via Access Health CT:

These free, in-person events will take place in Meriden, Norwich and Waterbury

HARTFORD, Conn. (May 24, 2023) — Access Health CT (AHCT) today announced it will host three free, in-person enrollment fairs in June to help HUSKY Health enrollees who have been affected by recent legislation. HUSKY Health is Connecticut’s Medicaid program. The events will take place in Meriden, Norwich and Waterbury.

Medicaid Unwinding is a term the federal government is using to describe the process of resuming the regular annual review of households for Medicaid eligibility after a three-year hiatus during COVID. The eligibility redetermination process resumed April 1. The Medicaid Unwinding process will be taking place over a 12-month period.

Connecticut residents who remain eligible for HUSKY Health will likely be automatically reenrolled; those who need to take action will receive mail with instructions about when they need to take action.

This is an updated version of a similar post from last month, when the legislation passed the MN Senate.

As I've written about several times, recently New Mexico passed (and Gov. Lujan Grisham signed) the first "true" Public Option bill, which will allow any permanent New Mexico resident to enroll in Medicaid regardless of income via a sliding premium scale. Today there's big Public Option news in another state: Minnesota.

The main distinction between the New Mexico and Minnesota approaches has to do with which existing publicly-funded healthcare program they're based on. While New Mexico went with Medicaid (which half the state's population is already enrolled in anyway), Minnesota is basing theirs on their Basic Health Plan program, MinnesotaCare. I first wrote about this back in February.

District of Columbia

via the District of Columbia Dept. of Insurance, Securities & Banking (DISB):

This page contains proposed health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2024.

The District of Columbia Department of Insurance, Securities and Banking (DISB) received 215 proposed health insurance plan rates for review from Aetna, CareFirst BlueCross BlueShield, Kaiser and United Healthcare in advance of open enrollment for plan year 2024 on DC Health Link, the District of Columbia’s health insurance marketplace.

The four insurance companies filed proposed rates for individuals, families and small businesses for the 2024 plan year. Overall, 215 plans were filed, compared to 238 last year. The number of small group plans decreased from 211 to 188, while the number of individual plans remained at 27.

Via the Oregon Dept. of Consumer & Business Services (Division of Financial Regulation):

Salem – Oregon consumers can get a first look at requested rates for 2024 individual and small group health insurance plans, the Oregon Department of Consumer and Business Services (DCBS) announced today.

In the individual market, six companies submitted rate change requests ranging from an average 3.5 percent to 8.5 percent increase, for a weighted average increase of 6.2 percent. That average increase is slightly lower than last year's requested weighted average increase of 6.7 percent.

In the small group market, eight companies submitted rate change requests ranging from an average 0.8 percent to 12.4 percent increase, for a weighted average increase of 8.1 percent, which is higher than last year's requested 6.9 percent average increase.


And here...we...go...

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

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

CMS Approves Delaware Postpartum Coverage Expansion Under the American Rescue Plan

May 15: CMS marked another important maternal health milestone by approving Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage expansion in Delaware, an opportunity made possible through the American Rescue Plan. This approval marks 33 states and the District of Columbia that have extended postpartum Medicaid/CHIP coverage to a full year. Information about Delaware’s postpartum coverage extension for Medicaid can be found here; Delaware’s postpartum coverage extension for CHIP can be found here.

Theodore Mermigos,
Acting Director Division of Medicaid and Medical Assistance
Molly Magarik, Secretary, DHSS
Delaware Health and Social Services
P.O. Box 906 New Castle, DE 19720-0906

Dear Mr. Mermigos:

I haven't written about the ACA's Medical Loss Ratio (MLR) program in over a year. Here's a very simplified explainer:

Ever since the ACA went into effect in 2011 (3 years before newly-sold policies had to be ACA compliant), to help reduce price gouging, insurance carriers have been required to spend a minimum of 80% of their premium revenue (85% for the large group market) on actual medical claims.

Put another way, their gross margins are limited to no more than 20% (or 15% in the large group market). Remember, that's their gross margin, not net; all operational expenses must come out of that 20% (15%). The idea is that they should be spending as much of your premium dollars as possible on actual healthcare, as opposed to junkets to Tahiti or marble staircases in the corporate offices, etc. Anything over that 20% (15%) gross margin has to be rebated to the policyholder.

With all the controversy over the frighteningly quick expansion of Artificial Intelligence (AI) systems over the past year or so into every facet of our lives, I decided to run a quick experiment using ChatGPT. My request was pretty simple:

"Write a blog post in the style of Charles Gaba."

I didn't include anything about healthcare or the Affordable Care Act...just my name.

Here's what it came back with, verbatim. I'm putting the whole thing in quotes because while it was sophisticated enough to make the topic of the post the history of the ACA and the U.S. healthcare system in general, I sure as hell didn't write this:

Title: The Healthcare Odyssey: Navigating the Waves of Change

Subtitle: Charting a Course Through the Turbulent Sea of Healthcare Reform



via Michigan Gov. Gretchen Whitmer's website:

May 09, 2023

To: State Department Directors and Autonomous Agency Heads

From: Governor Gretchen Whitmer

The federal Families First Coronavirus Response Act, passed to respond to the COVID-19 pandemic, required Medicaid programs to keep participants continuously enrolled and provided additional federal funding to do so.  In December 2022, Congress passed a law ending the continuous enrollment and winding down the associated federal funding.  As a result, more than 3 million Michiganders will need to undergo redeterminations for Medicaid coverage or find alternative health insurance if they no longer qualify.

During the COVID pandemic emergency, Congress passed legislation which, among other things, required states to provide "continuous coverage" of people who enrolled in Medicaid or the CHIP program.

Normally Medicaid/CHIP enrollees have their eligibility statuses "redetermined" every month (or quarter in some states, I believe) to make sure they were still eligible for the program, but the Families First Coronavirus Response Act (FFCRA) stated that in order to receive increased federal funding of their Medicaid/CHIP programs, states couldn't kick anyone off as long as the public health emergency was in place (unless they died, moved out of state or asked to be disenrolled).

This requirement ended effective April 1st, 2023 via an omnibus bill passed back in December.