Category: Implementation

“A day after Maryland committed to a gradual launch of its health exchange, state officials are still working out some key details — including where the opening day sign-up will be held — but experts say it could be a way to avoid a repeat of last year’s botched rollout.
Several health experts said the approach that limits enrollment in the first few days could allow Maryland to “kick the tires” on its new website.
“It’s a controlled way to open enrollment,” said Karen Pollitz, senior fellow at the Kaiser Family Foundation. “They can work with a controlled number of people for the first couple of days to see how this works in practice. I’m assuming there is some plan at the end of the day when people gather in a room and compare notes and say we need to fix this or that.””

“Lawmakers told officials with the Department of Health and Hospitals on Wednesday they needed to provide more complete information going forward about Bayou Health, Gov. Bobby Jindal’s Medicaid privatization program.
The Legislative Audit Advisory Council heard testimony from DHH and the Legislative Auditor’s Office about an audit that raised a number of questions about the program. Auditors testified 74 percent of the transparency report was based on self-reported data with no corroborating documentation.”

“RICHMOND — Republican leaders of Virginia’s House of Delegates, who have staunchly opposed Medicaid expansion all year, plan to put the question to a floor vote as early as Thursday in a special legislative session.
The GOP-dominated chamber is widely expected to shoot down the proposed $2 billion-a-year expansion, although a few conservative legislators have expressed fears that the measure might defy expectations and pass — just as a then-record tax hike did when Democrat Mark R. Warner was governor a decade ago.”

“Enrolling in Missouri’s Medicaid program has not been easy.
Many applicants have experienced a barrage of problems when trying to sign up for the program, including long delays until coverage kicks in, lost paperwork and a lack of one-on-one interaction with caseworkers. State officials have blamed a new computer system used to process Medicaid applications.
But there is another reason why some Missourians struggle to get help.
When Deborah Weaver, 28, had issues enrolling in the state’s Medicaid coverage for pregnant women, a switch from her Medicaid disability coverage, she was directed to use a toll-free number, 1-855-373-4636. When she called, Weaver endured long waits and received no guidance.”

“Very few industries in bed with Obamacare come off smelling like a rose. But if one had to pick a bad actor above all others, it would probably be Big Health Insurance.
America’s largest and most influential health insurance companies actively supported passage of Obamacare in Congress, and continue to do so today. That’s not surprising, since the heart of Obamacare is a mandate on Americans to purchase the product the health insurance companies are selling (the individual mandate). The “essential minimum coverage” on “qualified health insurance plans” as dictated by the Department of Health and Human Services tend to emphasize first dollar insurance coverage whenever possible, which increases insurance company profits. Worst of all, insurance companies are the beneficiaries of a giant taxpayer bailout that makes their Obamacare participation a “heads they win, tails taxpayers lose” kind of scenario.”

“Just days before the security of the Obamacare website is the subject of a new report by an independent government agency, a watchdog group today released documents showing federal health officials knew about security vulnerabilities in the run-up to the site’s shaky launch last fall.
Judicial Watch said it obtained 94 pages of government documents detailing HealthCare.gov’s “massive” security risks.
The documents, the watchdog said, show that officials at the Department of Health and Human Services and a subordinate agency, the Centers for Medicare and Medicaid Services, decided to roll out the online insurance exchange despite knowledge of the security flaws.”

“If you are looking for information on how Americans are engaging with the Affordable Care Act, the Census Bureau’s recently released latest annual estimates of health insurance coverage is probably not the place to look—at least for now.
The Census Bureau, which derives its information on healthcare from the Annual Social and Economic Supplement—the same survey where it asks how many toilets, computers, microwaves, etc., people have in their homes—does provide some useful insights.
It catalogues the demographic characteristics of the population based on participation in different types of health insurance coverage—government health care programs, private employer and individual plans, and the uninsured. It tells us young adults make up a disproportionate share of the uninsured and provides useful information on the relative availability of employer-sponsored coverage by industry and firm size.
But its hard numbers on enrollment and enrollment trends are not reliable for drawing “big picture” conclusions, especially regarding the ACA. Indeed, that unreliability is why this year the Census Bureau started using a new set of health coverage questions in the ASEC.”

“The uninsured rate for kids under age 18 hasn’t budged under the health law, according to a new study, even though they’re subject to the law’s requirement to have insurance just as their parents and older siblings are. Many of those children are likely eligible for coverage under Medicaid or the Children’s Health Insurance Program.
The Urban Institute’s health reform monitoring survey analyzed data on approximately 2,500 children, comparing the uninsured rate in June 2014 with the previous year, before the health insurance marketplaces opened and the individual mandate took effect. It found that rates remained statistically unchanged at just over 7 percent for both time periods.”

“Since the Affordable Care Act’s (ACA) passage, a number of lawsuits have been filed challenging various provisions of the law. The Supreme Court has decided cases about the constitutionality of the ACA’s individual mandate and Medicaid expansion as well as the applicability of the contraceptive coverage requirement to closely held for-profit corporations with religious objections. In addition, several cases challenging the availability of premium subsidies in the Federally-Facilitated Marketplace (FFM) are currently progressing through the federal courts. All of this litigation has altered, or has the potential to alter, the way in which the ACA is implemented and consequently could affect the achievement of the law’s policy goals. This issue brief examines the federal courts’ role to date in interpreting and affecting implementation of the ACA, with a focus on the provisions that seek to expand access to affordable coverage.
Court decisions about how to interpret the ACA will continue to affect the number of people who ultimately obtain affordable coverage. At present, access to Medicaid up to 138% FPL is dependent upon where people live because the Supreme Court held that implementation of the ACA’s Medicaid expansion is effectively a state option. This has resulted in a coverage gap for just over 4.5 million people with incomes too high to qualify for Medicaid but too low to qualify for Marketplace subsidies in the states that have not implemented the ACA’s Medicaid expansion to date.”

“Congress’ investigative arm said Tuesday (Sept. 16) that healthcare.gov continues to face security weaknesses, leaving the site subject to “increased and unnecessary” risk of unauthorized access, disclosure or modification of the information collected and maintained. CMS pledged to implement some of the fixes proposed by the Government Accountability Office, but GOP lawmakers used the opportunity to again blast the administration’s handling of Obamacare.
GAO recommended six ways CMS could put in place an effective information security program, and another 22 technical recommendations that could improve the effectiveness of information security controls.”