Charles Gaba's blog

Georgia

A couple of weeks ago I wrote about how the Georgia state government, which for years has been among the more ACA-hostile GOP states, and which has spent the past several years actively attempting to get out of having any official ACA exchange platform whatsoever, has seemingly done a complete 180 and now supposedly wants to go the other way:

Georgia GOP leaders have proposed a bill that they hope will lead to a state takeover of the health insurance exchange marketplace for Affordable Care Act plans.

...Traditionally a majority of Georgians shop for ACA plans on the federally run marketplace website, healthcare.gov. Eighteen states use their own marketplace website, according to the Kaiser Family Foundation. The key feature of these sites is they allow shoppers to objectively compare their options for price and coverage.

It’s unclear exactly what the state’s replacement would be.

As I noted at the time...

One of the big public health stories last week was that Johns Hopkins University, which has been operating one of the best COVID-19 tracking projects in the country since the pandemic hit U.S. shores, has announced that they're shutting it down next month:

When the pandemic hit, the federal government struggled to publish snapshots of the virus’ spread.

So, academics and journalists quickly filled the void, creating new tools with near real-time estimates of the unfolding pandemic.

(as an aside, that sounds awfully familiar to me...)

Since January 2020, Johns Hopkins University has operated one of the most prominent resources for tracking covid-19 case counts and deaths across the world.

Connect for Health Colorado Logo

via Connect for Health Colorado:

Tax Season is a Health Coverage Enrollment Opportunity 

DENVER— The annual Open Enrollment Period for health insurance ended mid-January, but Coloradans who missed the enrollment deadline could still have a special opportunity to sign up for health coverage as a result of the Tax Time Enrollment Program. 

The Tax Time Enrollment Program, which launched last year, provides Coloradans the opportunity to check a box on their state tax return to share their information with Connect for Health Colorado and the state Department of Health Care Policy & Financing for the purpose of obtaining health coverage. Through October 2022, approximately 1,700 people used the Tax Time Enrollment Program to enroll in a health insurance plan through Connect for Health Colorado.  

BeWellNM Logo

New Mexico's state-based ACA exchange, BeWell NM, has posted a powerpoint from a special Board of Director's meeting that they had last week.

For the most part it's unremarkable and full of inside baseball wonkery:

  • They're replacing WebEx with Zoom for video meetings
  • They're gonna split their Comms & Outreach into two separate divisions
  • They're preparing for the upcoming Medicaid Unwinding project

There's two items which are more noteworthy, however.

First, New Mexico is one of only three state-based marketplace (SBM) which handle premium bill payments as well as enrollment functions. The other two are Rhode Island and Massachusetts. Washington State's HealthPlanFinder tried dealing with payments within the exchange itself as well for a few years but eventually gave up on it due to it causing too many technical & administrative headaches.

North Carolina

While ACA Medicaid expansion just died for a 9th time in Wyoming, it may finally be on the verge of actually happening in a much larger state. Via Gary Robertson of the Associated Press:

RALEIGH, N.C. (AP) — The North Carolina General Assembly began on Tuesday what could become the final push to expand Medicaid to hundreds of thousands of low-income adults in the state with a House measure that quickly advanced through two committees with bipartisan support.

The bill is generally expected to pass the NC House as soon as today...and a different version of the bill is expected to pass the state Senate as well. The issue is the difference between the two versions:

Wyoming

Back in December, the state with the smallest population in the country, Wyoming, looked like it might finally carry the ACA Medicaid expansion football into the end zone:

‘Let’s just get this done’: Wyoming Legislature to consider Medicaid expansion again in 2023

Medicaid expansion will be up for debate once again when the Wyoming Legislature convenes for its 67th session in January.

The legislature’s Joint Revenue Committee voted to advance the Medical Treatment Opportunity Act to the legislative session during a meeting this month.

It’s the same bill the legislature considered during the 2022 session, state staffers said.

The proposed legislation would allow Medicaid expansion to occur in Wyoming as long as the federal contribution to the program remains at 90 percent or higher.

Over at Vox, Dylan Scott has an excellent overview of the pending Medicaid Unwinding debacle about to unfold across the country:

Perhaps the greatest success of the American health care system these last few benighted years is this surprising fact: The uninsured rate has reached a historic low of about 8 percent.

...One [COVID era] policy was likely the single largest factor. Over the past three years, under an emergency pandemic measure, states have stopped double-checking if people who are enrolled in Medicaid are still eligible for its coverage. If you were enrolled in Medicaid in March 2020, or if you became eligible at any point during the pandemic, you have remained eligible the entire time no matter what, even if your income later went up.

But in April, that will end — states will be re-checking every Medicaid enrollee’s eligibility, an enormous administrative undertaking that will put health insurance coverage for millions of Americans at risk.

The Biden administration estimates upward of 15 million people — one-sixth of the roughly 90 million Americans currently receiving Medicaid benefits — could lose coverage, a finding that independent analysts pretty much agree with. Those are coverage losses tantamount to a major economic downturn: By comparison, from 2007 to 2009, amid the worst economic downturn of most Americans’ lifetimes, an estimated 9 million Americans lost their insurance.

Minnesota

There's been a LOT of buzz among healthcare wonks over the past week about major developments happening with the ACA's Basic Health Plan (BHP) programs in both Minnesota and New York State. This article is about Minnesota; I'll post about what's happening in New York separately.

As Louise Norris explains:

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.

The out-of-pocket differences between Medicaid and QHPs are significant, even for people with incomes just above the Medicaid eligibility threshold who qualify for cost-sharing subsidies.

NOTE: With the news that the Johns Hopkins University COVID Tracking project is shutting down on March 10th, this may be the second to last update to this project, although there are other outlets tracking county-level COVID deaths which will likely continue to do so.

As of this writing, 69.2% of the total U.S. population has completed their primary COVID-19 vaccination series (including 94.2% of those 65+), but a mere 15.8% of the total population has also gotten their updated bivalent booster shotEven among seniors it's only at 40.8% nationally.

BeWellNM Logo

via beWell NM, New Mexico's ACA exchange:

A classic tax-season scam is back with a new twist. Clients in New Mexico have reported receiving calls from scammers posing as beWellnm representatives, trying to obtain private and secure information.

BeWellnm, New Mexico’s health insurance exchange, will never call and ask a customer to text or email your bank information, credit card or social security number.

“Customers who received insurance through the exchange will need a 1095-A form – Health Insurance Marketplace Statement – for their taxes. Scammers know this and think they can take advantage, but we are here to protect consumers and offer them free help with their 1095-A form,” said Bruce Gilbert, Chief Executive Officer of beWellnm.

BeWellnm will be providing customers who obtained insurance through the exchange at any point last year with their 1095-A form. You should expect to see if in the mail in the coming weeks. This form is very important and will be filed with your federal taxes to complete Form 8962: Premium Tax Credit.

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