Back in 2021 when I was posting weekly (and later, monthly) analysis of COVID vaccination rates at the county level, several counties in particular caught my eye for different reasons. One of these was Marin County, California. As I noted at the time:
Of counties with more than 100,000 residents, the top-vaxxed are Marin County, CA (76.9% vaxxed); Sumter County, FL (76.4%); and Montgomery County, MD (76.2% vaxxed).
New York's implementation of the ACA's Basic Health Plan provision (Section 1331 of the law) is called the Essential Plan. It currently serves over eleven times as many people as Minnesota's "MinnesotaCare" program does (around 1.1 million vs. 100K). Part of this is obviously due to New York having a larger population, but that's only part of it (NY has 19.84M residents, just 3.5x higher than MN's 5.71M).
Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.
There's been another development in the long, winding saga of the Kelley / Braidwood v. Becerra federal lawsuit, which seeks to strike down the Affordable Care Act's preventative services provisions requiring health insurance providers to cover a long list of preventative healthcare services at no out of pocket cost to enrollees.
For the full backstory behind this case (and why a plaintiff win against the government here would be far more devastating than "just" the specific provisions being struck down), read my prior post (with many updates) on the case.
The most recent development prior to today came on March 30th, 2023:
Judge Reed O'Connor STRIKES DOWN a major provision of the Affordable Care Act requiring insurers to cover a vast amount of preventive care cost-free (contraception, cancer screening, PrEP, a ton of pregnancy-related care). The ruling applies nationwide. https://t.co/wL26vkIPsd
NEW YORK – New York Attorney General Letitia James and Acting Department of Health (DOH) Commissioner Dr. James McDonald today warned New Yorkers about a new scam targeting New Yorkers enrolled in public health insurance programs and provided important tips to protect consumers. For the first time since March 2020, people enrolled in Medicaid, Child Health Plus and the Essential Plan will have to renew their health insurance coverage. Attorney General James and Acting Commissioner Dr. McDonald are urging New Yorkers to be vigilant in light of reports of scammers deceptively calling people and asking them to pay hundreds of dollars to maintain their health insurance.
“It is despicable that scammers are trying to exploit New Yorkers’ need for quality health insurance and uncertainty over ongoing Medicaid coverage,” said Attorney General James. “The best tool consumers and families have to combat scams is knowledge, and that is why I am committed to raising this issue. I urge everyone to follow our important tips, and anyone impacted by this scam to contact my office immediately.”
The Massachusetts Health Connector Board of Directors voted on Thursday, May 11, to ensure that health insurance plans used by five million Commonwealth residents to meet the state’s individual mandate continue to deliver high-value preventive services at no cost to consumers. This vote follows a March 2023 decision by a federal District Court in Texas to limit the scope of preventive services covered under the Affordable Care Act.
The proposed regulation amendments guarantee that Massachusetts residents with health insurance plans meeting state Minimum Creditable Coverage (MCC) standards will continue to receive key preventive services like cancer screenings, HIV prevention, and cholesterol-lowering medication without cost-sharing. These proposed regulation amendments protect coverage standards that are current practice in the Commonwealth.
FDA Finalizes Move to Recommend Individual Risk Assessment to Determine Eligibility for Blood Donations
Today, the U.S. Food and Drug Administration finalized recommendations for assessing blood donor eligibility using a set of individual risk-based questions to reduce the risk of transfusion-transmitted HIV. These questions will be the same for every donor, regardless of sexual orientation, sex or gender. Blood establishments may now implement these recommendations by revising their donor history questionnaires and procedures.
This updated policy is based on the best available scientific evidence and is in line with policies in place in countries like the United Kingdom and Canada. It will potentially expand the number of people eligible to donate blood, while also maintaining the appropriate safeguards to protect the safety of the blood supply.
An FDA advisory panel on Wednesday unanimously endorsed making daily birth control pills available over-the-counter for the first time, following two days of deliberations over whether patient misuse could lead to more unintended pregnancies.
Why it matters: If the FDA follows the recommendation and switches HRA Pharma's Opill away from prescription-only use, it could expand the availability of contraception and deepen partisan rifts over reproductive health in the post-Roe landscape.
HRA Pharma, part of consumer products giant Perrigo, expects a final decision from the FDA to come at some point this summer.
Driving the news: In a 17-0 vote, members of two FDA advisory committees decided that patients can properly follow Opill's labeling instructions — including taking the pill at around the same time every day — without consulting with a health provider.
New Opportunity To Enroll Through MNsure for Minnesotans With Unaffordable Job-Based Family Health Insurance
Special enrollment period open through October 31, 2023
ST. PAUL, Minn.—MNsure, Minnesota’s health insurance marketplace, is offering a special enrollment period (SEP) for Minnesotans who are currently enrolled in unaffordable family insurance through an employer with a renewal date other than January 1.
Under a new IRS rule, related household members who are covered by a family member’s employer-sponsored health insurance may be newly eligible to receive advanced premium tax credits through MNsure that lower the cost of private health plans. As a result, some eligible household members may be able to find a better deal on health insurance by shopping for a private plan through MNsure and saving on monthly premiums with a tax credit.
New Jersey Department of Banking and Insurance Establishes Extended Special Enrollment Period at Get Covered New Jersey for Individuals Losing NJ FamilyCare Coverage
TRENTON – New Jersey Department of Banking and Insurance Commissioner Marlene Caride today announced the creation of an extended Special Enrollment Period for individuals who are no longer eligible for NJ FamilyCare and qualify for health insurance through Get Covered New Jersey, the state’s Official Health Insurance Marketplace.
Per federal law, the Department of Human Services is restarting eligibility reviews for NJ FamilyCare as of April 1, which will result in some individuals who are no longer eligible being disenrolled from the program. For those who no longer qualify for NJ FamilyCare because their income is too high, they may be eligible to obtain health coverage through Get Covered New Jersey and may be able to get help paying for premiums.
