It's been over six weeks since the last time I checked in on how many Americans had lost Medicaid or CHIP coverage due to the ongoing Medicaid Unwinding process playing out nationally. At the time, "only" 612,000 people had been confirmed to have lost coverage purely due to procedural/red tape reasons (as opposed to others who lost coverage after being determined ineligible any longer).
The Kaiser Family Foundation (KFF) has taken up the mantle on this front, and the data so far, while still limited, is pretty much as bad as many healthcare advocates feared. Since then, a lot more data has been collected and the numbers have grown dramatically:
In April 2023, 94,151,768 individuals were enrolled in Medicaid and CHIP.
87,062,629 individuals were enrolled in Medicaid in April 2023, an increase of 348,055 individuals from March 2023.
7,089,139 individuals were enrolled in CHIP in April 2023, a decrease of 73,121 individuals from March 2023.
Since February 2020, enrollment in Medicaid and CHIP has increased by 23,276,699 individuals (32.8%).
Medicaid enrollment has increased by 22,982,836 individuals (35.9%).
CHIP enrollment has increased by 293,863 individuals (4.3%).
Medicaid enrollment likely increased due to the COVID-19 PHE and Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA), which started in March 2020 and ended on March 31, 2023.
Not a whole lot stands out to me other than Cigna apparently dropping out of the states indy market and Humana pulling out of the small group market. Otherwise, neither market has rate changes which seem terribly surprising--they come to a weighted average increase of 4.3% for individual market plans and 6.6% for the small group market.
As always, these are subject to state regulatory review and approval.
The most noteworthy developments below are that in addition to Friday, Oscar and Bright Health Plans all leaving the Colorado market (as documented/reported on several times earlier this year), it looks like Anthem is reducing its offerings on the individual market, while Aetna and Humana both appear to be dropping out of the states small group market.
Update: Correction, apparently I misread that about Anthem; they have the same total number of plans available after all...not sure how I messed that up; apologies. Their Rocky Mountain division is offering off-exchange policies only, abut aren't listed on CO DARA's summary for whatever reason.
In any event, the weighted average increase being requested is 9.8% on the individual market and 10.6% for the small group market.
While numerous other states have already done the same thing (and several more are in the process of doing so as well), Georgia's move to their own enrollment platform was especially noteworthy for two reasons:
First, because it represents as complete 180-degree policy turn from their prior attempts (over the course of several years) to eliminate any formal ACA exchange (federal or state-based) in favor of outsourcing it to private insurance carriers & 3rd-party web brokers.
Each year, the Idaho Department of Insurance posts rate changes of individual and small group health insurance products so consumers can review and provide comments on the proposed increases. Insurance companies submit proposed rates for the upcoming calendar year to the Department, along with descriptions and justifications for why the rates are reasonable and not excessive.
The Department of Insurance is seeking public input for rate changes of individual and small group health insurance products to improve insurer accountability and transparency. By following the links below, the public can access a summary of the increase amounts and the carrier justifications for the rates. Please submit any comments to the Department for consideration.
As for when the program would actually go into effect, however...that's been something of a mystery for awhile now. Apparently the wording of the legislation ties it in with it being included in the general state budget, which hasn't happened yet. As a result, no one seems to be sure whether NC Medicaid expansion will kick off in October, November, December or January of next year.
Nearly Three Quarters of New Yorkers Enrolled in Medicaid, Child Health Plus or the Essential Plan Have Renewed Their Coverage by the June Deadline; Renewal Strategies Are Working; Others Still Have Time to Act
New York Outperforming National Average as Reported by KFF
Monthly Dashboard Tracks Renewal Status, Demographics, and State Program Transitions During Public Health Emergency Unwind
ALBANY, N.Y. (July 18, 2023) – The New York State Department of Health today released the first issue of New York’s Public Health Emergency Unwind Dashboard, a monthly report reflecting data on renewal status, demographics, and program transitions for public health insurance enrollees, which shows renewal outreach strategies are working. The report indicates that roughly 72 percent of New Yorkers enrolled in Medicaid, Child Health Plus or the Essential Plan renewed their coverage before the June deadline to re-enroll and those who haven’t still have time to act to avoid potential lapses in coverage. As reported by KFF, the national renewal rate for states reporting data is 59 percent.
DENVER— Today, the Colorado Division of Insurance (DOI) announced that they have asked the courts to move Friday Health Plans of Colorado into liquidation, which will end coverage for Friday Health Plans customers on August 31, 2023.
Chief Executive Officer of Connect for Health Colorado, Kevin Patterson, released the following statement:
A few weeks ago I noted that, thanks to California Governor Gavin Newsom and the Democratically-controlled state legislature finally reaching a compromise agreement on how to allocate ~$330 million/year in revenue generated by the state's individual mandate penalty, around $83 million will be utilized to dramatically reduce out of pocket expenses for hundreds of thousands of ACA exchange enrollees.
UPDATE: It turns out that this is not a "new" study; it's the final, peer-reviewed version of the same pre-print study from last fall by the same researchers, which makes a lot more sense.
Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic
Jacob Wallace, PhD; Paul Goldsmith-Pinkham, PhD; Jason L. Schwartz, PhD
If this study title and its authors sound vaguely familiar, it's because the same three researchers (from the Yale School of Public Health/Management) published a similar study last fall...which I wrote about at the time:
I didn't actually get around to writing up the post until June, but I actually bought the car, a 2022 Kia Niro EV, in early March 2022. My write-up included my experience taking a road trip from my home in a suburb north of Detroit, Michigan to Washington, DC and back.
Well, it's 16 months later, I've driven over 10,000 miles in the new car, and I just got back from another road trip to DC & back.
As I noted in my last update from March of this year, the EV industry and market have both gone through some tumultuous changes since I first bought my car, including (but not limited to):
Some health care policy experts are sounding the alarm that allowing standalone telehealth plans may simply be a shortcut for employers to cut rising health care costs while subverting Affordable Care Act consumer protections, but telehealth proponents tout the policy as simply a way to complement not replace more-expansive health insurance benefits. The debate has been muddied by confusion over how the bill’s “excepted benefits” policy differs from a narrower pandemic waiver that allowed some workers to get standalone telehealth plans that mimicked excepted benefits.
The Telehealth Benefit Expansion for Workers Act would add telehealth as an excepted benefit to the “menu” of health care options for all employees, not just those who do not qualify for major medical insurance plans as was the case under an expired pandemic telehealth flexibility. The legislation has been passed by the House Education & the Workforce committee and will be taken up by E&C Thursday (July 13).
ST. PAUL, Minn.—As roughly 1.5 million Minnesotans who currently have Medical Assistance (Minnesota’s Medicaid program) or MinnesotaCare coverage are scheduled to go through the eligibility renewal process over the next year, some will find out they are no longer eligible for these public health care programs and need to find new health insurance. Minnesota’s official health insurance marketplace, MNsure, is here to help those Minnesotans find new coverage.
“If you learn you no longer qualify for Medical Assistance or MinnesotaCare coverage, you may have more health insurance options than you think,” said MNsure CEO Libby Caulum. “MNsure is here to help you and your family understand your options, apply for discounts to save money on monthly premiums, and make a smooth transition to a private health plan if you’re eligible. We can help you find new coverage so you can keep getting the care you need.”
Georgia's health department doesn't publish their annual rate filings publicly, but they don't hide them either; I was able to acquire pretty much everything via a simple FOIA request. Huge kudos to the GA OCI folks!
Unfortunately, it looks like less than half of Georgia's small group market carriers have submitted their filings (alternately, it's conceivable that the other have have pulled out of the G small group market, though I highly doubt that). Only four of the eleven carriers offering policies in 2023 have filings included in the package sent to me by GA OCI. Not sure what that's about.
In any event, Georgia's individual market has grown dramatically over the past year (813,000 people vs. 660,000 a year ago), but the requested 2024 rate filings are pretty ugly, ranging from a somewhat reasonable 6.4% to as high as 27.7% for Cigna (ouch). The weighted average overall is just over 15% even.
Arkansas is a problematic state for many reasons, but I have to give their insurance dept. website high praise for posting their annual rate filings in a clear, simple & comprehensive fashion (which is to say, not only do they post the avg. premium changes for each carrier, they also post the number of covered lives for each, which is often difficult for me to dig up). Better yet, they also include direct links to the filing summaries and include the SERFF tracking number for each in case I need to look up more detailed info.
Anyway, there's nothing terribly noteworthy in the 2024 filings, in which AR carriers are seeking an average 5.0% rate hike on the individual market and 5.5% for small group plans. USAble HMO is launching a new line of HMO insurance products in the state next year (called "Octave" I believe) but otherwise it looks pretty calm.
New Report Projects Nearly 19 Million Seniors Will Save $400 Per Year on Out-of-Pocket Prescription Drug Costs
Today, the U.S. Department of Health and Human Services (HHS), announced actions to protect consumers from junk health plans, surprise medical bills, and excess costs that lead to medical debt. These actions build on the Biden-Harris Administration’s effort to eliminate hidden fees in every sector of the economy and lower health care costs for American seniors and families.
Coinciding with the actions taken today, HHS also released a new report projecting that nearly 19 million seniors will save approximately $400 per year on prescription drug costs when the $2,000 out-of-pocket prescription drug spending cap from the Inflation Reduction Act – President Biden’s historic lower cost prescription drug law – goes into effect in 2025.
Surprise bills happen when an out-of-network provider is unexpectedly involved in a patient’s care. Patients go to a hospital that accepts their insurance, for example, but get treated there by an emergency room physician who doesn’t. Such doctors often bill those patients for large fees, far higher than what health plans typically pay.
Short-Term, Limited-Duration Insurance; Independent, Noncoordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance (CMS-9904-P)
MARYLAND WINS FEDERAL APPROVAL FOR “REINSURANCE” FOR ANOTHER FIVE YEARS
Program has helped drive down rates for Marylanders who buy their own health coverage to among the most affordable in the nation
BALTIMORE (July 5, 2023) – The Reinsurance Program that helped drive down costs for consumers who purchase their own health insurance in Maryland to among the lowest rates in the nation has been renewed for the next five years.
The U.S. Department of Health and Human Services and the Department of the Treasury informed Maryland health and insurance officials that they have approved the state’s application for the period from Dec. 31, 2023, when the current authorization expires, until Dec. 31, 2028.
They typically release state-level breakout estimates of the total U.S. individual market once or twice a year. They haven't done so in 2023 as of yet, but today they did release this overview analysis:
District Court Judge Terry Doughty, who was appointed by President Donald Trump, issued a preliminary injunction on Tuesday that bars several federal departments and agencies from various interactions with social media companies.
On Wednesday, the Justice Department filed a notice that it will appeal the injunction with the Fifth Circuit Court of Appeals in New Orleans. The government also expects to ask the court to stay the district judge's decision, meaning it would not go into effect while the appeal is heard.
The bottom line is that this funding was intended to go towards reducing health insurance premiums for ACA exchange enrollees via Covered California as supplemental subsidies to be added on top of federal ACA tax credits...but the passage of the American Rescue Plan and the subsequent Inflation Reduction Act kind of made that moot, since the federal subsidies were made more generous than what the state subsidies would have been anyway.
As a result, Gov. Newsom decided that the extra revenue should go into the general state fund, while Democrats on the state legislature wanted to redirect it to eliminate deductibles and other types of cost sharing for ACA enrollees instead. This led to an impasse for the past several months:
As I wrote about back in March and updated in May, New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over 1.1 million New Yorkers, or over 5x as many residents as ACA exchange plans do.
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.
Governor Kathy Hochul today encouraged eligible New Yorkers to renew their health insurance coverage as insurance renewal deadlines rapidly approach. The Governor also issued a public service announcement to get the message out to New Yorkers.
These free, in-person events will take place in Bridgeport, East Hartford, Middletown and Torrington
HARTFORD, Conn. (June 27, 2023) — Access Health CT (AHCT) today announced it will host four free, in-person enrollment fairs in July and August to help HUSKY Health enrollees who have been affected by recent legislation. The events will take place in Bridgeport, East Hartford, Middletown and Torrington. HUSKY Health is Connecticut’s Medicaid program.
Medicaid Unwinding is a term the federal government is using to describe the process of resuming reviewing households for Medicaid eligibility after a three-year hiatus during the Public Health Emergency. The eligibility redetermination process resumed April 1.
Connecticut residents that remain eligible for HUSKY Health will likely be automatically reenrolled; those that need to take action will receive mail with instructions.
