Medicaid

One of the most popular provisions of the Affordable Care Act's Three-Legged Stool's "Blue Leg" is the prohibition of caps on annual or lifetime benefits. When you consider that a baby born prematurely or a cancer patient undergoing chemotherapy can eat up several million dollars worth of care within a few months, this makes perfect sense. Even a moderately wealthy family can be brought down by high medical costs, and a middle class family can be financially wiped out. If you're lower income, don't even get me started.

Naturally, the Trump Administration's response to everything above is "Hmmmmm...screw all that:"

After approving Medicaid work requirements, Trump’s HHS aims for lifetime coverage limits

After allowing states to impose work requirements for Medicaid enrollees, the Trump administration is now pondering lifetime limits on adults’ access to coverage.

Press Release: Governor Cuomo Ensures Medicaid Coverage for DACA Recipients Regardless of Federal Action
If Congress Does Not Act to Protect DACA, New York DACA Recipients will Remain Eligible for State-Funded Medicaid

Governor Andrew M. Cuomo today announced that recipients of the Deferred Action for Childhood Arrivals policy will remain eligible for state-funded Medicaid, regardless of any federal changes to or termination of the program. There are approximately 42,000* DACA recipients in New York, many of whom are at risk of losing their employment-based health insurance if the federal government changes or terminates the program. Under New York law, DACA recipients are considered PRUCOL (Permanently Residing Under Color of Law) and eligible for state-funded Medicaid or CHIP.

Note: This is slightly lower than my own spitball estimate of around 50,000 DACA recipients.

OK, first of all, here's the actual press release from CMS about it:

CMS announces new policy guidance for states to test community engagement for able-bodied adults
Will support states helping Medicaid beneficiaries improve well-being and achieve self-sufficiency

CMS today announced new guidance that will support state efforts to improve Medicaid enrollee health outcomes by incentivizing community engagement among able-bodied, working-age Medicaid beneficiaries. The policy responds to numerous state requests to test programs through Medicaid demonstration projects under which work or participation in other community engagement activities – including skills training, education, job search, volunteering or caregiving – would be a condition for Medicaid eligibility for able-bodied, working-age adults. This would exclude individuals eligible for Medicaid due to a disability, elderly beneficiaries, children, and pregnant women.

In other words, work requirements for Medicaid expansion enrollees are now officially on the table.

I used to track the monthly Medicaid/CHIP enrollment reports issued by CMS, watching as the numbers rose dramatically thanks to ACA Medicaid expansion.

I pretty much stopped doing that about a year ago, however, since the expansion numbers have mostly petered out. ACA Medicaid expansion actually has continued to climb a bit more since January, and is likely somewhere around 16 million people as of now, but it's also been partly cancelled out by a slight drop in standard Medicaid enrollment as the economy has continued to improve in general. In short, there's little reason to keep writing the same update every month.

 

I used to write about Kentucky quite a bit shortly after incoming GOP Governor Matt Bevin made good on his promise to disassemble their beloved and award-winning "kynect" state ACA exchange. I haven't written much about the state since then, however, until now.

Bevin made two major campaign promises while running to replace former Democratic Governor Steve Beshear (who expanded Medicaid and established kynect via executive order): He said he'd kill kynect and get rid of ACA Medicaid expansion. He stuck to his guns on the former, and while it's a damned shame that he did so for a number of reasons (it was working perfectly well, had a high public image and awareness, etc), it didn't cause too much damage, since KY simply shifted to the federal exchange instead (HealthCare.Gov). Enrollment did drop off by over 13% year over year, but a few other states saw similar drops, so the move probably wasn't a major factor.

Every month I post an entry about the official CMS Medicaid enrollment report, documenting the increase in Medicaid enrollment since ACA expansion went into effect. The numbers were increasing dramatically every month for nearly two years, but started slowing down last fall as most of the expansion states started maxing out on their eligible enrollees.

As of August 2016, total Medicaid enrollment continued to quietly increase for a total of 73.1 million people, with 15.7 million of that being mainly due to the ACA (~11 million via official expansion, ~1 million early additions/transfers and ~4 million "woodworkers").

HOORAY! FACE-EATING LEOPARDS FOR EVERYONE!!

I don't write a whole lot about Medicare, since just about all U.S. citizens over 65 are covered by it and therefore don't enroll via the ACA exchanges anyway. However, it does come up on this site from time to time, and a good 55 million or so are enrolled in the program, so this little story might be of some relevance:

Every month I post an entry about the official CMS Medicaid enrollment report, documenting the increase in Medicaid enrollment since ACA expansion went into effect. The numbers were increasing dramatically every month for nearly two years, but started slowing down last fall as most of the expansion states started maxing out on their eligible enrollees.

As of July 2016, total Medicaid enrollment continued to quietly increase for a total of 72.8 million people, with 15.4 million of that being mainly due to the ACA (~10 million via official expansion, ~1 million early additions/transfers and ~4 million "woodworkers").

Regular readers know that I used to regularly post an entry about the official CMS Medicaid enrollment reports every month, documenting the increase in Medicaid enrollment since ACA expansion went into effect. The numbers were increasing dramatically every month for nearly two years, but started slowing down last fall as most of the expansion states started maxing out on their eligible enrollees.

As of November 2015, there had been a net increase of 14.1 million people added to the Medicaid rolls since October 2013 (the month when ACA expansion enrollment began), plus another 950,000 people who had already been quietly transferred over to Medicaid from existing, state-funded programs prior to 2013 via other ACA provisions. I sort of forgot to post about the reports for awhile, but checked back in again for the May report, released back in July.

Regular readers know that I used to regularly post an entry about the official CMS Medicaid enrollment reports every month, documenting the increase in Medicaid enrollment since ACA expansion went into effect. The numbers were increasing dramatically every month for nearly two years, but started slowing down last fall as most of the expansion states started maxing out on their eligible enrollees.

In fact, I realized this morning that I got so caught up in other ACA stories earlier this year that I haven't even posted a monthly update once since last November!

As of November 2015, there had been a net increase of 14.1 million people added to the Medicaid rolls since October 2013 (the month when ACA expansion enrollment began), plus another 950,000 people who had already been quietly transferred over to Medicaid from existing, state-funded programs prior to 2013 via other ACA provisions.

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