Oregon

via the Centers for Medicare & Medicaid Services:

  • Initiatives will ensure children in Oregon have continuous Medicaid coverage until the age of six, and expand access to coverage and address nutrition and housing needs in Massachusetts and Oregon
  • Approvals of the initiatives come during the White House Conference on Hunger, Nutrition, and Health, taking direct action on the Biden-Harris Administration’s National Strategy to end hunger, reduce diet-related diseases, and eliminate health inequities

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved groundbreaking Medicaid section 1115 demonstration initiatives in Massachusetts and Oregon. Both demonstrations aim to test improvements in coverage, access, and quality with innovative approaches to ensure more eligible people retain their Medicaid coverage, including by approving Oregon’s demonstration to keep children enrolled in Medicaid up to age six — preventing gaps in coverage that can cause children to lose access to needed care in their formative early years.

Oregon

via the Centers for Medicare & Medicaid Services:

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced approval of the Oregon Health Authority’s proposal to cover community-based mobile crisis intervention services in Medicaid. Made possible by President Biden’s American Rescue Plan, the new first-in-the-nation Medicaid State plan amendment will allow Oregon to provide community-based stabilization services to individuals experiencing mental health and/or substance use crises throughout the state by connecting them to a behavioral health specialist 24 hours per day, every day of the year. 

CMS Logo

via the Centers for Medicare & Medicaid Services:

  •  States will have an additional year to use American Rescue Plan funds to strengthen the home care workforce and expand access to services

 Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), is notifying states that they now have an additional year — through March 31, 2025 — to use funding made available by the American Rescue Plan (ARP) to enhance, expand, and strengthen home- and community-based services (HCBS) for people with Medicaid who need long-term services and supports. This policy update marks the latest action by the Biden-Harris Administration to strengthen the health care workforce, help people receive care in the setting of their choice, and reduce unnecessary reliance on institutional care.

CMS Logo

via the Centers for Medicare & Medicaid Services:

Today, the U.S. Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) approved California, Florida, Kentucky, and Oregon actions to expand Medicaid and Children’s Health Insurance Program (CHIP) coverage to 12 months postpartum for a total of an additional 126,000 families across their states, annually—supporting 57,000; 52,000; 10,000; and 7,000 parents, respectively.

Oregon

via the Oregon Division of Financial Regulation:

Salem – Oregon consumers can get a first look at requested rates for 2023 individual and small group health insurance plans, the Oregon Department of Consumer and Business Services announced today.

In the individual market, six companies submitted rate change requests ranging from an average 2.3 percent to 12.6 percent increase, for a weighted average increase of 6.7 percent. In the small group market, nine companies submitted rate change requests ranging from an average 0 percent to 11.6 percent increase, for a weighted average increase of 6.9 percent. Our initial review has found that insurers have identified inflation, medical trend, and enrollment changes as factors in the proposed increases. See the attached chart for the full list of rate change requests.

 

I haven't written much about the ACA's Basic Health Plan (BHP) program for awhile, aside from noting that it's well past time for the Centers for Medicare & Medicaid Services (CMS) to start including BHP enrollment in their official Open Enrollment Period reports, seeing how over a million people in Minnesota & New York now have healthcare coverage via BHP policies.

As a refresher, here's Louise Norris' summary explainer:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

Oregon

As I just noted, the end of the official COVID-19 Public Health Emergency, whenever it happens (it's currently scheduled to end as of April 16th but could be extended once again at any point before then) will cause a new problem:

Millions of Americans currently enrolled in Medicaid will likely no longer be legally eligible to remain on the public healthcare program, threatening to cause a massive overload of agencies and potentially leaving many of them stranded without any healthcare coverage at all.

I noted at the end that leadership in certain states are (sadly) gleefully anticipating exactly that outcome, while others are (thankfully) scrambling to try and deal with the fallout. Case in point, Oregon, where Elizabeth Hayes reports in the Portland Business Journal that...

Legislation to help about 300,000 Oregonians on Medicaid to maintain their coverage after the Covid-19 public health emergency ends advanced out of committee on Monday.

Oregon

(sigh) It's a bit silly for me to write about this now, given that the 2022 Open Enrollment Period ended a few weeks ago, but it's still relevant going forward.

As long-time readers know, I was one of a handful of healthcare wonks who coined the phrase "Silver Loading" to describe a wonky policy pricing strategy which insurance carriers started using back in late 2017 to counteract the Trump Administration's decision to terminate Cost Sharing Reduction subsidy reimbursement payments:

Let's say in 2017 a carrier projected that overall claim expenses in 2018 would increase around 5%. To keep things simple, let's say they offered just 3 plans: One Bronze, one Silver (which happends to also be the "benchmark Silver" used to determine subsidies) and one Gold, priced at an average of $450, $600 and $750/month.

Oregon

Every year, I spend months tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need. The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:

How many effectuated enrollees they have enrolled in ACA-compliant individual market policies;

What their average projected premium rate change is for those enrollees (assuming 100% of them renew their existing policies, of course); and

Ideally, a breakout of the reasons behind those rate changes, since there's usually more than one.

Usually I begin this process in late April or early May, but this year I've been swamped with other spring/summer projects: My state-by-state Medicaid Enrollment project and my state/county-level COVID-19 vaccination rate project.

Oregon

I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For the various enrollment data, I'm using data from Medicaid.gov's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In most states I've been able to get more recent enrollment data from state websites and other sources.

For Oregon, I'm relying on raw data from the Oregon Health Authority for January 2021 and later.

Total Medicaid enrollment in Oregon (including ACA expansion peaked at a little over 1.1 million back in 2015, but dropped off to around 950,000 for a couple of years before COVID hit the country. Since then, non-ACA enrollment has gone up about 14%, ACA expansion has increased by over 30% and overall enrollment is 22% higher than it was in February 2020.

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