CMS issues proposed rule on mental health parity
Posted by Sara Rothenberg on April 8, 2015
The Centers for Medicare and Medicaid Services (CMS) published a proposed rule that applies the Mental Health Parity and Addiction Equity Act to Medicaid and the Children’s Health Insurance Program (CHIP). The federal mental health parity law requires that health plans providing behavioral health care coverage do so with the same terms covering medical and surgical care. The CMS proposed rule applies the law to Medicaid enrollees who receive services through managed care organizations and alternative benefit plans. It applies it to all CHIP participants regardless of whether their care is provided through fee-for-service or managed care.
GAO issues Medicaid report
Posted by Sara Rothenberg on February 17, 2015
The Government Accountability Office (GAO) issued a report examining (1) the extent to which Medicaid enrollees have private insurance, and (2) state and CMS initiatives to improve third-party liability (TPL) efforts. GAO found that 7.6 million Medicaid enrollees (13.4 percent) had private health insurance in 2012. Additionally, the number of Medicaid enrollees with private health insurance is expected to increase with the expansion of Medicaid. To combat this issue, GAO recommends that the Centers for Medicare and Medicaid Services (CMS) routinely monitor and share across all states information regarding key TPL efforts and challenges, as well as provide guidance on state oversight of TPL efforts conducted by Medicaid managed care plans.
CMS releases monthly Medicaid and CHIP enrollment report
Posted by Sara Rothenberg on December 20, 2014
The Centers for Medicare and Medicaid Services released a report showing state Medicaid and Children’s Health Insurance Program (CHIP) enrollment and growth. The data shows that Medicaid and CHIP grew by 9.7 million enrollees between the beginning of the first Affordable Care Act (ACA) open enrollment period and October 2014- that’s a 17 percent growth in average monthly enrollment, compared to the July-September 2013 period. Additionally, the report finds that enrollment in states that expanded Medicaid increased by 24 percent since first open enrollment, compared to 7 percent in states that did not expand. In total, Medicaid and CHIP had 68.5 million enrollees in October, an increase of about 400,000 over the previous month.
Study assesses states’ Medicaid spending per enrollee
Posted by Nikki Hurt on July 17, 2014
A new Government Accountability Office (GAO) report finds that eight states spent at least $10,500 per Medicaid recipient in 2008, while the majority of states were clustered in the $6,000-$8,000 range, per enrollee. For Fiscal Year (FY) 2013 Medicaid spending is estimated at $267 billion, a figure that is expected to nearly double by FY 2024. The GAO’s report assessed why there is so much variation in per-enrollee spending across states and how states account for those differences when setting Medicaid managed care rates.
Two new ACA studies released
Posted by Nikki Hurt on June 26, 2014
A new study published in Health Affairs found that open enrollment for the Affordable Care Act (ACA) should coincide with the tax filing season. The researchers argued that consumers are more likely to make better decisions with their health coverage when taxes are on their minds, not the stresses associated with holiday spending. Currently, ACA open enrollment for 2015 is scheduled for November 15, 2014 to February 15, 2015.
Another study from the Urban Institute indicates that Medicaid expansion was associated with a reduction in the number of uninsured individuals as of March 2014. The study, which relied upon data from Urban’s Health Reform Monitoring Survey, found that states expanding Medicaid saw a drop in the uninsurance rate by 4%, whereas states that did not expand Medicaid saw a 1.4% reduction. Unlike the ACA open enrollment period, individuals eligible for Medicaid can enroll in the program at any point in a year.
Article discusses likelihood of funding gaps for safety-net hospitals
Posted by Nikki Hurt on June 2, 2014
A new article published in Health Affairs finds that some safety-net hospitals will still face funding issues, even after implementation of the Affordable Care Act (ACA). The article cites rising healthcare costs, the number of Americans still without insurance, and the disproportionate share hospital payment reductions within the ACA as reasons contributing to the continuation of funding gaps for many safety-net hospitals. States that did not expand Medicaid may be particularly impacted by these funding gaps, as they will not be receiving federal expansion money to offset the cuts in the safety-net funds.
Update: State Medicaid, Marketplace and Navigator Law Status
Posted by Nikki Hurt on May 12, 2014
This post provides the most updated map concerning state status on Medicaid expansion, Marketplace operation, and passage of Navigator laws.
RWJF and Urban report discusses repealing employer mandate
Posted by Nikki Hurt on
A new report released by the Urban Institute and the Robert Wood Johnson Foundation stated that aside from costs, there would be a minimal impact if the administration removed the Affordable Care Act’s (ACA) employer mandate. The report, Why Not Just Eliminate the Employer Mandate?, stated that repealing the provision would result in 200,000 fewer individuals being covered in 2016, 500,000 fewer receiving employer-sponsored coverage, and 300,000 more qualifying for Medicaid or health insurance subsidies. Repealing the employer mandate, which the report states is not pivotal in expanding coverage under the ACA, would remove the business industry’s main issue with the ACA. The biggest challenge with removing the employer mandate would be finding a pay-for to account for the $130 billion the provision was anticipated to generate in fines and the costs of providing more subsidies.
NBER study discusses positive impact of including dental benefits in Medicaid
Posted by Nikki Hurt on April 22, 2014
A new study released by the National Bureau of Economic Research (NBER) indicates that including adult dental benefits in Medicaid plans can have a multitude of positive results. The study, How Do Providers Respond to Public Health Insurance Expansions? Evidence from Adult Medicaid Dental Benefits, found that covering dental benefits resulted in more dentists participating in Medicaid without decreasing the number of privately insured patients these dentists see. Additionally, the study reported that dentists participating in Medicaid were able to make greater use of dental hygienists while only mildly increasing patient wait times.
RAND survey shows uptick in employer sponsored insurance
Posted by Nikki Hurt on April 9, 2014
A survey recently released by the RAND Corporation found that a net of 9.3 million individuals gained health insurance during the Affordable Care Act’s (ACA) open enrollment period. The majority of these individuals gained coverage through employer sponsored insurance (ESI), with Medicaid coming in as the second most frequent payer. RAND posits the uptick in ESI resulted from either the individual mandate forcing people to take coverage they had previously denied, or the improvements in the economy that have enabled more individuals to be employed and therefore receive benefits.