Category: Implementation

States that expanded Medicaid realized a 49.5 percent decline in the uninsurance rate, compared to a 33.8 percent decline in the uninsurance rate in non-expansion states since 2012, according to a Department of Health and Human Services report released today.

The department is touting the results of the study, which was conducted by its Office of the Assistant Secretary for Planning and Evaluation, as evidence that the roughly 20 states that have not yet expanded the program should do so.

“Today’s report is a clear reminder of the important role Medicaid expansion plays in improving access to quality, affordable care while addressing and improving overall health for millions of Americans,” HHS Secretary Sylvia Burwell said in a statement.

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With time running out for the Obama administration to prove the success of the Affordable Care Act, officials are aggressively targeting a group that could help turn things around: young people.

Federal health officials announced Tuesday they will comb tax records to find 18-34 year-olds who paid the penalty stipulated under President Barack Obama’s health act for not buying health insurance and reach out to them directly with emails to urge them to avoid even higher penalties scheduled for this year. They also plan to heavily advertise the enrollment campaign, including a promotion with trendy ride-sharing service Lyft to offer discounted rides to enrollment events.

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When the nation’s largest insurer announced its departure from a few Obamacare state exchanges last year, the law’s defenders pooh-poohed the development as a blip on the radar. Then the health insurance giant pulled out of almost all markets, forcing apologists to insist that all was well because UnitedHealth’s overall Obamacare marketshare was relatively small. Next, the company said it was closing up shop within Covered California, the massive exchange in America’s largest state. And now we get word that another enormous insurer is edging away from participation in the law — withdrawing not just from Minnesota’s Obamacare exchange, but from the state’s entire individual-based market.

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Minnesota’s largest health insurer, Blue Cross and Blue Shield of Minnesota, has decided to stop selling health plans to individuals and families in Minnesota starting next year.

The insurance carrier’s parent company, which goes by the same name, will continue to sell a much more limited offering on the individual market through its Blue Plus HMO.

The insurer explained extraordinary financial losses drove the decision.

“Based on current medical claim trends, Blue Cross is projecting a total loss of more than $500 million in the individual [health plan] segment over three years,” BCBSM said in a statement.

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ObamaCare officials are partnering with the IRS to help drive down uninsured rates among young people.

For the first time, the federal tax agency is working with the Department of Health and Human Services (HHS) to reach out directly to taxpayers who paid the required fee last year because they lacked coverage.

About 45 percent of people who paid the fee — or claimed an exemption, like financial hardship — were under 35, according to HHS.
The planned mailings will lay out options for coverage and include details about how to qualify for federal subsidies. HHS will also again partner with the ride-hailing service Lyft, which will offer discounts to customers who attend open enrollment sessions.

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Gov. Matt Bevin of Kentucky promised big changes were coming to Medicaid — and on Wednesday, he unveiled his plan. Bevin said the plan, “Kentucky Helping to Engage and Achieve Long Term Health” (or Kentucky HEALTH), will ensure the program’s long-term fiscal stability. Bevin’s predecessor, Steve Beshear, expanded Medicaid in Kentucky to adults making as much as 138 percent of the federal poverty level. Kentucky HEALTH is for that same population, plus all non-disabled adults currently covered under traditional Medicaid. The plan has two pathways: an employer premium assistance program and a high-deductible, consumer-driven health plan.

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The three key questions to ask of any Medicaid financing proposal that ends the open-ended federal reimbursement are: 1) what is the level of federal commitment? 2) how are the funds divided among the states? and 3) how are state incentives affected? Sensible Medicaid reform must accomplish two aims: reduce the unsustainable trajectory of federal and state Medicaid spending, and produce better outcomes for people most in need of public assistance. Although much more work needs to be done, the House task force proposal would take steps to accomplish both aims.

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The healthcare plan released today by House Speaker Paul Ryan offers a modern refashioning of the consumer empowerment that has formed the foundation of conservative policymaking. This turns principally on an expansion of health savings accounts and other elements that reshape the healthcare benefit into a defined contribution of money that consumers can own and control, and that becomes more portable. The idea is that people can own their own coverage and take it with them, even as they move around and between different insurance pools and jobs.
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The Department of Health and Human Services will up their direct outreach to uninsured young adults, who they hope will enroll in the Affordable Care Act exchanges and help stabilize the markets.

HHS on Tuesday announced steps the department will take during the upcoming open enrollment period to enhance their outreach to people between ages 18 and 35 who they hope will purchase insurance policies on the federal exchanges. The announcement is the latest in a string of expected steps the department is announcing this month to strengthen the marketplace.

The department hopes to increase the number of young and healthy adults enrolled on the exchanges to improve the risk pools, which would help lower costs for all marketplace consumers.

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House Speaker Paul Ryan’s policy plan for health care, as expected, leans heavily on market forces, more so than the current system created by Obamacare. The proposal contains a host of previously proposed Republican ideas on health care, many of which are designed to drive people to private insurance markets.

Importantly for conservatives, as part of a full repeal of the Affordable Care Act, the current law’s mandates for individuals and insurers would disappear under the GOP plan. It would overhaul Medicare by transitioning to a premium support system under which beneficiaries would receive a set amount to pay for coverage. The plan also would alter Medicaid by implementing either per capita caps or block grants, based on a state’s preference.

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