Charles Gaba's blog

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

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.

Medicare

  • As of November 2022, 65,372,781 people are enrolled in Medicare. This is an increase of 136,217 since the last report.
  • 35,114,923 are enrolled in Original Medicare.
  • 30,257,858 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.

CMS Logo

via the Centers for Medicare & Medicaid Services:

Based on current COVID-19 trends, the Department of Health and Human Services is planning for the federal Public Health Emergency for COVID-19 (PHE), declared under Section 319 of the Public Health Service Act, to expire at the end of the day on May 11, 2023. Thanks to the Administration’s whole-of-government approach to combatting the virus, we are in a better place in our response than we were three years ago, and we can transition away from an emergency phase.

Illinois

I'd never heard of Illinois state Senator Laura Fine before now. I know absolutely nothing else about her besides her being a Democrat who represents IL Senate District 9.

What I do know (thanks to a heads up from my friend & colleague Louise Norris) is that Sen. Fine recently introduced IL SB1912 into the legislative process:

As I noted a few weeks back, the Patient Protection & Affordable Care Act now directly provides healthcare coverage for a stunning 40 million Americans:

...it's very likely that another 50,000 - 100,000 people will be added to the final QHP tally when the dust settles tomorrow (Tuesday, January 31st) evening. Even assuming the same 94% effectuation rate, that will still bring the effectuated QHP total to roughly 15.4 million.

Add to this the 1,217,517 confirmed Basic Health Plan (BHP) enrollees in New York and Minnesota and the subtotal comes to around 16.62 million QHPs + BHPs combined.

Next, we need to add Medicaid Expansion enrollees.

...the MBES reports only run through March 2022, at which point the national ACA expansion total stood at 22,275,433.

We're up to 38.9 million Americans with ACA coverage already, and we're still missing a lot of Medicaid expansion enrollees.

Updated 8/17/23: D'oh! I completely forgot about this development when I started running my state-by-state rate filing analyses this summer. No wonder Humana has disappeared from over a dozen states for 2024!

Update 3/15/23: At the request of Humana's Sales Integrity Dept., I've removed their logo from this blog entry.

Before I start, let me say that I've never been a fan of Medicare Advantage, at least as its currently structured, for a number of reasons. I am not advocating for the Medicare Advantage system--again, as currently structured--to be expanded.

Get Covered NJ Logo

via the New Jersey Dept. of Banking & Insurance:

ICYMI: Governor Murphy and Commissioner Caride Announce Record-Breaking 341K People Signed Up for Health Insurance During Open Enrollment Period 

  • Nearly 40% Increase in Sign-Ups Since the Murphy Administration Assumed Operation of the Health Insurance Exchange 
  • Residents with a Qualifying Life Event or Who Meet Certain Income Levels Still Have Options to Get Covered 

TRENTON – Governor Phil Murphy and Department of Banking and Insurance Commissioner Marlene Caride today announced that more than 341,000 New Jerseyans signed up for health coverage through Get Covered New Jersey during the Affordable Care Act Open Enrollment Period – a record high in New Jersey. 

UPDATE 2/27/23: Looks like the bill has made it past the first hurdle:

#hb400 #medicaidforward passed in the House Health and Human Services Committee with a 7 to 3 vote! #nmleg #nmpol #hb400

— New Mexico RCRC (@nmrcrc) February 27, 2023

Ohio

Over on Twitter, political commentator Krystal Ball made an interesting claim:

A provision in Obamacare allows residents in areas deemed a public health disaster to be covered by Medicare for life. At the very least, East Palestine residents deserve this universal coverage after being exposed to a known carcinogen. https://t.co/ooPYmJ4Y8b

— Krystal Ball (@krystalball) February 21, 2023

What she's referring to is an obscure & fascinating nugget buried in the Patient Protection & Affordable Care Act: Section 10323, which states:

SEC. 10323. MEDICARE COVERAGE FOR INDIVIDUALS EXPOSED TO ENVIRONMENTAL HEALTH HAZARDS.

(a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is amended by inserting after section 1881 the following new section:

``SEC. 1881A. <<NOTE: 42 USC 1395rr-1.>> MEDICARE COVERAGE FOR INDIVIDUALS EXPOSED TO ENVIRONMENTAL HEALTH HAZARDS.

Michigan

Dear Governor Whitmer, House Speaker Tate, Senate Majority Leader Brinks, House Health Policy Committee Chair Rogers & Senate Health Policy Chair Hertel:

Five years ago, ahead of the 2018 midterm election, I wrote an open letter to all Michigan Democratic legislative candidates with a healthcare policy wish list. It included 26 ways to Protect, Repair & Strengthen the #ACA at the state level, several of which overlapped with the Democratic caucus's "Michigan Health Care Bill of Rights."

Unfortunately, while Democrats made large gains in Michigan in 2018, we didn't quite flip control of either the state House or Senate; it would take another four years to pull that off. Fortunately, that did happen last November, giving Democrats a trifecta in the House, Senate and Governor's office at the same time for the first time in decades, so it's time for me to compile an updated version of my Michigan healthcare policy wish list.

Disclosure: Health Sherpa is a paid sponsor of this site.

Holy Toledo. I've written about Health Sherpa's stunning ACA enrollment growth several times in the past, but this latest one is a true jaw-dropper:

HealthSherpa continues to be the largest private channel for ACA enrollments in the US, insuring over 5 million people for 2023 and growing more than 50% year over year

In its strongest season yet, HealthSherpa has enrolled more than 5 million people in Plan Year 2023 coverage and enrolled HALF of all new Affordable Care Act enrollees in Federally Facilitated Marketplace (FFM) states during Open Enrollment. HealthSherpa now accounts for 35% of all FFM enrollments and volume grew more than 50% year over year, far outpacing the FFM as a whole which grew only 13% (1).

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