Charles Gaba's blog

Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid, just announced that CMS has authorized expanding Medicaid to 15,000 children and pregnant women in Flint, Michigan, as well as expanding the services provided to 30,000 current Medicaid enrollees. Here's the full press release (emphasis mine): 

HHS Approves Major Medicaid Expansion for Flint

FLINT, Mich. – Today, the U.S. Department of Health and Human Services announced that the Centers for Medicare & Medicaid Services (CMS) has approved the State of Michigan’s 1115 demonstration to extend Medicaid coverage and services to Flint residents impacted by the lead exposure. In recognition of the public health crisis in Flint, it is a top priority for the Administration and for the Department to ensure that all children and pregnant women exposed to lead in their water in Flint have access to the services they need.  Approximately 15,000 additional children and pregnant women will be eligible for Medicaid coverage and 30,000 current Medicaid beneficiaries in the area will be eligible for expanded services under this new waiver agreement.

“Expanding Medicaid coverage to tens of thousands of expectant mothers and youth means the most vulnerable citizens served by the Flint water supply can now be connected to a wide range of needed health and developmental services, including lead-blood level monitoring and behavioral health services,” said HHS Secretary Sylvia M. Burwell.

Michigan will expand Medicaid coverage to children up to age 21 and pregnant women who were served by the Flint water system from April 2014 up to a date specified by the Governor, and who have incomes up to 400 percent of the federal poverty level (FPL).  Michigan will also set up a state program allowing pregnant women and children up to age 21 who were served by the Flint water system and individuals with incomes above 400 percent of FPL to purchase unsubsidized coverage.  This comprehensive health and developmental coverage includes lead-blood level monitoring and behavioral health services, among other services.

So, yesterday evening, Donald Trump finally released his "terrific" healthcare plan to replace the ACA. I started to write up a full deconstruction of it, point by point...

Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare.

Translation: Since March of 2010, nearly 18 million additional Americans have gained healthcare coverage, while nearly 14 million jobs have been added to the workforce.

This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan President in American history...

So here it is...Super Tuesday. Unless the GOP base suddenly decides that they don't want a xenophobic, misogynistic, hate-mongering, con-artist moron to be their standard-bearer, it's looking very likely that by the time midnight rolls around, Donald Drumpf will indeed be almost unstoppable as the Republican Presidential Nominee for 2016.

Which means, aside from the GOP establishment being on collective suicide watch, Mr. Drumpf will have to think about who his running mate will be for the general election.

First, the legal issues:

Last week I decided to check in on the "grandfathered/transitional plan" situation and attempted to do some crude back-of-the-envelope math to try and get a rough idea of just how many people are still enrolled in these non-compliant policies, and how many may still be enrolled in them a year and a half from now.

Last November, the Centers for Medicare & Medicaid (CMS) posted a whole mess of proposed ACA policy improvements for the 2017 Open Enrollment Period. They included a Public Comment period, then spent awhile reviewing all of the suggestions and making tweaks/changes to the proposals accordingly.

Just moments ago, they released the final parameters/rules for 2017...all 540 pages of it. Good grief.

Anyway, while there's a mountain of legalese to wade through here, the first one which leaps out at me is the one relating to the public Rate Review policy.

Yeah, I know it's extremely short notice, but if anyone happens to spend a half hour listening to me drone on about the whole Single Payer kerfuffle, feel free to tune into Netroots Radio tomorrow morning (Monday, Feb. 29th) at 8:00am EST, where I'm being interviewed by "Hopping Mad with Will McLeod and Arliss Bunny":

• Netroots Radio
• Hopping Mad with Will McLeod & Arliss Bunny
• iTunes Podcast
• Stitcher Podcast

SEE IMPORTANT UPDATES AT BOTTOM.

Chris Jennings is a respected healthcare policy expert who worked for the Clinton administration for over 6 years and more recently worked for President Obama for a brief stint from 2013 - 2014. Neera Tanden is the President of the Center for American Progress, but before that she was a policy advisor for Hillary Clinton's 2008 campaign. Lee Fang is an investigative journalist for The Intercept whose work has been published and referenced in numerous respected national publications.

Unfortunately, Mr. Fang made a rather embarrassing false accusation the other day which he has yet to correct. [edit: see updates below]

After Scott Brown won in his election, Neera emails Hillary about secret plan to basically destroy health reform https://t.co/An008xLDjz

Some of the ACA provisions have been a huge success, such as the Medicaid expansion program, which has added over 14 million people to the program over the past 3 years. Others can be viewed as being successful or so-so depending on your POV, like the 12.7 million people who have enrolled in private policies via the ACA exchanges.

And then there are the portions of the law which have gone, well, not so great, to put it mildly...in particular the non-profit, public/private hybrid Co-Ops, which are the only remaining remnant of the originally much-hoped-for "Public Option". For a variety of reasons, not the least of which was an utterly unnecessary and ultimately pointless stunt pulled by Marco Rubio and other Congressional Republicans (aka the Risk Corridor Massacre), over half of the two dozen Co-Ops nationwide melted down in spectacular fashion last fall, leaving only 11 of them surviving into 2016 after the dust settled.

In light of this, I figured it would be worth posting some positive Co-Op news for a change. First up, Ohio.

In my latest exclusive over at healthinsurance.org, I try to make something resembling sense out of the latest grunts and howls about Obamacare from the remaining Republican Presidential candidates.

Teaser: It included a discussion of the following scenario:

On September 26, 2013, just 5 days before the disastrous initial launch of HealthCare.Gov (as well as ugly rollouts of many of the state-based exchanges), President Obama gave a speech pumping up the impending start of the first Open Enrollment Period at Prince Geroge's Community College.

At one point in the speech, he touted how easy and handy the website would be to use:

Starting on Tuesday, every American can visit HealthCare.gov to find out what’s called the insurance marketplace for your state.  Here in Maryland, I actually think it's called MarylandHealthConnection.gov.  (Applause.)  MarylandHealthConnection.gov.  But if you go to HealthCare.gov, you can look and they'll tell you where to go.  They'll link to your state. 

Now, this is real simple.  It’s a website where you can compare and purchase affordable health insurance plans, side-by-side, the same way you shop for a plane ticket on Kayak -- (laughter) -- same way you shop for a TV on Amazon.  You just go on and you start looking, and here are all the options.