Charles Gaba's blog

New York State of Health

via NY State of Health:

  • Enrollment Assistors Attend YMCA Kids Day Events Throughout the State to Help Consumers Renew or Enroll in Health Coverage
  • Eligibility Redeterminations will be Resuming for Over 9 Million New Yorkers in Medicaid, Child Health Plus and the Essential Plan  

ALBANY, N.Y. (April 27, 2023) – NY State of Health, the state’s official health plan Marketplace, today announced it will participate in the YMCA’s annual Healthy Kids Day, a national initiative featuring free community events with family-friendly activities that promote wellness. Certified enrollment assistors will be available at select YMCAs statewide on April 29, 2023, to provide free help to New Yorkers. They will provide information about upcoming changes to their health insurance, answer questions about renewals, and provide information to uninsured New Yorkers about enrolling in coverage through the Marketplace.  

via the Centers for Medicare & Medicaid Services:

CMS Approves of State of Washington Medicaid Section 1115 Demonstration

April 14: CMS approved an amendment to the State of Washington's Medicaid section 1115(a) demonstration, titled “Medicaid Transformation Project." Approval of this demonstration amendment includes several improvements, like historic continuous eligibility for Medicaid children from the point they become eligible until they reach age six, regardless of income fluctuations or changes that would affect eligibility. The demonstration also expands the definition of transportation so eligible program participants can gain access to benefits, including community services and activities based on their service plan.

So far, so good; that's a pretty big deal, especially as we're in the middle of the Medicaid Unwinding process nationally.

However, there's a rather curious provision at the end of the announcement:

Via the Centers for Medicare & Medicaid Services:

CMS marked another important maternal health milestone by approving Medicaid and Children’s Health Insurance Program (CHIP) postpartum coverage expansion in Rhode Island, an opportunity made possible by the American Rescue Plan. With this approval, 32 states and D.C. have extended postpartum Medicaid/CHIP coverage to a full year.

They include links to the approval letters for both Medicaid and CHIP, but the Medicaid one is oddly both extremely brief ("We received your request; it has been approved") and wonky at the same time, while not being in an easy-to-copy text format.

Here's the CHIP letter, however:

Dear Ms. Sousa:


This just in, via CBS News:

The House on Wednesday passed a bill that would raise the debt ceiling and slash trillions of dollars in government spending, delivering House Speaker Kevin McCarthy a victory in his efforts to pressure the White House to begin negotiations ahead of a fast-approaching deadline to avoid a default.

The House voted 217 to 215 to pass the Limit, Save, Grow Act of 2023, with all but four Republican members voting in favor. The Republicans who voted against the bill were Reps. Ken Buck of Colorado, Andy Biggs of Arizona, Tim Burchett of Tennessee and Matt Gaetz of Florida. No Democrats supported its passage.

The measure would lift the debt ceiling by $1.5 trillion or until the end of March 2024, whichever comes first, and cut spending to the tune of $4.5 trillion.

Those cuts mean it's dead on arrival in the Democratic-controlled Senate and President Biden has vowed to veto it.


The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.

While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)

Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented for the following year.

Two weeks 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.

New York State of Health

via NY State of Health:

  • As Eligibility Redeterminations Resume, New York Gets Ready to Renew Coverage for Over 8 Million Enrollees in Medicaid, Child Health Plus and the Essential Plan
  • Enrollment Assistors Available at Kinney Drugs, ShopRite and Rite Aid to Educate Consumers About Insurance Through the Marketplace

ALBANY, NY (April 26, 2023) – NY State of Health, the state’s official health plan Marketplace, is teaming up with retail pharmacies across the state to educate New Yorkers enrolled in public health insurance programs about upcoming changes to their coverage. With federal rules now requiring the state to resume eligibility redeterminations for nearly 9 million enrollees in Medicaid, Child Health Plus and the Essential Plan this spring, the Marketplace is increasing outreach to ensure consumers don’t risk a gap in their coverage. Certified enrollment assistors will be available on-site at pharmacies to answer current enrollees’ questions about renewals, as well as provide information to uninsured New Yorkers about enrolling in health insurance through NY State of Health. 

This happened last week but I was preoccupied with some personal issues and never got around to posting about it. The news is widespread by now but important enough that I figured I should at least give it a mention anyway.

Via the New York Times a few days ago:

The Supreme Court issued a decision on Friday evening that maintained the Food and Drug Administration’s approval of a commonly used abortion pill while an appeal moves forward, the latest development in a fast-moving legal battle that followed a lower court’s ruling that ordered the drug pulled off the market.

Justice Samuel A. Alito Jr. had paused the lower court’s ruling on the pill, mifepristone, but that freeze had been set to expire at midnight. The justices issued their decision about five hours before the deadline.

via NY State of Health:

  • Since March 2020, Aligned with Federal Continuous Coverage Requirements, Enrollment in NY State of Health Programs has Grown by 41 Percent
  • As the Post-Public Health Emergency Redetermination Process Begins, State Has Deployed Multi-pronged Strategy to Maximize Number of Consumers who Maintain Coverage

ALBANY, N.Y. (April 20, 2023) – NY State of Health, the state’s official health plan Marketplace, today released the 2023 Health Insurance Coverage Update, a detailed summary of NY State of Health enrollment, including demographics, quality measures, and the cost savings realized by millions of New Yorkers who have comprehensive health insurance through the Marketplace.  As of January 31, 2023, NY State of Health enrollment is nearly 6.9 million, or more than one in three New Yorkers across the state.

Read the Marketplace’s 2023 Health Insurance Coverage Update here.

via the Maine Dept. of Health & Human Services:

Individuals losing eligibility for MaineCare can enroll in plans on through July 31, 2024

AUGUSTA— The Maine Department of Health and Human Services (DHHS) announced today the launch of a Special Enrollment Period (SEP) through, Maine’s Health Insurance Marketplace, to help Maine people transitioning from MaineCare coverage after the COVID-19 pandemic explore affordable health insurance options and avoid gaps in coverage. The Special Enrollment Period began on April 15, 2023, and will continue through July 31, 2024, allowing Maine individuals found no longer eligible for MaineCare to apply for plans through outside of the annual Open Enrollment Period.