Charles Gaba's blog

Michigan

Back in February, I posted an updated & overhauled version of my Michigan healthcare legislative wish list for the newly-elected Democratic majorities in my home states House and Senate.

The list includes 9 major items (some of which actually include a lot more than one provision within them). It really should include ten, since I forgot about implementing a Basic Health Plan program like New York and Minnesota have (and as Oregon is ramping up to do soon as well), but it's still a pretty full plate.

The second and third items on the list include:

via the Maryland Insurance Dept:

Health Carriers Propose Affordable Care Act (ACA) Premium Rates for 2024

  • Public Invited to Submit Comments

BALTIMORE – The Maryland Insurance Administration has received the rate filings containing the proposed 2024 premium rates for Affordable Care Act (ACA) products offered by health and dental carriers in the Individual, Non-Medigap and Small Group markets, which impact approximately 471,000 Marylanders.

via the Connecticut Insurance Commissioner:

The Connecticut Insurance Department has received a total of 10 rate filings from 9 health insurers for plans that will be available on the individual and small group market, both on and off the state-sponsored exchange, Access Health CT. As part of our regulatory responsibilities, we will conduct a thorough examination of these filings to ensure that the requested rates comply with state laws and regulations.

The review process will delve deeply into each submission, requiring insurers to provide justifications and supporting evidence. As always, the rate reviews will be comprehensive, continuing our ongoing efforts to promote transparency and accountability. By utilizing various tools, such as benchmarking and other industry best practices, we strive to maintain a fair and competitive insurance market while prioritizing the interests of consumers.

Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of February 2023:

via the Pennsylvania Dept. of Human Services website:

Erie, PA - Pennsylvania Department of Human Services (DHS) Acting Secretary Dr. Val Arkoosh and Pennie® Director of External Affairs Chachi Angelo joined representatives from Community Health Net today to highlight how the Shapiro Administration, Pennie, and local health centers are collaborating to support Pennsylvanians through federal changes to Medicaid and CHIP renewal requirements so they can protect their health and stay covered.  

“Everyone deserves the dignity and peace of mind of having access to affordable, high-quality, local health care and knowing they can go to the doctor when they need it. DHS’ goal throughout the renewal process is to make sure that all Pennsylvanians stay covered,” said Acting Secretary Arkoosh. “I urge all Pennsylvanians who get their health coverage through the state Medicaid program to be on the lookout for communications from DHS about your renewal, and to make sure you complete it on time when it’s your turn to renew.”  

via Connect for Health Colorado:

Colorado’s Marketplace Offers Free Enrollment Help and Low-Cost Health Plans

DENVER— For the first time in more than three years, Coloradans who are no longer eligible for Health First Colorado (Colorado’s Medicaid program) or Child Health Plan Plus (CHP+) will start to lose their coverage.

Why Coloradans Might Lose Health First Colorado (Colorado’s Medicaid Program)

This change was the result of federal legislation passed in winter of 2022: the Omnibus bill, otherwise known as the Consolidated Appropriations Act. It included a provision to end the requirement for states to keep individuals covered by Medicaid during the COVID-19 Public Health Emergency. 

The Department of Health Care Policy & Financing (HCPF) estimates that more than 325,000 current members will no longer be eligible for Health First Colorado coverage following their annual eligibility review. These eligibility reviews will be done in the anniversary month of when the person enrolled.

Back in February, I wrote about how the state of Georgia, in an eyebrow-raising move, announced that they were moving from the federal ACA exchange (HealthCare.Gov) onto their own state-based ACA exchange.

While numerous other states have already done the same thing (and several more are in the process of doing so as well), Georgia's move to their own enrollment platform was especially noteworthy for two reasons:

First, because it represents as complete 180-degree turn from their prior attempts (over the course of several years) to eliminate any formal ACA exchange (federal or state-based) in favor of outsourcing it to private insurance carriers & 3rd-party web brokers.

Secondly, because of the timeframe involved:

When we last checked in on the Braidwood v. Becerra federal lawsuit, there was a lot of confusion as to exactly which preventative services mandated by the Affordable Care Act to be covered at no out-of-pocket (OOP) charge to enrollees were supposed to be stricken and which weren't.

As a refresher, here's where the list of services comes from, via the Kaiser Family Foundation:

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

In February 2023, 93,373,794 individuals were enrolled in Medicaid and CHIP.

  • 86,174,094 individuals were enrolled in Medicaid in January 2023, an increase of 291,095 individuals from January 2023.
  • 7,199,700 individuals were enrolled in CHIP in February 2023, an increase of 111,838 individuals from January 2023.
  • Since February 2020, enrollment in Medicaid and CHIP has increased by 22,723,554 individuals (32.2%).
    • Medicaid enrollment has increased by 22,369,004 individuals (35.1%).
    • CHIP enrollment has increased by 354,550 individuals (5.2%).

The Medicaid enrollment increases are likely driven by COVID-19 and the continuous enrollment condition in the Families First Coronavirus Response Act (FFCRA).

One of the most important provisions of the Inflation Reduction Act, passed with only Democratic votes in the U.S. House last summer, was this one: After decades of prior attempts, it finally allows the Centers for Medicare & Medicaid Services (CMS) to actively negotiate the price of at least some prescription drugs. As explained by the Kaiser Family Foundation:

The Inflation Reduction Act of 2022 (the Act), signed into law by President Biden in August 2022, includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. One of the Act’s key drug-related policies is a requirement for the Secretary of Health and Human Services (HHS) to negotiate prices with drug companies for certain drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). This new requirement is the culmination of years of debate among lawmakers over whether to grant the federal government the authority to negotiate drug prices in Medicare.

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