A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

Archive: August 2012

Heritage Foundation report suggests state Medicaid percent match could exceed 10 percent in 2020

Posted on August 31, 2012

In a new report released by the Heritage Foundation, author Drew Gonshorowski suggests that states could be responsible for more than the 10 percent Medicaid match currently called for by 2020 under the Affordable Care Act (ACA). According to the Heritage issue brief, states could face $3.4 billion in new costs if the match rate is reduced to a level that can be called the “blended rate.” This is an estimation of what the match rate could be under the Administration’s suggestion. The brief explains, “blended rate is an average of a state’s current Medicaid match, its enhanced match rate for the Children’s Health Insurance Program, and the expansion match rate. The result of this scheme is a drastic reduction in federal spending at the expense of the states.”

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HHS announces new workforce grants

Posted on August 31, 2012

Yesterday, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced $58.7 million in grants to strengthen training for health professionals and increase the size of the American health care workforce. The 254 grants support nursing workforce development, interdisciplinary and geriatric education and training, centers for excellence health professions schools, and dentistry. For a list of grant awards by state, click here

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GAO report examines state practices for assessing Medicaid long-term care coverage eligibility

Posted on August 29, 2012

Medicaid paid for nearly half of the nation’s $263 billion long-term care expenditures in 2010. Federal law discourages individuals from artificially impoverishing themselves in order to establish financial eligibility for Medicaid. Specifically, those who transfer assets for less than fair market value during a specified time period before applying for Medicaid may be ineligible for coverage for long-term care for a period of time. The Deficit Reduction Act (DRA) extended the look-back period to 60 months and introduced new requirements for the treatment of certain types of assets, such as annuities, in determining eligibility. States are responsible for assessing applicants’ eligibility for Medicaid, the criteria for which varies by state.

The Government Accountability Office (GAO) was asked to…

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RWJF and SHADAC report finds that the number of insured children has increased, despite economic downturn

Posted on August 29, 2012

A report recently published by the Robert Wood Johnson Foundation in collaboration with State Health Access Data Assistance Center analyzes recent trends in health insurance coverage for children at the state level between 2008 and 2010. The percentage of children with public coverage through Medicaid or the Children’s Health Insurance Program (CHIP) increased substantially, while rates of private coverage and uninsurance declined. However, the report found substantial variation across states.

The main findings of this report include the following…

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HHS IFR amendment prohibits illegal aliens from joining PCIP

Posted on August 29, 2012

The Department of Health and Human Services (HHS) issued an amendment to an interim final rule to prevent young illegal aliens allowed to stay in the United States under President Obama’s amnesty program from joining a high-risk insurance pool program. from joining high-risk insurance pool programs. The amendment modifies the 2010 interim final rule which implements the Affordable Care Act’s (ACA’s) Pre-Existing Condition Insurance Plan (PCIP) program. The purpose of PCIP is to enable people who have been uninsured for at least six months due to medical problems to obtain coverage at the same price as those without pre-existing conditions. PCIP will end in 2014 when plans are barred from charging more to consumers with medical problems. The amendment was released because the 2010 interim final rule held that individuals could enroll in these pools if they were citizens, nationals, or a “lawfully present” in the United States.

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KFF brief reviews characteristics of uninsured adult population

Posted on August 29, 2012

Effective January 2014, the Affordable Care Act (ACA) establishes a new minimum Medicaid eligibility level of 138 percent of poverty for non-disabled adults who were not previously eligible for the program. As with current Medicaid, legal immigrants who have been in the country for five years or fewer are not eligible for this coverage. Nationally, 21.5 million currently uninsured nonelderly adults may meet the income and citizenship criteria to be eligible for Medicaid after the expansion.

A brief recently released by the Kaiser Family Foundation uses the American Community Survey to describe the low-income uninsured adult population — the target group for the Medicaid expansion under the Affordable Care Act — by state. Many people in this target population have substantial health needs and face barriers to health care, and nearly half have incomes of 50 percent of poverty or less.

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Provider group recommends federal officials instate incentives for long-term care providers to adopt EHR

Posted on August 28, 2012

Long-term and post-acute care providers and officials from the Office of the National Coordinator (ONC) for Health Information Technology recommended that Electronic Health Records (EHRs) design requirements focus on longitudinal care plans, transitions of care and patient assessments during a roundtable discussion held in May. A report summarizing the roundtable discussion stated that federal health officials should offer long-term care providers incentives to adopt Stage 3 Meaningful Use criteria for EHR.

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Employers look for new ways to cut costs

Posted on August 28, 2012

The 2012 Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care offers insights into the actions and plans of leading U.S. employers and views of what the future of employer-provided health care in the U.S. may look like this year and in the coming three years. According to the study, as health care costs continue to rise, employers are looking for ways to cut costs. While the total cost of health care is predicted to rise 5.3%, to $11,507 per employee in 2013, the growth is slowing. Many companies will keep premium increases in line with the health care cost increases. The study found that 13% of companies would increase premiums by 5% in 2013, for example.

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HHS releases ICD-10 final rule

Posted on August 24, 2012

The U.S. Department of Health and Human Services (HHS) today released a final rule establishing a unique health plan identifier. The rule also makes official that the new ICD-10 billing codes will be delayed a year, from October 1, 2013 to October 1, 2014.

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Commonwealth publishes paper on choosing health plans in State Exchanges

Posted on August 24, 2012

Beginning in 2014, the health insurance exchanges created under the Affordable Care Act (ACA) will be available in every state as marketplaces for individuals without employer insurance and small employers. All plans will include the same package of essential health benefits, but will vary by four different levels of “actuarial value,” or the percentage of medical costs that a plan pays for on average. The actuarial value of a plan will be indicated by the tiers of bronze, silver, gold, and platinum, and comparative information will be available to help people select plans. A new study recently published by the Commonwealth Fund looks at out-of-pocket costs that might result from plans with various designs and actuarial values. The study found that average out-of-pocket expenses decline as actuarial values rise, but two plans with similar actuarial values might result in different out-of-pocket costs for a given person. The overall affordability of a plan also will be influenced by age rating, income-related premium subsidies, and out-of-pocket subsidies, report the authors.

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