Charles Gaba's blog

via Nevada Health Link (this was actually from a couple weeks ago but I missed it until now):

Nevada Health Link Extends Special Enrollment Period for Medicaid-ineligible, Launches SMS Text Campaign to Boost Awareness

A Special Enrollment Period through is extended through November 30 for those redetermined ineligible for Medicaid benefits

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

Nursing home minimum staffing standards promote resident care and safety 

  • Medicaid and CHIP to have historic access standards, advance fair compensation for direct care workers 

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today issued three final rules to fulfill President Biden’s commitment to support family caregivers, boost compensation and job quality for care workers, expand and improve care options, and improve the safety and quality of care in federally-funded nursing homes. The actions, announced during Care Workers Recognition Month and the Month of Action on Care, represent a transformational investment to support America’s families and workers.

Regular readers may have noticed that while I've written plenty about non-ACA compliant Short-Term, Limited Duration (STLD) healthcare policies (the "Short" part of my #ShortAssPlans hashtag), I've written far less about the "Ass" part...namely, Association Health Plans (AHPs)

The main reason for this is that I simply don't understand AHPs as well and don't want to misinform people about them. The other reason is that they sort of have one foot each in the worlds of the Individual and Small Group markets, and I write mostly about the Individual market.

Here's a taste of why AHPs are bad news, from New York Times reporter Robert Pear several years back:

But these health plans, created for small businesses, have a darker side: They have a long history of fraud and abuse that have left employers and employees with hundreds of millions of dollars in unpaid medical bills.

The problems are described in dozens of court cases and enforcement actions taken over more than a decade by federal and state officials who regulate the type of plans Mr. Trump is encouraging, known as association health plans.

via the Health & Human Services Dept. (HHS):

HHS Releases New Data Showing Over 10 Million People with Medicare Received a Free Vaccine Because of the President’s Inflation Reduction Act; Releases Draft Guidance for the Second Cycle of Medicare Drug Price Negotiation Program

  • Over 10 million people with Part D Medicare received a free vaccine in 2023 thanks to the Inflation Reduction Act, up from just 3 million in 2021.

President Biden’s lower cost prescription drug law, the Inflation Reduction Act, is helping millions of seniors and families save money on health care costs and prescription drugs. The law took on Big Pharma to finally allow Medicare to directly negotiate with participating drug companies for the prices of covered prescription drugs, caps the cost of insulin at $35 for seniors, and makes recommended vaccines free for Medicare Part D enrollees. Today, the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) published a new report showing that in 2023 more than 10 million people with Medicare Part D received a free vaccine thanks to the law – an increase from just 3.4 million people receiving covered vaccines in 2021.

February 16th:

I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...

...As I noted, however, in all three [states] it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper.

February 28th:

BREAKING: The Mississippi House just passed Medicaid expansion by a 96-20 vote.
That's more than enough to overcome a veto from Gov. Tate Reeves.
It now heads to the Senate.


— Ashton Pittman (@ashtonpittman) February 28, 2024

Just over a year ago, the Associated Press reported that the Biden Administration planned on opening up eligibility for ACA exchange, Basic Health Program, Medicaid & CHIP coverage to hundreds of thousands of Americans who have Deferred Action of Childhood Arrivals status:

President Joe Biden is set to announce that his administration is expanding eligibility for Medicaid and the Affordable Care Act’s health insurance exchanges to hundreds of thousands of immigrants brought to the U.S. illegally as children, according to two U.S. officials briefed on the matter.

The action will allow participants in the Obama-era Deferred Action for Childhood Arrivals program, or DACA, to access government-funded health insurance programs. The officials spoke on the condition of anonymity to discuss the matter before the formal announcement on Thursday.

As I noted at the time:

Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of January 2024:

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

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

  • • In January 2024, 84,041,447 individuals were enrolled in Medicaid and CHIP, a decrease of 1,056,384 individuals (1.2%) from December 2023.
    • 76,930,368 individuals were enrolled in Medicaid in January 2024, a decrease of 983,655 individuals (1.3%) from December 2023.
    • 7,111,079 individuals were enrolled in CHIP in January 2024, a decrease of 72,729 individuals (1.0%) from December 2023.
  • As of January 2024, enrollment in Medicaid and CHIP has decreased by 9,826,559 individuals (10.5%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 9,800,191 individuals (11.3%).
    • CHIP enrollment has decreased by 26,368 individuals (0.4%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,992,937 individuals (32.4%) to 93,868,006.
    • Medicaid enrollment increased by 22,650,766 individuals (35.3%).
    • CHIP enrollment increased by 342,171 individuals (5.0%).