Charles Gaba's blog

CMS Logo

Thanks to Amy Lotven of Inside Health Politics for the heads up:

CMS Thursday (July 15) announced a new advertising campaign that will run in the final 30 days of the special enrollment period slated to end Aug. 15, and the agency also confirmed Inside Health Policy’sreport that the agency plans to auto-adjust tax credits for consumers who do not return to the federal marketplace starting Sept. 1.

Sure enough, this press release was put out by CMS earlier today:

Energy & Commerce Committee

 

I'm finally pulling myself out of my self-imposed COVID Vaccination Graphing project, and this seems like a good place to start: Earlier today, the House Energy & Commerce Committee held markup hearings for not one, not two, but nineteen different healthcare-related bills...some major, some minor, but all of them are kind of interesting. I don't really know much about any of these so I'm just posting the initial description of most of them, though in a few cases which catch my eye I'll go a bit more in depth:

  • H.R. 4369, the "National Centers of Excellence in Continuous Pharmaceutical Manufacturing Act"

To amend the 21st Century Cures Act to provide for designation of institutions of higher education that provide research, data, and leadership on continuous manufacturing as National Centers of Excellence in Continuous Pharmaceutical Manufacturing, and for other purposes.

Access Health CT Logo

via Access Health CT:

The Access Health CT American Rescue Plan Act Special Enrollment Period has saved Connecticut residents more than $4.5 million in health insurance costs since May 1

  • Connecticut residents have one month left to enroll.
  • More than 33,000 enrollees have received new financial help, saving approximately $4.5 million dollars in total.
  • The American Rescue Plan Act (ARPA) made health insurance coverage more affordable for many Connecticut residents by virtually eliminating or vastly reducing monthly payments (premiums) for people with low and moderate incomes.

HARTFORD, Conn. (July 15, 2021) — Access Health CT (AHCT), Connecticut’s official health insurance marketplace, is reminding Connecticut residents they have one month left to enroll in health insurance coverage during the American Rescue Plan Act Special Enrollment Period ending August 15.

DC Heatlh Link

Washington, DC­­ –The DC Health Benefit Exchange Authority (DCHBX) Executive Board voted to adopt recommendations from its Social Justice and Health Disparities Working Group, in an effort to stop racism in health care. These recommendations are focused on three crucial areas in order to establish practices, structures, and policies that can be implemented by DCHBX and DC Health Link health plans to (1) expand access to providers and health systems for communities of color, (2) eliminate health outcome disparities for communities of color, and (3) ensure equitable treatment for patients of color in health care settings and in the delivery of health care services. There are 100,000 people and more than 5,200 employers with private health insurance coverage through DC Health Link.  DCHBX is responsible for DC Health Link – the Affordable Care Act on-line health insurance marketplace in DC.  The recommendations are for coverage through DC Health Link. However, several recommendations will also benefit residents not covered through DC Health Link.  

Medicaid Expansion map

As I (and others) have written many times, closing the so-called "Medicaid Gap" is one of the trickiest challenges President Biden and Congressional Democrats face when it comes to strengthening and improving the Affordable Care Act.

Once again: Under the ACA, all Americans earning up to 138% of the Federal Poverty Level (FPL)... roughly $17,700/year for a single adult or around $36,500 for a family of four...were supposed to be eligible to join Medicaid regardless of their health status, whether they had kids and so forth.

This was supposed to be the case in all 50 states and the District of Columbia (I'm not sure about Puerto Rico or the other U.S. territories...many ACA provisions never applied to them in the first place).

Unfortunately, one of the major consequences of the NFIB vs. Sebelius Supreme Court Case in 2012 was that expansion of the Medicaid program has to be voluntary on the part of each state.

COVID-19

 

I'm presenting snippets of these stories without much comment because...really, there's not much more for me to add:

Via Brett Kelman of the Nashville Tennessean, two days ago:

Tennessee fires top vaccine official as COVID-19 shows signs of new spread

The Tennessee state government on Monday fired its top vaccination official, becoming the latest of about two dozen states to lose years of institutional knowledge about vaccines in the midst of the coronavirus pandemic.

The termination comes as the virus shows new signs of spread in Tennessee, and the more-transmissible delta variant surfaces in greater numbers.

Dr. Michelle Fiscus, the medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health, said she was fired on Monday afternoon and provided a copy of her termination letter. It provides no explanation for her termination.

HealthCare.Gov Logo

The previous CMS Special Enrollment Period report put the HC.gov total at 1.24 million via HC.gov as of the end of May, slightly exceeding my own projection. In addition, I had already confirmed at least 400,000 additional SEP enrollments via the 15 state-based ACA exchanges, for a total of at least 1.6 million nationally as of the end of May.

I didn't make any specific projection for the end of June as I've been swamped with my COVID vaccination tracking project, though I generally expected the enrollment pace to drop off significantly (anyone enrolling in June didn't have their policy kick in until July 1st, meaning their deductible & out-of-pocket cap would be the same even though they're only getting 6 months to use them up). Several hundred thousand more was a reasonable assumption, which would probably bring the national total up to somewhere in the 2 million range.

MNsure Logo

via MNsure:

ST. PAUL, Minn.—Health insurance helps individuals and families prepare for life’s unexpected challenges. To enable more Minnesotans to gain the security of health insurance during the COVID-19 pandemic, MNsure has offered a five-month special enrollment period (SEP) that closes this Friday, July 16, 2021.

If you’re uninsured or are currently enrolled in a health plan outside of MNsure, the COVID-19 SEP is a unique opportunity for you to find affordable, comprehensive health care coverage for 2021 through MNsure. The next open enrollment window won’t be until November 2021, with coverage beginning in January 2022—so don’t wait!

COVID-19 Vaccine

It's been a week since I last ran a scatter plot displaying current COVID-19 vaccination rates across every COUNTY nationwide according to the 2020 election results...all 3,100+ of them.

As I noted last week, with the more aggressive Delta variant now spreading quickly among the unvaccinated in the U.S., 85% of the total population seems to indeed be the more likely threshold which will be needed.

For the updated graph below, I've made a few more tweaks to both my data sources and the graph itself, neither of which makes that much of a difference in terms of impact on the final results:

Medicaid

A few weeks ago, after the Centers for Medicare & Medicaid (CMS) confirmed over 80 million Americans were enrolled in Medicaid or the CHIP program as of January 2021, I posted an analysis which looked at state Medicaid enrollment data beyond January.

While the "thru dates" vary from as early as February to as recent as June, my overall conclusion was that actual total Medicaid/CHIP enrollment as of last month has continued to grow, and now likely stands at more like 88 million. It's even conceivable that it's broken the 90 million threshold as of July.

As I noted:

Since then, the combination of sudden, massive unemployment combined with the Families First & CARES COVID Relief acts (which boost federal funding of Medicaid programs while also prohibiting states from disenrolling current Medicaid enrollees during the public health crisis) have resulted in overall Medicaid enrollment rising dramatically over the past year and a half.

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