Medicare

One of the most important provisions of the Inflation Reduction Act, passed with only Democratic votes in the U.S. House last summer, was this one: After decades of prior attempts, it finally allows the Centers for Medicare & Medicaid Services (CMS) to actively negotiate the price of at least some prescription drugs. As explained by the Kaiser Family Foundation:

The Inflation Reduction Act of 2022 (the Act), signed into law by President Biden in August 2022, includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. One of the Act’s key drug-related policies is a requirement for the Secretary of Health and Human Services (HHS) to negotiate prices with drug companies for certain drugs covered under Medicare Part D (starting in 2026) and Part B (starting in 2028). This new requirement is the culmination of years of debate among lawmakers over whether to grant the federal government the authority to negotiate drug prices in Medicare.

Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of January 2023:

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

In January 2023, 93,008,246 individuals were enrolled in Medicaid and CHIP.

• 85,915,795 individuals were enrolled in Medicaid in January 2023, an increase of 629,200 individuals from December 2022.

• 7,092,451 individuals were enrolled in CHIP in January 2023, an increase of 30,891 individuals from December 2022.

• Since February 2020, enrollment in Medicaid and CHIP has increased by 22,358,006 individuals (31.6%).
  • Medicaid enrollment has increased by 22,110,705 individuals (34.7%).
  • CHIP enrollment has increased by 247,301 individuals (3.6%).

The Medicaid enrollment increases are likely driven by COVID-19 and the continuous enrollment condition in the Families First Coronavirus Response Act (FFCRA).

Hmmm...this is a bit odd. Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

For the December update, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow which I summarized yesterday, along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of December 2022:

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

In December 2022, 92,340,585 individuals were enrolled in Medicaid and CHIP.

• 85,280,085 individuals were enrolled in Medicaid in December 2022, an increase of 425,110

• 7,060,500 individuals were enrolled in CHIP in December 2022, an increase of 87,296 individuals from November 2022.

• Since February 2020, enrollment in Medicaid and CHIP has increased by 21,690,345 individuals (30.7%).
  • Medicaid enrollment has increased by 21,474,995 individuals (33.7%).
  • CHIP enrollment has increased by 215,350 individuals (3.1%).

The Medicaid enrollment increases are likely driven by COVID-19 and the continuous enrollment condition in the Families First Coronavirus Response Act (FFCRA).

In December 2022, 2,360,820 applications for Medicaid and CHIP were submitted directly to states.

Just to prove that there's still some sane healthcare-related legislation coming out of Republican-controlled legislatures these days, Indiana state representative Mark Carbaugh (R) has introduced a bill which seems harmless enough and makes sense to me:

Transition from Marketplace plan to Medicare.

Requires an insurer or health maintenance organization that provides coverage under an Affordable Care Act Marketplace (Marketplace) plan to provide to each individual covered under the Marketplace plan, not more than two months before the birthday on which the individual will become 65 years of age, a written message that includes: (1) a statement that the individual will be eligible to enroll in Medicare during the individual's initial enrollment period, which begins three months before the individual becomes 65 years of age; (2) a statement advising the individual that, in most cases, someone covered by a Marketplace plan will want to end their Marketplace coverage upon becoming eligible for Medicare; and (3) detailed instructions that the individual may follow to cancel the individual's Marketplace plan.

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

Inflation Reduction Act Tamps Down on Prescription Drug Price Increases Above Inflation

• New Medicare Prescription Drug Inflation Rebate Program protects people with Medicare and taxpayers when drug companies increase prices faster than the rate of inflation
• HHS announces savings for some people with Medicare on 27 Part B prescription drugs 

The Biden-Harris Administration has made lowering prescription drug costs in America a key priority — and President Biden is delivering results. Today, the Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), announced 27 prescription drugs for which Part B beneficiary coinsurances may be lower from April 1 – June 30, 2023. Thanks to President Biden’s new law to lower prescription drug costs, some people with Medicare who take these drugs may save between $2 and $390 per average dose starting April 1, depending on their individual coverage. Through the Inflation Reduction Act, President Biden and his Administration are lowering prescription drug costs for American seniors and families. 

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.

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.

Over on Twitter, political commentator Krystal Ball made an interesting claim:

A provision in Obamacare allows residents in areas deemed a public health disaster to be covered by Medicare for life. At the very least, East Palestine residents deserve this universal coverage after being exposed to a known carcinogen. https://t.co/ooPYmJ4Y8b

— Krystal Ball (@krystalball) February 21, 2023

What she's referring to is an obscure & fascinating nugget buried in the Patient Protection & Affordable Care Act: Section 10323, which states:

SEC. 10323. MEDICARE COVERAGE FOR INDIVIDUALS EXPOSED TO ENVIRONMENTAL HEALTH HAZARDS.

(a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is amended by inserting after section 1881 the following new section:

``SEC. 1881A. <<NOTE: 42 USC 1395rr-1.>> MEDICARE COVERAGE FOR INDIVIDUALS EXPOSED TO ENVIRONMENTAL HEALTH HAZARDS.