Charles Gaba's blog

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%).

Not sure how long ago this was actually released but it was just sent to me recently:; via Health Source Rhode Island:

HealthSource RI’s 11th annual health coverage Open Enrollment (OE) period began November 1, 2023 and ended on January 31, 2024.


Washington HealthPlan Finder

via the Washington HealthPlan Finder:

  • Nearly one-third of Washington residents receive access to their health and dental insurance through Washington Healthplanfinder
  • More than 253,000 Washingtonians enrolled in a qualified health plan (QHP) through Washington Healthplanfinder for plan year 2024.
  • Approximately 81% of QHP customers are receiving Cascade Care Savings (Washington’s state subsidy) and/or are eligible for federal premium subsidies.
  • Almost 90,000 people receiving Cascade Care Savings save an average of $514 per member per month in combined federal and state subsidies, for an average net premium of $68.

Enrollment into health insurance through Washington Healthplanfinder continues to grow, with a record number of more than 253,000 Washingtonians signing up for a plan for 2024. Washington Health Benefit Exchange (Exchange) released its Spring 2024 Enrollment Report today, reflecting upon the success of its most recent open enrollment period, which ran from Nov. 1, 2023, through Jan. 15, 2024.

This is actually from a couple of weeks ago (I'm playing catchup from my trip to Houston): via the Massachusetts Health Connector:

The Massachusetts Health Connector is celebrating today’s 18th anniversary of health care reform in Massachusetts, highlighting all-time high enrollment in health and dental plans, and providing health insurance to more than 1.1 million Massachusetts residents since 2015.

Today, 350,000 Massachusetts residents get their health or dental coverage (or both) through the Health Connector, the most in the Marketplace’s history. This includes more than 250,000 in ConnectorCare coverage, the Health Connector’s landmark subsidized health insurance program.

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

From the linked article in Pittman's tweet:

OK, not actually, but I won't be in a position to post any blog entries until next Tuesday.

No crisis, I'm just volunteering for my sons robotics tournament which runs the entire week & it's a pretty grueling 12+ hour shift every day.

In response to the recent story by KFF reporter Julie Appleby about rogue agents switching ACA exchange enrollee plans without their knowledge or permission, the Centers for Medicare & Medicaid Services (CMS) have released a statement about the actions they're taking to resolve the issue:

CMS is committed to protecting consumers in the Marketplace. CMS has received reports of consumers in states whose coverage was switched by agents and brokers without their knowledge. In response, CMS is taking swift actions to protect consumers from unauthorized activity by agents and brokers, and to root out bad actors who are violating CMS rules.  

According to the latest estimates from KFF, over 20 million Americans have now had their Medicaid or CHIP healthcare coverage terminated since the post-public health emergency "unwinding" process began one year ago:

At least 20,104,000 Medicaid enrollees have been disenrolled as of April 11, 2024, based on the most current data from all 50 states and the District of Columbia. Overall, 31% of people with a completed renewal were disenrolled in reporting states while 69%, or 43.6 million enrollees, had their coverage renewed (one reporting state does not include data on renewed enrollees). Due to varying lags for when states report data, the data reported here undercount the actual number of disenrollments to date.

I'm obviously a major proponent of making the enhanced ACA premium subsidies originally included in the American Rescue Plan (and later extended by another three years by the Inflation Reduction Act) permanent...or at the very least bumped out by another few years.

At the same time, I'm not naive enough to think that there's any realistic chance of that happening before January given the current makeup of the House of Representatives.

Even so, healthcare reform advocacy organizations like Families USA are making the strongest case they can for getting Congress to extend the subsidies for at least one year as soon as possible for practical reasons. Via Amy Lotven of Inside Health Policy:

It was just a week ago that Nevada Health Connect announced they'll be integrating a form of artificial intelligence software into their enrollee engagement system.

Today, Covered California is the second state-based ACA exchange to announce something similar:

Covered California Collaborates with Google Public Sector to Accelerate and Simplify Health Insurance Enrollment Using AI

  • Google Cloud AI integration will enable Covered California to verify more than 50,000 health care documents with an 84 percent verification rate monthly, providing residents with affordable, high-quality health care options at unprecedented speed.

SACRAMENTO, Calif. – Covered California, California’s health insurance marketplace, announced today that it is leveraging Google Cloud’s AI solutions to help streamline the organization’s efforts to provide California residents with affordable, quality health insurance.