Under the Inflation Reduction Act, some people with Medicare will pay less for some Part B drugs because the drug’s price increased faster than the rate of inflation.
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today announced that some Medicare enrollees will pay less for 64 drugs available through Medicare Part B. The drugs will have a lowered Part B coinsurance rate from January 1, 2025 – March 31, 2025, since drug companies raised prices for each of these 64 drugs faster than the rate of inflation. Over 853,000 people with Medicare use these drugs annually to treat conditions such as cancer, osteoporosis, and substance use disorder. Since April 1, 2023, people with Medicare have seen savings on over 120 drugs thanks to Inflation Reduction Act’s Medicare Prescription Drug Inflation Rebate Program.
Biden-Harris Administration Announces Medicare Advantage and Medicare Part D Prescription Drug Proposals that Aim to Improve Care and Access for Enrollees
Today, the Centers for Medicare & Medicaid Services (CMS) is proposing actions in the Medicare Advantage (MA) and Medicare Part D prescription drug programs to continue to strengthen protections and access to care for people with Medicare. The Contract Year (CY) 2026 MA and Part D proposed rule aims to hold MA and Part D plans more accountable for delivering high-quality coverage so that people with Medicare are connected to the care they need when they need it.
Yep, my wife & I screwed up royally. Yes, I know: I'm "The ACA Guy" and yes, it's incredibly embarrassing to tell this story, but I'm doing so in the hopes of helping others avoid making the same mistake.
It's been several years since we enrolled in an ACA policy ourselves via HealthCare.Gov, since we were enrolled in my wife's student plan up until recently (she returned to college to get her master's degree). The last few times we were able to enroll or renew our policies without any issues, so we assumed it wouldn't be an issue this time.
However, there seem to have been a few changes to some of the questions during the application process, and one of them threw us for a loop.
In the household income section of the application process, Healthcare.Gov asks both how much you expect to earn this month specifically (November 2024) as well as how much you expect to earn for all of 2025.
It was the first of these questions which is what caused the problem for us.
You see, both my wife and I are self-employed, which means we have highly variable incomes--we may earn $10,000 one month but not earn anything the next.
In July 2024, 79,560,396 individuals were enrolled in Medicaid and CHIP, a decrease of 403,074 individuals (0.5%) from June 2024.
72,429,055 individuals were enrolled in Medicaid in July 2024, a decrease of 441,475 individuals (0.6%) from June 2024.
7,131,341 individuals were enrolled in CHIP in July 2024, an increase of 38,401 individuals (0.5%) from June 2024.
As of July 2024, enrollment in Medicaid and CHIP has decreased by 14,455,287 individuals (15.4%) 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 14,440,102 individuals (16.6%).
CHIP enrollment has decreased by 15,185 individuals (0.2%).
Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 23,109,188 individuals (32.6%) to 94,015,683.
Medicaid enrollment increased by 22,819,861 individuals (35.6%).
CHIP enrollment increased by 289,327 individuals (4.2%).
In June 2024, 79,963,470 individuals were enrolled in Medicaid and CHIP, a decrease of 851,310 individuals (1.1%) from May 2024.
72,870,530 individuals were enrolled in Medicaid in June 2024, a decrease of 838,377 individuals (1.1%) from May 2024.
7,092,940 individuals were enrolled in CHIP in June 2024, a decrease of 12,933 individuals (0.2%) from May 2024.
As of June 2024, enrollment in Medicaid and CHIP has decreased by 13,943,010 individuals (14.8%) 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 13,860,029 individuals (16.0%).
CHIP enrollment has decreased by 82,981 individuals (1.2%).
Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,999,985 individuals (32.4%) to 93,906,480.
Medicaid enrollment increased by 22,681,263 individuals (35.4%).
CHIP enrollment increased by 318,722 individuals (4.6%).
Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved section 1115 demonstration amendments that allow, for the first time ever, Medicaid and Children’s Health Insurance Program (CHIP) coverage of traditional health care practices provided by Indian Health Service (IHS) facilities, Tribal facilities, and urban Indian organizations (UIO). Today’s action is expected to improve access to culturally appropriate health care and improve the quality of care and health outcomes for tribal communities in Arizona, California, New Mexico, and Oregon, and will support IHS, Tribal, and UIO facilities in serving their patients.
Mississippi is one of the 10 states which still hasn't expanded Medicaid to all residents earning up to 138% of the Federal Poverty Level (FPL) under the Affordable Care Act. If they did so, up to 123,000 uninsured residents would gain healthcare coverage, while up to another 180,000 who are currently enrolled in zero-premium ACA exchange plans would be transferred over to Medicaid instead.
However, it turns out that the Magnolia State does at least have a much smaller Medicaid expansion program called "Healthier Mississippi:"
In May 2024, 80,855,947 individuals were enrolled in Medicaid and CHIP, a decrease of 840,795 individuals (1.0%) from April 2024.
73,793,274 individuals were enrolled in Medicaid in May 2024, a decrease of 846,948 individuals (1.1%) from April 2024.
7,062,673 individuals were enrolled in CHIP in May 2024, an increase of 6,153 individuals (0.1%) from April 2024.
As of May 2024, enrollment in Medicaid and CHIP has decreased by 13,012,059 individuals (13.9%) 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 12,937,285 individuals (14.9%).
CHIP enrollment has decreased by 74,774 individuals (1.0%).
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.
