Charles Gaba's blog


via Black Chronicle New Service:

Nearly a decade after then-Vermont Gov. Peter Shumlin nixed a plan for a publicly funded system, advocates have renewed a push to transform health care with a single-payer system.

About 60 House Democrats have signed onto a proposal that calls for eventually replacing private health insurance premiums in the state with a public financing system. This week, supporters of the plan announced the creation of a universal healthcare caucus to push for the approval of the single-payer system.

The bill’s primary sponsor, Rep. Brian Cina, D-Burlington, said despite efforts to bring down the rate of uninsured Vermonters, thousands of people are still without healthcare coverage. He said those who may be eligible for healthcare plans have “fallen through the holes of a tattered social safety net.”

via NPR by way of WSIU:

Over the past several months, a handful of community pharmacies in states where abortion remains legal have begun to take advantage of a new rule that allows them to fill prescriptions for the abortion pill mifepristone. Prior to the rule change, which was finalized last January by the Food and Drug Administration, pregnant people had to get the drug directly from their doctor or by mail if using telemedicine, depending on the laws in their state.

Reproductive health experts have said relaxing that requirement could help ease the growing burden on abortion clinics in states where abortion is legal. And perhaps nowhere is the potential for that greater than in Washington state, where efforts are underway to open up access to medication abortion in a radical new way: by training pharmacists not only to dispense abortion pills but also to prescribe them to their walk-in patients.

On the one hand the state of Texas has enacted a policy of literally allowing women with life-threatening pregnancies to die in hospital lobbies rather than save their lives by allowing an emergency abortion.

On the other hand, well, at least if women manage to survive childbirth, they & their newborn baby will have Medicaid coverage for a full year in the future. Via the Austin American-Statesman:

Texas mothers are one step closer to getting health coverage for 12 months following pregnancy.

This week, the federal Centers for Medicare and Medicaid Services approved Texas' plan to provide 12 months of postpartum health care coverage through Medicaid or Children's Health Insurance Program instead of the current 60 days. Those programs are for people who qualify based on income. The extended coverage will begin March 1.

Back in September, Inside Health Policy reporter Dorothy Mills-Gregg checked in on "Georgia Pathways," the Peach State's new program which partially expands Medicaid to residents earning up to 100% of the Federal Poverty Level (FPL), but with a rather significant string attached: Work reporting requirements:

As noted by Madeline Guth of the Kaiser Family Foundation last year: spite of nearly every state which tried to (or succeeded in) implement Medicaid work requirements having their programs shut down by the courts, one state's work/reporting managed to survive: Georgia. As explained in the Kaiser article:

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

The Department, through CMS, will launch a new effort to support patients, hospitals, and providers to help ensure access to emergency health care

Today, the Department of Health and Human Services (HHS) announced that, together with the Centers for Medicare & Medicaid Services (CMS), it will launch a series of actions to educate the public about their rights to emergency medical care and to help support efforts of hospitals to meet their obligations under the Emergency Medical Treatment and Labor Act (EMTALA). As part of this comprehensive plan, the Department will:

It was just 53 days ago that North Carolina became the 40th state (plus DC & the U.S. territories) to fully expand Medicaid under the Affordable Care Act. At the time, around 600,000 lower-income North Carolinians were estimated to be eligible for the public healthcare program.

So where do things stand now? Well, the NC government has posted a handy Medicaid enrollment dashboard which is tracking the data as once a month; the most recent update was on January 12th:

NC Medicaid Expansion Enrollment as of January 12th, 2024: 314,101

The dashboard has some nifty interactive tools letting. you filter enrollees out by plan, age bracket, gender, ethnicity, urban/rural status and county, along with enrollment trends.

With all the fuss & bother over student loan debt over the past few years, this story out of the Aloha State caught my eye:

To say the topic of student loan program debt forgiveness has gotten a lot of attention in recent years would certainly be an understatement. Plenty of debate has been completed on both sides of the issue, with no real resolution anywhere in sight. In Hawaii, however, some action has been taken with the goal of both helping healthcare workers and also strengthening the healthcare system for residents of the 50th state.

In order to provide the funds needed to help healthcare workers pay off student loan debt that was incurred, this program is going to use a blend of state and private funding. As a starting point, $30 million will be provided by the state and an additional $5 million is going to be contributed by the CEO of Salesforce, Marc Benioff.

As I noted a month ago, as of January 1st, 2024, California extended Medicaid (Medi-Cal) eligibility to around 700,000 more undocumented residents:

On Jan. 1, immigrants may qualify for Medi-Cal regardless of legal status

...Milagro and her husband are among the more than 700,000 immigrants ages 26-49 expected to newly qualify for full health insurance come Jan. 1. That’s when California takes the final step in opening up Medi-Cal, the state’s health care program for low-income residents, to everyone who meets eligibility requirements, regardless of their immigration status.

Because of this, I admit to scratching my head at first when I read this article from the Redwood City Pulse:

This is about as minor of an enrollment update as it gets, but for what it's worth, the DC Health Benefit Exchange Authority posted this update a couple of weeks ago:

As of January 4th, 2024

Current Enrollment: 14,248
Enrollment 1 Year Ago: 13,941
CHANGE: +307

Current Enrollment: 5,267 groups, 86,639 covered lives
Enrollment 1 Year Ago: 5,381 groups, 87,033 covered lives
CHANGE: -114 groups, -394 covered lives

The year over year individual enrollment total is up 2.2%.

Last year's final enrollment tally as of January 31st was 14,768, so DC is still running 520 or 3.5% behind last year.

SHOP (small business exchange) enrollment is down about 0.4%.


In my last 2024 ACA Open Enrollment Period projection on January 4th, I concluded that:

...we could now be looking at anywhere from 21.4 - 22.7 million QHPs, for a grand total of somewhere between 22.7 - 24.0M QHPs+BHPs combined by the time the dust settles in every state on January 1st. I'll stick with 23M for the moment just in case...

A week later, the Centers for Medicare & Medicaid Services (CMS) posted their final pre-deadline Open Enrollment Snapshot Report, which confirmed that over 20.3 million people had selected Qualified Health Plans (QHPs) through December 23rd.