Medicaid

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:"

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

  • 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.

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

  • In April 2024, 81,696,742 individuals were enrolled in Medicaid and CHIP, a decrease of 1,060,543 individuals (1.3%) from March 2024.
    • 74,640,222 individuals were enrolled in Medicaid in April 2024, a decrease of 1,011,238 individuals (1.3%) from March 2024.
    • 7,056,520 individuals were enrolled in CHIP in April 2024, a decrease of 49,305 individuals (0.7%) from March 2024.
  • As of April 2024, enrollment in Medicaid and CHIP has decreased by 12,171,264 individuals (13.0%) 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 12,090,337 individuals (13.9%).
    • CHIP enrollment has decreased by 80,927 individuals (1.1%).
  • 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.

Last fall Oregon moved to the next step on their Basic Health Plan program (via Oregon Public Broadcasting):

Oregon becomes 3rd in nation to seek federal approval for a basic health program

A group of volunteer advisors to the Oregon Health Authority has voted Tuesday to make the state the third in the nation to seek federal approval for a basic health program.

...The Oregon Health Policy Board voted unanimously to approve Oregon’s blueprint application. It was the last step in a lengthy policy-making process needed for state approval of the plan after a task force last year recommended moving forward with it.

I last checked in on the "Georgia Pathways" program (the Peach State's partial-Medicaid expansion program which offiically extends up to 100% of the Federal Poverty Level but which also includes a draconian work reporting requirement) back in January.

At the time, only around 2,500 Georgians had actually enrolled in Georgia Pathways, for a number of rather obvious reasons:

As Leonardo Cuello of the Georgetown University McCourt School of Public Policy noted last winter:

Back in May I noted that North Carolina's ACA Medicaid expansion initiative, which started in December 2023, had officially enrolled more than 450,000 of the estimated 600,000 NC residents eligible for the program.

Cut to a few days ago:

North Carolina Celebrates More Than 500,000 Enrolled in Medicaid Expansion

PRESS RELEASE — More than half a million North Carolinians have now enrolled in Medicaid expansion since the program began seven months ago. Beneficiaries are now able get the quality health care they need at low cost. Governor Roy Cooper was joined by North Carolina Department of Health and Human Services Secretary Kody Kinsley, Dr. Karen L. Smith MD, FAAFP, a family physician in Raeford and Verlina Lomick,CHW-IV, Director of Community Outreach & Advocacy for Kintegra Health and health care advocates to celebrate reaching this major milestone, which had originally been projected to take as long as two years.

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

  • In March 2024, 82,751,338 individuals were enrolled in Medicaid and CHIP, a decrease of 636,453 individuals (0.8%) from February 2024.
    • 75,645,578 individuals were enrolled in Medicaid in March 2024, a decrease of 644,997 individuals (0.8%) from February 2024.
    • 7,105,760 individuals were enrolled in CHIP in March 2024, an increase of 8,544 individuals (0.1%) from February 2024.
  • As of March 2024, enrollment in Medicaid and CHIP has decreased by 11,116,668 individuals (11.8%) 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 11,084,981 individuals (12.8%).
    • CHIP enrollment has decreased by 31,687 individuals (0.4%).
  • 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%).

Before I get started, I want to be clear about two things.

First, what exactly is "Project 2025?"

Via Wikipedia:

Project 2025, also known as the Presidential Transition Project, is a collection of conservative and right-wing policy proposals from the Heritage Foundation to reshape the United States federal government and consolidate executive power should the Republican Party candidate win the 2024 presidential election.

It proposes reclassifying tens of thousands of merit-based federal civil service workers as political appointees in order to replace them with those who will be more willing to enact the wishes of the next Republican president.

It asserts that the president has absolute power over the executive branch.

Critics of Project 2025 have characterized it as an authoritarian, Christian nationalist plan to transform the United States into an autocracy.

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