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

  • In November 2023, 85,815,827 individuals were enrolled in Medicaid and CHIP, a decrease of 1,503,283 individuals (1.7%) from October 2023.
    • 78,710,401 individuals were enrolled in Medicaid in November 2023, a decrease of 1,523,107 individuals (1.9%) from October 2023.
    • 7,105,426 individuals were enrolled in CHIP in November 2023, an increase of 19,824 individuals (0.3%) from October 2023.
  • As of November 2023, enrollment in Medicaid and CHIP has decreased by 8,034,913 individuals (8.6%) since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 8,007,036 individuals (9.2%).
    • CHIP enrollment has decreased by 27,877 individuals (0.4%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,975,671 individuals (32.4%) to 93,850,740.
    • Medicaid enrollment increased by 22,637,644 individuals (35.3%).
      • CHIP enrollment increased by 338,027 individuals (5.0%).

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

Two weeks ago:

As I concluded in the last piece:

I strongly suspect that at least one of the remaining holdout states will join the expansion crowd this year, most likely Georgia, Mississippi or Alabama...but it likely will be some state-specific variant as described above. Stay tuned...

...As I noted, however, in all three [states] it's pretty likely they'll go with at least a partially privatized version as Arkansas has instead of a "clean" expansion of Medicaid proper.

Of course, as one Alabama-based advocate put it...

Mississippi better not beat us to expand.

— Jane Adams (@janeadamsid) February 16, 2024

Well, it looks like Ms. Adams may end up being disappointed...

via Connect for Health Colorado:

DENVER— Connect for Health Colorado, Colorado’s official health insurance marketplace, is requesting applications from new and returning organizations to operate Assistance Sites, Certified Application Counselor locationsEnrollment Centers, and Referral Partner locations across the state.

“Our partners provide a crucial one-on-one service to help Coloradans get covered,” said Connect for Health Colorado’s Chief Executive Officer, Kevin Patterson. “They help us make sure local communities, especially those who face barriers in getting health coverage, can access the plans and savings we offer. I encourage interested organizations and current partners to apply.”

Partnership Opportunities

via Access Health CT:

HARTFORD, Conn. (Feb. 20, 2024) — Access Health CT (AHCT) today announced it will host two free, in-person enrollment fairs in February and March to help HUSKY Health enrollees who have been affected by the Medicaid Unwinding process. The events will take place in New Britain and Stamford.

Medicaid Unwinding is the process of resuming the review of households for Medicaid eligibility after a three-year break during the Public Health Emergency. The eligibility redetermination process resumed April 1, 2023 and HUSKY Health clients will be notified when it is their turn to enroll. The process will end March 31. HUSKY Health is Connecticut’s Medicaid program.

Connecticut residents who remain eligible for HUSKY Health will likely be automatically reenrolled. Those who need to take action will receive mail with instructions.

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

February 23: CMS approved a postpartum coverage extension state plan amendment (SPA) for Alaska (link to come). This SPA approval will extend comprehensive coverage after pregnancy through Medicaid and the Children’s Health Insurance Program (CHIP) for a full 12 months. The approval of Alaska’s SPA marks critical progress in implementing the CMS Maternity Care Action Plan, which supports the Biden-Harris Administration’s Maternal Health Blueprint, a comprehensive strategy aimed at improving maternal health, particularly in underserved communities. Alaska is the 44th state, including D.C. and the U.S. Virgin Islands that have extended postpartum Medicaid coverage to a full year, made possible by President Biden’s American Rescue Plan (ARP), and made permanent by the Consolidated Appropriations Act, 2023 (CAA, 2023), which President Biden signed into law in December 2022.

Arizona

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

February 16: CMS approved coverage expansions in Arizona through an amendmentof two policies, “Parents as Paid Caregivers” (PPCG) and “KidsCare Expansion." Approval of the Parents as Paid Caregivers amendment will allow the state to continue to reimburse legally responsible parents for providing direct care to their minor children, helping to mitigate the direct care worker shortage and improve access to timely, effective care in the home and community.

Additionally, the KidsCare Expansion amendment will allow the state to increase the Children’s Health Insurance Program (CHIP) eligibility thresholds from 200% of the federal poverty level (FPL) to 225% of the FPL. Expanding KidsCare is expected to improve the rate of child health insurance coverage, increase access to affordable health care coverage, decrease costs by addressing health needs earlier, when care is less expensive, and provide financial relief for families. The demonstration will remain in effect until September 30, 2027.

Connecticut

Right on top of my last post regarding Maryland moving legislation to allow undocumented immigrants to enroll in ACA exchange policies (at full price) is this story out of Connecticut:

Advocates spoke before the Connecticut Appropriations Committee on Wednesday, pushing to include more immigrant children in the Husky Medicaid program.

The hearing before the budget committee witnessed a significant turnout, with 260 individuals offering testimonies supporting Husky expansion in the upcoming state budget. Advocates emphasized the need to close the coverage gap for immigrant and undocumented children aged 16 to 18.

...Segovia says it is difficult to come up with an estimated cost to cover the population between 15 and 18, but it could be approximately $4.5 million. While this may seem significant, she emphasized the long-term benefits of health care access to vulnerable communities, outweighing the minimal budgetary impact.

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, by default, 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):

(3) Access limited to lawful residents.--If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.

via the NJ Dept. of Banking & Insurance:

Governor Murphy and Acting Commissioner Zimmerman Announce Record-Breaking 397K People Signed Up for Health Insurance Through Get Covered New Jersey During Open Enrollment

  • Enrollment Up 61% 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 Acting Commissioner Justin Zimmerman today announced that more than 397,000 New Jerseyans signed up for health coverage through Get Covered New Jersey during the Affordable Care Act Open Enrollment Period, marking another year of historic enrollment in New Jersey.

The headline says 397K but it's actually just shy of 398K.

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