Charles Gaba's blog

I managed movie theaters for most of the '90's, and was in charge of the concession stand & its staff. One year I came back from vacation to find the employees cleaning the concession stand after a big rush of customers.

I was happy to see this until I realized that some of the staff were using a mop with bleach-based cleanser to clean the floor at the same time other staffers were using an ammonia-based cleanser to clean the glass popcorn bins right next to the employee mopping.

I freaked out a bit, ordering them to stop immediately and turning on a fan to blow the fumes in opposite directions. Apparently neither the employees nor the other manager who had been covering my department while I was on vacation had ever learned that mixing bleach and ammonia can be fatal.

When I asked about it, the other manager apologized but explained that they were simply trying to follow both state and local health/safety board rules. You see, some of the staff were college students while others were minor high school students.

Yesterday I noted that Idaho, which was the one of the first states to start "redetermining" Medicaid/CHIP enrollees the moment the Medicaid Unwinding process began last spring, has at least completed doing so; in the end, over 121,000 - 145,000 Idahoans got the boot, of which somewhere between 51,000 - 106,000 may still actually be eligible for Medicaid/CHIP coverage due to having their coverage terminated for purely procedural reasons.

Today, there's a consolation prize of sorts; via Your Health idaho:

Special Enrollment Period for the Loss of Medicaid Extended

Idahoans who have lost Medicaid coverage have until Nov 30, 2023, to enroll in health insurance through Your Health Idaho

via Dorothy Mills-Gregg of Inside Health Policy:

While most states are reaching the height of their post-pandemic Medicaid renewals, Idaho is returning to nearly normal redeterminations, closing out the bulk of its pandemic eligibility unwinding after removing more than 121,000 Medicaid and CHIP beneficiaries the state deemed most likely ineligible from the programs in six months.

Hmmm...IHP's estimate is lower than that of KFF's daily tracker, which puts Idaho's total disenrollment number at 145,000 as of today.

Idaho’s Medicaid and Children’s Health Insurance Program enrollment grew by roughly 150,000 people during the pandemic’s continuous coverage requirement, maxing out at about 450,000 beneficiaries. An estimated 42% of the beneficiaries who were disenrolled lost coverage due to procedural or paperwork issues.

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

The Centers for Medicare & Medicaid Services’ (CMS’) final rule will make it easier for millions of eligible people to enroll in and retain their Medicare Savings Program (MSP) coverage. The final rule reduces red tape and simplifies Medicare Savings Program enrollment, helping millions of seniors and people with disabilities afford coverage. The final rule follows President Biden’s executive orders in January 2021, December 2021, and April 2022, directing federal agencies to take action to expand affordable, quality health coverage.

Mississippi is one of the ten states where ACA Medicaid expansion still hasn't gone through a full decade after it could have (well...eleven if you include North Carolina, where the Republican-controlled legislature is currently holding it hostage).

A few years ago, Medicaid expansion in Mississippi looked like it might actually happen: While the states GOP Governor and Republican supermajority-controlled state legislature opposed it, in May 2021 there was a strong grassroots effort to put a statewide initiative on the ballot to push it through regardless, exactly how it happened in other deep red states like Utah, Nebraska, Idaho and South Dakota.

Unfortunately, just a few weeks later, the Mississippi Supreme Court crushed that effort:

Back in March, after years of failed and stalled attempts to get it passed, the North Carolina legislature finally pushed ACA Medicaid expansion over the line to be signed into law by Democratic Governor Roy Cooper.

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 when the healthcare expansion program for up to ~600,000 North Carolina residents will actually launch.

Back in July, the Health & Human Services Dept. took an optimistic stance, preparing for the possibility of the program kicking off starting on October 1st of this year. Unfortunately, that was based on the assumption that the GOP-controlled state legislature would actually pass the general budget required for it to happen by September 1st.

It's now September 18th. Where do things stand?

via the Maryland Insurance Dept:

Maryland Insurance Administration Approves 2024 Affordable Care Act Premium Rates

  • Reinsurance Program Continues Positive Impact on Individual Rates

BALTIMORE – Maryland Insurance Commissioner Kathleen A. Birrane today announced the premium rates approved by the Maryland Insurance Administration for individual and small group health insurance plans offered in the state for coverage beginning Jan. 1, 2024.

Rate Changes for the Individual Market

The rates for individual health insurance plans subject to the Affordable Care Act (ACA) will change/increase by an average of 4.7% for 2024. Approximately 229,000 Marylanders are impacted by the approved rates. However, the actual percentage by which the rates for a specific plan will change depends on the carrier and plan.

Fantastic news via the New Jersey Dept. of Banking & Insurance:

NJDOBI Adopts Regulations to Require Comprehensive Abortion Coverage in Department Regulated Health Insurance Markets

TRENTON – As part of the Murphy Administration’s efforts to protect access to reproductive health care, the New Jersey Department of Banking and Insurance today announced the adoption of rules to require comprehensive abortion coverage as a part of all health benefits plans regulated by the department. This requirement, which was in place as of January 1, 2023 in the individual and small employer health insurance markets, will now be in effect for the fully-insured large employer health insurance market upon plan issuance or renewal.

Note: I decided that while the original headline accurately reflected my feelings about this WSJ Op-Ed, it was a bit over the top, so I've changed it to something less crude.

For years, the Patient Protection & Affordable Care Act, generally shorthanded as the ACA or, more colloquially known as "Obamacare," was the top policy target of Republicans and other conservatives.

It seemed as though not a day went by without some right-wing opinion piece being published attacking the ACA for one thing or another. Once in awhile these attacks had some validity, but the vast majority were either completely baseless or grossly exaggerated.

And yet, after the dust settled on the infamous 2017 ACA "repeal/replace" debacle, it seemed as though the GOP had pretty much tired of their relentless assault on the healthcare law. They had failed to repeal it even with control of the White House, Senate, House of Representatives and Supreme Court, and ended up settling for zeroing out of the federal Individual Mandate Penalty as a consolation prize.

Over at Inside Health Policy, Amy Lotven confirms that House Democrats haven't forgotten about the pending expiration of the upgraded federal subsidies provided by the American Rescue Plan and extended via the Inflation Reduction Act last summer:

While the Census found the percentage of Americans without insurance fell, even as a supplemental poverty measure increased following the end of pandemic-era assistance, ranking House Ways & Means Committee Democrat Richard Neal (MA) is highlighting the need to extend the enhanced Affordable Care Act credits that are set to expire at the end of 2025.