CMS Announces Data RFI to Improve Data Sharing and Enhance Competition
On December 7, the Biden-Harris Administration announced new actions to promote competition in health care, including increasing transparency in the Medicare Advantage (MA) insurance market and strengthening MA programmatic data. Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is continuing momentum in this area by releasing a Request for Information (RFI) to solicit feedback from the public on how best to enhance MA data capabilities and increase public transparency.
The Department, through CMS, will launch a new effort to support patients, hospitals, and providers to help ensure access to emergency health care
Today, the Department of Health and Human Services (HHS) announced that, together with the Centers for Medicare & Medicaid Services (CMS), it will launch a series of actions to educate the public about their rights to emergency medical care and to help support efforts of hospitals to meet their obligations under the Emergency Medical Treatment and Labor Act (EMTALA). As part of this comprehensive plan, the Department will:
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.
In September 2023, 88,414,773 individuals were enrolled in Medicaid and CHIP.
81,408,432 individuals were enrolled in Medicaid in September 2023, a decrease of 1,621,776 individuals (2.0%) from August 2023.
7,006,341 individuals were enrolled in CHIP in September 2023, an increase of 28,391 individuals (0.4%) from August 2023.
As of September 2023, enrollment in Medicaid and CHIP has decreased by 5,435,967 individuals 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 5,309,005 individuals (6.1%).
CHIP enrollment has decreased by 126,962 individuals (1.8%).
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%).
Biden-Harris Administration Releases New Medicaid and CHIP Renewal Data Showing the Role State Policy Choices Play in Keeping Kids Covered
Sec. Becerra Calls on Nine States with the Highest Child Disenrollments to Immediately Take Up Proven Federal Flexibilities to Protect Children and Families; Biden-Harris Administration Extends Federal Flexibilities to States Until End of 2024
Today, the U.S. Department of Health and Human Services (HHS) released new data on state Medicaid and Children’s Health Insurance Program (CHIP) enrollment changes among children and youth since full eligibility renewals for these programs restarted earlier this year. The data released today make it clear that state policy choices have real consequences for children and families during Medicaid and CHIP renewals. States that take up proven flexibilities and strategies from the Centers for Medicare & Medicaid Services (CMS) are better able to protect kids’ coverage – especially when the state has also expanded Medicaid.
U.S. health care spending grew 4.1% to reach $4.5 trillion in 2022, faster than the increase of 3.2% in 2021, but much slower than the rate of 10.6% in 2020. The growth in 2022 reflected strong growth in Medicaid and private health insurance spending that was somewhat offset by continued declines in supplemental funding by the federal government associated with the COVID-19 pandemic.
Assuming the U.S. population is ~335 million, that averages out to around $13,432 apiece.
In 2022, the insured share of the population reached 92% (a historic high).Private health insurance enrollment increased by 2.9 million individuals and Medicaid enrollment increased by 6.1 million individuals. In 2022, 26.6 million individuals were uninsured, down from 28.5 million in 2021 (a difference of 1.9 million individuals).
In August 2023, 89,994,594 individuals were enrolled in Medicaid and CHIP.
83,029,628 individuals were enrolled in Medicaid in August 2023, a decrease of 1,488,269 individuals (1.8%) from July 2023.
6,964,966 individuals were enrolled in CHIP in August 2023, a decrease of 30,312 individuals (0.4%) from July 2023.
As of August 2023, enrollment in Medicaid and CHIP has decreased by 3,862,970 individuals 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 3,699,342 individuals (4.3%).
CHIP enrollment has decreased by 163,628 individuals (2.3%).
Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,982,495 individuals (32.4%) to 93,857,564.
Medicaid enrollment increased by 22,649,177 individuals (35.3%).
CHIP enrollment increased by 333,318 individuals (4.9%)
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.
The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)
Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented for the following year (actually, it's the year after the following year, since the final rule is generally released in mid-December).
President Joe Biden is set to announce that his administration is expanding eligibility for Medicaid and the Affordable Care Act’s health insurance exchanges to hundreds of thousands of immigrants brought to the U.S. illegally as children, according to two U.S. officials briefed on the matter.
