Charles Gaba's blog

via MNsure:

Minnesota Department of Commerce and MNsure, Minnesota’s official health insurance marketplace, are issuing a joint public service announcement alerting consumers to be aware of scams targeting Minnesotans who are no longer eligible for Medical Assistance (Minnesota’s Medicaid program).

This alert is specifically for Minnesotans who submitted their Medical Assistance renewal paperwork, found out they do not qualify for the program, and need to find new health insurance. When trying to buy health insurance, they may be vulnerable to scams from someone pretending to be MNsure that sells them a bogus insurance product. In some cases, scammers have taken money from consumers by saying they must pay for help enrolling in a plan or asking them to pay for premiums up front over the phone.

“Consumers should be on the alert for health insurance scams, including people claiming to represent MNsure who are not legitimate. MNsure.org is the safest place for consumers to shop for and buy health insurance with confidence or connect with a trusted, MNsure-certified assister for free application and enrollment help,” said CEO Libby Caulum.

As I noted a month ago, Virginia insurance carriers participating in the ACA individual market submitted preliminary 2024 rate filings which averaged over a 20% hike, almost entirely due to the prospect of the states reinsurance program (which had only been implemented one year earlier) possibly not being funded for the second year.

In 2023, average unsubsidized indy market premiums in Virginia had dropped by around 13% thanks to the new reinsurance program, which offloads a portion of high-cost enrollee care to the federal government in return for reducing the amount of subsidies received by low/moderate-income enrollees.

Fortunately, cooler heads eventually prevailed, and in the end the state legislature passed a budget which did indeed properly fund the program. This allowed insurance carriers to file modified rates for 2024 which include the reinsurance program being in place.

Last month I noted that Amy Lotven of Inside Health Policy had reported that Virginia's brand-new state-based ACA health insurance exchange had been officially approved by the Centers for Medicare & Medicaid Services:

Virginia is slated to become the nation’s 19th state-based exchange now that CMS has given officials the greenlight to fully transition away from healthcare.gov starting Nov. 1 for the 2024 plan year. Meanwhile, the State Corporation Commission (SCC), which administers the exchange, has suspended the state’s reinsurance program that had lowered premiums by about 20% for 2023, so individual plan rates are set to increase by an average 28.4%, according to a presentation made during an Aug. 9 hearing on the 2024 rates.

Virginia’s Health Benefit Exchange (VHBE) was enacted in 2020 by former Gov. Ralph Northam (D) and has been operating as a state-based exchange reliant on the federal platform (SBE-FP) since plan year 2021. The state paused the transition activity in 2021 after the enhanced premium tax credits were enacted but restarted it the following year.

Wyoming just became the latest state to have Medicaid coverage extended from 2 months to a full year for new mothers:

CMS approved a postpartum coverage extension state plan amendment (SPA) for Wyoming to extend postpartum coverage for a full year for individuals enrolled in Medicaid. The opportunity to extend postpartum coverage was made possible under the American Rescue Plan and made permanent in the Consolidated Appropriations Act, 2023. Wyoming’s approval marks 37 states, D.C., and the U.S. Virgin Islands that have extended postpartum Medicaid coverage to a full year. This approval supports the CMS Maternity Care Action Planand Biden-Harris Maternal Health Blueprint.

As noted last month:

Mississippi is one of the ten states where ACA Medicaid expansion still hasn't gone through a full decade after it could have.

A few years ago, Medicaid expansion in Mississippi looked like it might actually happen: While GOP Governor Tate Reeves and the 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 wouldn't be voted on or approved for months. As a result, no one seemed 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...which didn't happen.

Three weeks ago, the Centers for Medicare & Medicaid Services (CMS) announced that they were cracking down on one of the main reasons why so many people are being kicked off of Medicaid and the Children's Health Insurance Program (CHIP) even though they were still eligible: 

CMS believes that eligibility systems in a number of states are programmed incorrectly and are conducting automatic renewals at the family-level and not the individual-level, even though individuals in a family may have different eligibility requirements to qualify for Medicaid and CHIP. For example, children often have higher eligibility thresholds than their parents, making them more likely to be eligible for Medicaid or CHIP coverage even if their parents no longer qualify. This conflicts with existing federal Medicaid requirements and may have a disproportionate impact on children.

The National Association of Community Health Centers (NACHC) was first established in 1965 but also had its annual budget nearly doubled thanks to a provision in the Affordable Care Act:

Since the nation’s first health Community Health Centers opened in 1965, expansion of the federally supported health center system to over 1,400 organizations has created an affordable health care option for more than 30 million people. Health centers in every state, U.S. territory, and the District of Columbia, provide care to patients, regardless of ability to pay.

Health centers help increase access to crucial primary care by reducing barriers such as cost, lack of insurance, distance, and language for their patients. In doing so, health centers — also called Federally Qualified Health Centers (FQHCs) — provide substantial benefits to the country and its health care system.

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