The Biden-Harris Administration today continued its historic investment in health care coverage and the Affordable Care Act (ACA) by awarding a new round of $100 million to organizations vital to helping underserved communities, consumers, and small businesses find and enroll in quality, affordable health coverage through HealthCare.gov, the Health Insurance Marketplace®.
The Centers for Medicare & Medicaid Services (CMS) is awarding the grants, in advance of this year’s Marketplace Open Enrollment (which begins November 1, 2024) to 44 Navigator grantees in states using HealthCare.gov. The grants are part of a commitment of up to $500 million over five years — the longest grant period and financial commitment to date, and a critical boost for recruiting trusted local organizations to better connect with those who often face barriers to obtaining health care coverage.
The Inflation Reduction Act is saving Americans millions in lower prescription drug costs and making health insurance more affordable.
Two years ago today, President Biden signed into law historic legislation to lower health care costs for millions of Americans. The Inflation Reduction Act, also known as the lower cost prescription drug law, created the first ever annual cap on out-of-pocket drug costs for people with Medicare, capped the cost of each covered insulin at $35 per month, granted Medicare the power to directly negotiate drug prices, and made Affordable Care Act (ACA) marketplace plans more affordable, leading to the lowest uninsured rate in history.
In a historic moment that will help lower prescription drug prices for millions of people across America, the Biden-Harris Administration announced that it has reached agreement for new, lower prices for all 10 drugs selected for negotiations. These negotiated drugs are some of the most expensive and most frequently dispensed drugs in the Medicare program and are used to treat conditions such as heart disease, diabetes, and cancer. The new prices will go into effect for people with Medicare Part D prescription drug coverage beginning January 1, 2026.
via Covered California: (this is actually from nearly a month ago; somehow I missed it at the time):
SACRAMENTO, Calif. — Covered California announced its health plans and rates for the 2025 coverage year with a preliminary weighted average rate increase of 7.9 percent.
The rate change can be attributed to many factors, including a continued rise in health care use, increases in pharmacy expenditures, the rising cost of care, labor shortages and other issues affecting the health care industry.
Because of the robust financial help available to Covered California enrollees, many will see a small impact, if any, to their monthly cost. Covered California, with the support of Gov. Newsom and the California Legislature, has worked to reduce the impact of increased consumer costs in 2025 by providing more support for its state-enhanced cost-sharing reduction (CSR) program, which will eliminate deductibles and lower the cost of care for over a million Californians.
The good news about New Hampshire's health insurance market is that they're the only state without its own ACA exchange which produces publicly-accessible monthly reports on individual on-exchange market enrollment. The bad news is that they don't seem to publish the actual rate filings in an easy-to-read format, which means I'm left with the federal rate review website, which sometimes posts average rate requests which don't match up with the actual filings...but it's gonna have to do here.
With these two data sources in hand, New Hampshire's individual market carriers are asking for a weighted average increase of 4.8%. It's important to note that Anthem Health Plans and Matthew Thornton Health Plan are listed as separate carriers on the federal Rate Review website (with separate average rate requests), but on the state's monthly report, they're merged into a single listing.
With no way of knowing what the actual enrollment breakout is between these two, I'm assuming a 50/50 split.
Alaska is a sparsely populated state with only two carriers on their individual market and four on their small group market. Alaska's insurance department website is useless when it comes to getting rate filings or enrollment data; I had to use the federal Rate Review site to even get the requested rate changes.
Fortunately, both carriers (Premera Blue Cross and Moda Health Plan) include summaries which list their current enrollment data. Unfortunately, the average rate increase being requested by the carriers for 2025 is up another 17%. While nearly all ACA exchange enrollees receive financial subsidies, this is still pretty steep for the few who aren't.
In April 2024, 81,696,742 individuals were enrolled in Medicaid and CHIP, a decrease of 1,060,543 individuals (1.3%) from March 2024.
74,640,222 individuals were enrolled in Medicaid in April 2024, a decrease of 1,011,238 individuals (1.3%) from March 2024.
7,056,520 individuals were enrolled in CHIP in April 2024, a decrease of 49,305 individuals (0.7%) from March 2024.
As of April 2024, enrollment in Medicaid and CHIP has decreased by 12,171,264 individuals (13.0%) 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 12,090,337 individuals (13.9%).
CHIP enrollment has decreased by 80,927 individuals (1.1%).
Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,023,434 individuals (32.5%) to 93,868,006.
Medicaid enrollment increased by 22,681,263 individuals (35.4%).
CHIP enrollment increased by 342,171 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.
Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.
The good news is that RateReview.HealthCare.Gov has posted the preliminary 2025 rate filing summaries for every state, making it much easier to pin down which carriers are actually participating in the individual & small group markets next year, as well as what the carriers average requested rate changes are in states which don't publish that data publicly (or which make it difficult to track down if they do).
The bad news is that in many of those states, acquiring the actual enrollment data is even more difficult, as their rate filings tend to be heavily redacted.
