Medicaid

Lost in all the fuss last week over the ACA's 13th anniversary, the corresponding enrollment report, and North Carolina's expansion of Medicaid to an additional 600,000 people was this announcement via the Centers for Medicare & Medicaid Services (CMS):

Biden-Harris Administration Announces the Expansion of Medicaid Postpartum Coverage in Oklahoma; 30 States and D.C. Now Offer a Full Year of Coverage After Pregnancy

Connecticut House Bill 6616 was introduced to the state House in February with a total of 13 cosponsors (all Democrats). Since then it's had a public hearing and has been reported favorably out of the legislative commissioners' office and to the House Appropriations Committee.

The bill seems to expand Medicaid and/or CHIP eligibility ("Husky A, B or D") to a significant number of undocumented children in the state, but it's rather densely worded, making it difficult for me to be certain just how far up the age range it applies. However, according to Louise Norris, it would extend it from the current 12-year old limit for undocumented children up to age 20 by January 2024 and age 25 by later that year, as long as their household income is still below the thresholds currently in place for those populations:

Section 17b-261 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2024):

Arizona

Arizona Senate Bill 1292 was introduced by Democratic state Representative Rosanna Gabaldon in February. Here's the most relevant portionf of the legislative text:

Title 20, chapter 1, article 1, Arizona Revised Statutes, is amended by adding a new section 20-123, to read:

20-123. Health care insurers; requirements; prohibitions; definitions

A. Notwithstanding any other law, every health care insurer that offers an individual health care plan, short-term limited duration insurance or a small employer group health care plan in this state:

1. Shall:

(a) Ensure that all products sold cover essential health care benefits.

(b) Limit cost sharing for the coverage of essential health care benefits, including deductibles, coinsurance and copayments.

A few weeks ago I raised an alarm about the federal budget introduced by former Trump Administration OMB Director Russell Vought's think tank, which is being embraced by many House Republicans as their blueprint for a formal budget proposal.

As I noted at the time, Vought's proposed budget would include, among many other horrific things, completely eliminating funding for the ACA's Medicaid expansion program as well as complete elimination of all Advance Premium Tax Credit (APTC) funding for ACA exchange-based individual market enrollees.

I went on to note that if this proposal were to somehow pass the Senate and be signed into law by President Biden (neither of which is likely to happen, to put it mildly), nearly 40 million Americans would lose healthcare coverage as a result nationally.

Below, I've broken that number out by state to give better context about just how draconian such an eventuality would be.

Last fall I noted that Oregon (along with Kentucky, although it looks like the latter got cold feet later on) may end up becoming the third state (after Minnesota and New York) to create a Basic Health Plan program which would provide comprehensive, inexpensive (or potentially free) healthcare coverage for residents who earn between 138% - 200% of the Federal Poverty Level (FPL)...basically, the next income tier above the cut-off for ACA Medicaid expansion. A few days ago, the state legislature passed a bill which would create a task force to put together their findings and recommendations no later than September 1st of this year.

UPDATE 3/15/23: The agreed-to Medicaid expansion deal has passed the NC State Senate! It now just needs to pass the state House one final time and then it's on to Gov. Cooper's desk to be signed into law!

UPDATE 3/22/23: The bill has now passed the state House by a stunning 94-22 margin as well! It still has to pass one more time tomorrow (a "concurrence" vote) and then it's on to Gov. Cooper's desk!

UPDATE 3/23/23: On the 13th Anniversary of the Affordable Care Act, the North Carolina House has officially taken the final vote needed for passage, with the bill easily passing 87 - 24. It's now onto Gov. Cooper, who has vowed to sign it into law ASAP.

UPDATE 3/8/23: HB 400 just overwhelmingly passed the New Mexico House!

HUGE NEWS! #HB400 just passed the House Floor by a vote of 58-10! Huge thanks to Rep. @reenaszcz & Speaker @JavierForNM for their work carrying #MedicaidForward through the House of Representatives & to everyone who reached out to their legislator. On to the Senate! #nmleg #nmpol 

— NM Together for Healthcare (@NMT4HC) March 8, 2023

CMS Logo

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

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.

Medicare

  • As of November 2022, 65,372,781 people are enrolled in Medicare. This is an increase of 136,217 since the last report.
  • 35,114,923 are enrolled in Original Medicare.
  • 30,257,858 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.

CMS Logo

via the Centers for Medicare & Medicaid Services:

Based on current COVID-19 trends, the Department of Health and Human Services is planning for the federal Public Health Emergency for COVID-19 (PHE), declared under Section 319 of the Public Health Service Act, to expire at the end of the day on May 11, 2023. Thanks to the Administration’s whole-of-government approach to combatting the virus, we are in a better place in our response than we were three years ago, and we can transition away from an emergency phase.

As I noted a few weeks back, the Patient Protection & Affordable Care Act now directly provides healthcare coverage for a stunning 40 million Americans:

...it's very likely that another 50,000 - 100,000 people will be added to the final QHP tally when the dust settles tomorrow (Tuesday, January 31st) evening. Even assuming the same 94% effectuation rate, that will still bring the effectuated QHP total to roughly 15.4 million.

Add to this the 1,217,517 confirmed Basic Health Plan (BHP) enrollees in New York and Minnesota and the subtotal comes to around 16.62 million QHPs + BHPs combined.

Next, we need to add Medicaid Expansion enrollees.

...the MBES reports only run through March 2022, at which point the national ACA expansion total stood at 22,275,433.

We're up to 38.9 million Americans with ACA coverage already, and we're still missing a lot of Medicaid expansion enrollees.

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