CMS approves Arizona’s plan to re-open CHIP program
Today, the Centers for Medicare & Medicaid Services (CMS) announced that it has approved Arizona’s plan to allow new enrollment in the Children’s Health Insurance Program (CHIP) after enrollment was frozen for several years. Now all states provide CHIP coverage to eligible children.
“Today’s approval is a step forward for the health of Arizona children in low-income families,” said Vikki Wachino, CMS Deputy Administrator and Director of the Center for Medicaid and CHIP Services. “With Arizona’s decision, all states in the nation now provide CHIP coverage to any eligible child who applies. More children in Arizona will have access to coverage early in their lives, which helps kids grow into healthy adults and provides parents with the peace of mind that comes from their children having affordable coverage.”
Having coverage through CHIP improves children’s health and increases their ability to succeed in school. Recent research on Medicaid and CHIP shows that these gains are long lasting, with children who gained coverage experiencing better health, higher educational attainment, and higher earnings as adults.
Republican lawmakers maneuver to force a vote on KidsCare, reviving a debate over the role of government in people's lives vs. personal responsibility
Chastened and angry over their failure to reinstate KidsCare, Republican lawmakers in the Arizona House got Democrats to join them Thursday in a successful bid to revive the children’s health-insurance program.
"Get him out of my sight, Lou! I want him in town, though. He's still under contract. I want you in town, Fink...and out of my sight." --Barton Fink
The big ACA story Thursday morning was about UnitedHealthcare announcing that while they're still available across half the country for 2016, they may drop out of the ACA exchanges next year (2017). Furthermore, they're cutting their marketing/promotional efforts for the exchanges and, in an additional exclusive tidbit from myself, they've also informed their commission-based brokerage network that they'll be slashing their commission rates by as high as 80% for exchange-based enrollments. On top of that, they've even supposedly deliberately disabled various database tools used specifically by brokers to assist in helping people sign up for UHC policies through the exchanges.
Two Arizona health insurance companies have been placed under supervision by the Arizona Director of Insurance, Andy Tobin. Director Tobin filed an Order for Supervision on October 30, 2015, to place Meritus Health Partners and Meritus Mutual Health Partners into supervision. Meritus declined to consent to the Order for Supervision. The Meritus companies’ ability to write new policies or renew existing policies is suspended. The Centers for Medicare and Medicaid Services has removed the Meritus plans from the Marketplace. Director Tobin, appointed as Supervisor under Arizona law, will oversee the two companies.
IMPORTANT:See this detailed explanation of how I've come up with the following estimated maximum requested weighted average rate increases for this state.
As explained in the first link above, I've still been able to piece together rough estimates of the maximum possible and most likely requested average rate increase for the state's individual market:
As noted in the table, the Arizona analysis is even more fuzzy than most other states, because the enrollment/market share estimate for Health Net is a guess. According to their Q2 2015 SEC filing (page 49), Health Net had 69,000 people enrolled in individual policies in Arizona as of 6/30/15. They don't break out grandfathered/transitional policies (I'm assuming about 14% combined), nor do they provide a PPO/HMO split, so I'm just going with 50/50, or 60K total ACA-compliant enrollees.
Florida Gov. Rick Scott announced Thursday that his administration will file a lawsuit against the federal government for threatening to withhold more than $1 billion in funding for hospitals if the state fails to expand Medicaid.
“It is appalling that President Obama would cut off federal health care dollars to Florida in an effort to force our state further into Obamacare,” Scott said, citing a 2012 Supreme Court ruling that said the federal government couldn’t put a “gun to the head” of states to force them to expand Medicaid under the health care law.
The Obama administration quickly accused Scott of misconstruing that court decision because the state is not being forced to do anything. And White House spokesman Josh Earnest blasted the governor for putting politics above people.
Arizona may not be adding Medicaid expansion recipients at nearly the same rate as states like Michigan, West Virginia and Arkansas, but they're doing a pretty good job; AZ is now up to over 192K people, or about 41% of the estimated 469K uninsured individuals who are eligible for Medicaid:
During the month of June, 19,736 were added to AHCCCS in the Proposition 204 Restoration Category (0-100% FPL) and 4,771 were added to Adult Expansion category. To date, 192,268 Arizonans have been added since January. The total AHCCCS population now stands at 1,552,186.
The QHP number (80K) looks about right, but that 67K Medicaid number bears no connection whatsoever to the existing number (91,115). On the other hand, AZ has some sort of unusual situation going on with their Medicaid program anyway, so I'll leave that one alone for now.
As of March 1, the enrollments were behind projections, with just about 58,000 enrolled. But Plese said she’s seen unofficial figure that show the number rose to about 80,000 by mid-March.
Another 67,000 who used the federal site had been determined to be eligible for Medicaid.
I received the following yesterday, and was given the OK to post it publicly. Given my prior screeds about both a) off-exchange enrollments and b) insurance company billing systems being overwhelmed/backlogged, this is a perfect example of why both of these issues are so important to include when discussing the QHP numbers.
Obviously anecdotal stories can't be used as hard data, but I've read dozens of similar stories. Some refer to going off-exchange; some refer to billing problems with the companies; some, like this one, refer to both. Presented without further comment (emphasis mine):
I'm an independent contractor/consultant in Arizona. I have several friends in the same boat. We all had Arizona state-sponsored (but not supported) small business insurance that had no underwriting.
We were all basically locked out of the ACA website from early on and never got back on. BUT WE ALL BOUGHT insurance with BCBS directly, with ACA policies (none of us could have gotten through underwriting) because we all make too much for a subsidy. NONE of us, and the people like us, are being counted. But I'm sure BCBS is keeping track of these direct purchases, which have to be counted toward the total.
When I first read this article submitted by contributor Maurice H., I was pretty concerned, as it made it sound like Arizona's exchange QHP total was only around perhaps 60,100 as of March 18 (the artilce was posted on the 19th):
Final numbers for Arizona enrollment will not be available for a few weeks, but more than 80,000 Arizonans have enrolled in Medicaid and more than 60,000 have enrolled in private health care plans through the site, said Herb K. Schultz, regional director of the Health and Human Services Department.
This concerned me because Arizona already had 57,611 QHPs as of March 1st...and had 43,495 on February 1st. That means that AZ's February average was 504/day.
If the 3/18 number was only around 60,100, that would mean they were only at 2,489 for March, or only 146/day…a 71% plummet from February.