Services:

Temporary Special Enrollment Period (SEP) for Consumers Losing Medicaid or the Children’s Health Insurance Program (CHIP) Coverage Due to Unwinding of the Medicaid Continuous Enrollment Condition– Frequently Asked Questions (FAQ)

...Since the onset of the novel coronavirus disease of 2019 (COVID-19) Public Health Emergency (PHE), state Medicaid agencies have made policy, programmatic, and systems changes to respond effectively to the pandemic. State Medicaid agencies also have made changes to qualify for the temporary Federal Medical Assistance Percentage (FMAP) increase under section 6008 of the Families First Coronavirus Response Act (FFCRA), including satisfying a continuous enrollment condition for most Medicaid beneficiaries who were enrolled in the program as of or after March 18, 2020.1 Similarly, during the COVID-19 PHE, some states have been granted 1115 demonstration authority to provide continuous enrollment for Children’s Health Insurance Program (CHIP) beneficiaries in addition to other flexibilities that have had this effect.

Huh. This is interesting...via the Centers for Medicare & Medicaid Services (CMS):

First-of-its-kind initiative will help people get the behavioral health care they need as they leave incarceration 

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved a first-of-its-kind section 1115 demonstration amendment in California which will provide a set of critical pre-release services and improve access to critically needed care for people returning home from jails and prisons. 

For example, Medi-Cal will be able to cover substance-use treatment before a Medicaid beneficiary is released from jail, prison, or youth correctional facility. Additionally, the state will be able to help connect the person to community-based Medicaid providers 90 days prior to their release to ensure they can continue their treatment after they return to the community. 

via the Centers for Medicare & Medicaid Services:

January 11, 2023: CMS marked another important maternal health milestone by approving  Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage expansions in Alabama and a Medicaid postpartum coverage expansion in North Dakota through the American Rescue Plan (ARP). Nationally, more than 439,000 people across 28 states and the District of Columbia now have access to Medicaid and CHIP coverage for a full 12 months following pregnancy — up from just 60 days before the ARP. Postpartum coverage extensions form one of the cornerstones of CMS’ Maternity Care Action Plan — part of the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis. Click here and here to learn more about Alabama’s approvals, and here to learn more about North Dakota’s approval.