Charles Gaba's blog

Mazel Tov to Audrey Morse Gasteier, who I know via online discussions & have met a couple of times in person at the annual Families USA conference. I'm sure she'll continue to do a great job:

BOSTON — Audrey Morse Gasteier, who has served as a policy leader at the Massachusetts Health Connector for more than a decade, was named executive director of the state-based Marketplace today by Secretary of Health and Human Services and Health Connector Board Chair Kate Walsh.

Morse Gasteier had been serving as acting executive director since January. 

 “Since its establishment in 2006, the Health Connector has been where Massachusetts residents can find affordable health care,” said Secretary Walsh. “Audrey has been a key part of that important work for many years, and I look forward to working with her as we continue to make health care coverage accessible to everyone in Massachusetts.”

I first wrote about this back in May 2022, but had lost track of the waivers' status since then. As I wrote at the time:

One of the most inane restrictions of the ACA in my view, as I noted in my "If I Ran the Zoo" wish list back in 2017, is that it doesn't allow undocumented immigrants to enroll in ACA marketplace health plans ("Qualified Health Plans" or QHPs).

I don't just mean that they aren't eligible for federal financial subsidies--that's a prohibition which I can at least understand, even if I don't agree with it. I mean that they aren't allowed to enroll in ACA exchange-based QHPs even at full price, as noted in Section 1312(f)(3):

As I noted last month, as we've reached the 3rd anniversary of the COVID-19 pandemic hitting U.S. shores and with the Public Health Emergency winding down, it's become more & more difficult for data analysts and researchers to acquire comprehensive, county-level data about cases, hospitalizations, deaths, vaccinations and so forth.

In particular, at least three major sources of this data have either announced that they're shutting down their data tracking projects or have already done so, including Johns Hopkins University, the White House COVID-19 Community Profile Report and the New York Times.

With two of these already discontinued and the third set to do so within the next few weeks, this story is somehow even more depressing to me (via Robert King at Fierce Healthcare; h/t Katherine Hempstead for the heads up):

St. Elsewhere

Earlier today I received a first: A "cease & desist"-type email from Humana Inc's "Sales Integrity Department" asking me to remove their logo from a blog post about the company:

Dear Website Owner:

Humana encourages agents and agencies (collectively, “Agents”) to promote the Humana Brand in a manner that complies with applicable laws and Humana’s own policies and procedures.

Internet-based capabilities are providing new and interactive ways to sell Humana products and services. Although these capabilities offer tremendous opportunities, they also create responsibilities for Humana and its Agents to maintain a system of controls and monitoring.

The Sales Integrity Department at Humana has done a review of websites containing the Humana logo and we have detected your use of the logo...

Arizona

Arizona Senate Bill 1292 was introduced by Democratic state Representative Rosanna Gabaldon in February. Here's the most relevant portionf of the legislative text:

Title 20, chapter 1, article 1, Arizona Revised Statutes, is amended by adding a new section 20-123, to read:

20-123. Health care insurers; requirements; prohibitions; definitions

A. Notwithstanding any other law, every health care insurer that offers an individual health care plan, short-term limited duration insurance or a small employer group health care plan in this state:

1. Shall:

(a) Ensure that all products sold cover essential health care benefits.

(b) Limit cost sharing for the coverage of essential health care benefits, including deductibles, coinsurance and copayments.

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

Inflation Reduction Act Tamps Down on Prescription Drug Price Increases Above Inflation

  • New Medicare Prescription Drug Inflation Rebate Program protects people with Medicare and taxpayers when drug companies increase prices faster than the rate of inflation
  • HHS announces savings for some people with Medicare on 27 Part B prescription drugs 

The Biden-Harris Administration has made lowering prescription drug costs in America a key priority — and President Biden is delivering results. Today, the Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), announced 27 prescription drugs for which Part B beneficiary coinsurances may be lower from April 1 – June 30, 2023. Thanks to President Biden’s new law to lower prescription drug costs, some people with Medicare who take these drugs may save between $2 and $390 per average dose starting April 1, depending on their individual coverage. Through the Inflation Reduction Act, President Biden and his Administration are lowering prescription drug costs for American seniors and families. 

Sometimes the simplest bills can have huge positive impacts. California Assembly Bill 503 was introduced by Democratic Assemblymember Juan Carrillo in February.

AB 503, as introduced, Juan Carrillo. Health care: organ donation enrollment. Existing law, the Uniform Anatomical Gift Act, authorizes the creation of a not-for-profit entity to be designated as the California Organ and Tissue Donor Registrar and requires that entity to establish and maintain the Donate Life California Organ and Tissue Donor Registry for persons who have identified themselves as organ and tissue donors upon their death. Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.

Existing law requires the department, in consultation with the board governing the California Health Benefit Exchange, to develop a single paper, electronic, and telephone application for insurance affordability programs, including Medi-Cal.

A few weeks ago I raised an alarm about the federal budget introduced by former Trump Administration OMB Director Russell Vought's think tank, which is being embraced by many House Republicans as their blueprint for a formal budget proposal.

As I noted at the time, Vought's proposed budget would include, among many other horrific things, completely eliminating funding for the ACA's Medicaid expansion program as well as complete elimination of all Advance Premium Tax Credit (APTC) funding for ACA exchange-based individual market enrollees.

I went on to note that if this proposal were to somehow pass the Senate and be signed into law by President Biden (neither of which is likely to happen, to put it mildly), nearly 40 million Americans would lose healthcare coverage as a result nationally.

Below, I've broken that number out by state to give better context about just how draconian such an eventuality would be.

via Covered California:

La versión en español de este Comunicado puede ser descargada en este enlace.

SACRAMENTO, Calif. — Covered California announced that 263,320 people had newly selected a health plan for 2023, continuing a trend of steady growth in recent years. The total is more than 14,000 higher than 2021’s total, and 8,000 higher than last year’s figure. In addition, more than 1.4 million Californians renewed their health insurance for 2023, bringing Covered California’s overall enrollment to 1.74 million.

“Covered California is woven into the fabric of our health care system, providing quality coverage in every corner of the state and protecting more than 1.7 million Californians,” said Jessica Altman, executive director of Covered California. “The strength in these numbers is driven by the Inflation Reduction Act, which provides increased and expanded financial help, bringing the cost of coverage within reach for millions of Californians who need health insurance.”

Obviously much of this is unlikely to actually go anywhere given House Republicans plans to almost completely defund the ACA and completely gut Medicaid overall, but as President Biden always says, "Don’t tell me what you value. Show me your budget—and I’ll tell you what you value.”

So, you know...there's that. Via the HHS Dept:

HHS Releases President’s Fiscal Year 2024 Proposed Budget 

Investments address urgent needs to extend Medicare solvency, lower drug costs, bolster public health preparedness, improve the well-being of children and seniors, expand access to health care, increase the health care workforce, and advance research underlying medicine, public health, and social services

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