Charles Gaba's blog

Yesterday I noted that the Maryland legislature, which has had an excellent record on healthcare reform policy in recent years, had a rare misstep when they took a pass on allowing undocumented immigrants to enroll in the states ACA exchange. While the lack of federal subsidy eligibility would have severely limited the number of undocumented Maryland residents who would be able to utilize this path towards healthcare, it was still a missed opportunity.

Today, however, I can report that the MD legislature has passed several other bills which move things in the right direction. Via Rob Flaks of WMDT:

With just days left in the General Assembly session, Maryland lawmakers have passed a series of bills aimed at expanding healthcare access and combating costs across the state.

Arizona

Via the Centers for Medicare & Medicaid Services:

Arizona became the latest state to extend postpartum coverage for individuals enrolled in Medicaid and the Children’s Health Insurance Program, following CMS’ approval of the state’s postpartum coverage extension state plan amendments (SPAs). The opportunity to extend this coverage was made possible by the American Rescue Plan, and this approval marks 31 states and D.C. that have extended postpartum Medicaid/CHIP coverage to a full year.

I have no idea why the administration hasn't put out a formal standalone press release about this...they've done so for every other state to my knowledge (including Oklahoma just two weeks ago), but whatever; it's still good news!

via NJ Gov. Murphy's website:

Feds Approve Innovative NJ FamilyCare Projects Addressing Housing, Behavioral & Physical Health, Providing Care & Other Creative Approaches

  • 1115 Demonstration Approval Continues Long-Standing Medicaid Programs and Allows New Innovations

TRENTON – The Centers for Medicare and Medicaid Services (CMS) has approved innovative NJ FamilyCare projects designed to address priorities such as housing, integrating behavioral and physical health services, and new and creative approaches to providing care.

CMS signed off on the projects by approving NJ FamilyCare’s Comprehensive 1115 Demonstration renewal. The 1115 demonstration provides the state with federal authority to operate large parts of the NJ FamilyCare program.  The approval is in effect from April 1, 2023 through June 30, 2028.

via the Washington Post:

...The proposal at issue would allow undocumented immigrants to buy health insurance through the state exchange, a policy change that state analysts predict would lead to coverage for about one-third of the state’s undocumented population, or 82,500 people. The move would add Maryland to a small number of states targeting the group in an effort to shore up gaps in health care access — a goal that has faced head winds in Congress.

Supporters say the proposal dovetails with Gov. Wes Moore’s goal of eliminating child poverty and would reduce overall premiums and care provided by hospitals free of charge to the uninsured. But instead of passing a bill that would open the insurance marketplace, which would require a federal waiver, lawmakers instead approved legislation that calls for the Maryland Health Department and the Maryland Health Benefit Exchange to study options for undocumented immigrants’ health care needs to guide their work moving forward.

via the California Dept. of Justice website:

Attorney General Bonta Announces $2.1 Million Settlement Against Companies Over Sham Health Insurance Plans

OAKLAND — California Attorney General Rob Bonta today announced a $2.1 million settlement against two companies, Shared Health Alliance, Inc. (SHA) and Alliance for Shared Health (ASH), to resolve allegations that they offered and deceptively advertised sham health insurance and violated insurance regulations that protect consumers. ASH, a nonprofit corporation that purported to be a healthcare sharing ministry (HCSM), created, operated, and sold unauthorized health insurance through its for-profit administrative vendor, SHA.

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

In December 2022, 92,340,585 individuals were enrolled in Medicaid and CHIP.

  • 85,280,085 individuals were enrolled in Medicaid in December 2022, an increase of 425,110
  • 7,060,500 individuals were enrolled in CHIP in December 2022, an increase of 87,296 individuals from November 2022.
  • Since February 2020, enrollment in Medicaid and CHIP has increased by 21,690,345 individuals (30.7%).
    • Medicaid enrollment has increased by 21,474,995 individuals (33.7%).
    • CHIP enrollment has increased by 215,350 individuals (3.1%).

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

In December 2022, 2,360,820 applications for Medicaid and CHIP were submitted directly to states.

via Connect for Health Colorado:

DENVER— In its tenth year of enrollment operations, Connect for Health Colorado, the state’s official health insurance marketplace, is providing more financial help for health insurance, offering more local enrollment assistance and enrolling more people into coverage than ever before.

In a report published today, Connect for Health Colorado provides a comprehensive look at the Open Enrollment Period data and outcomes. (Connect for Health Colorado released preliminary enrollment totals from the Open Enrollment Period at the end of January.) This new report includes information such as average costs and enrollments by county and the significance of Broker and Assister enrollment assistance. Here are the highlights:

Making Plans More Affordable

I was out of town for much of last week (my son's robotics team made it to the state championship) so I'm afraid I'm playing a bit of catch up today, so I kind of missed out on writing about this development which, while expected, is both depressing and enraging. Via the NY Times:

A federal judge in Texas issued a preliminary ruling invalidating the Food and Drug Administration’s 23-year-old approval of the abortion pill mifepristone, an unprecedented order that — if it stands through court challenges — could make it harder for patients to get abortions in states where abortion is legal, not just in those trying to restrict it.

The drug will continue to be available at least in the short-term since the judge, Matthew J. Kacsmaryk, stayed his own order for seven days to give the F.D.A. time to ask an appeals court to intervene.

Less than an hour after Judge Kacsmaryk’s ruling, a judge in Washington state issued a ruling in another case, which contradicted the Texas decision, ordering the F.D.A. to make no changes to the availability of mifepristone in the 18 states that filed that lawsuit.

via the Maryland Insurance Administration:

Consumer Advisory: Maryland-issued health insurance policies are not impacted by Braidwood Management, Inc. v. Becerra; preventative services, including PrEP, are still required to be covered

​​​BALTIMORE – Health insurance policies (including HMO plans) issued in Maryland are not impacted by a recent ruling by a federal judge in Texas that health plans do not have to cover certain preventive services.

 

October 2022:

Texas: Friday Health Plans Bails; Another ~230K Enrollees Will Have To Pick A Different Day Of The Week

It was just four days ago that Bright Healthcare, which had been aggressively expanding their individual market coverage area footprint as recently as a year ago, suddenly announced that they were doing a complete 180 and instead pulling out of virtually the entire individual & small group markets nationally starting in January 2023.

...Well, just one day after the Bright Healthcare bombshell news broke, Texas-based health insurance broker Jenny Chumbley Hogue sounded the alarm on another large carrier bailing on Texas next year:

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