CBO releases new report describing budgetary impact of the ACA
Posted by Nikki Hurt on May 15, 2013
The Congressional Budget Office (CBO), in conjunction with the Joint Committee on Taxation (JCT), issued updated budget projections for fiscal years 2014-2023, which include updated impact estimates of the insurance provisions in the Affordable Care Act (ACA). Slower than anticipated growth in health care spending, particularly in programs such as Medicare and Medicaid, is one of several factors that influenced the revised estimates…
GWU study examines Medicaid churn
Posted by Nikki Hurt on May 14, 2013
A study released by The George Washington University finds that churning, the process of moving in and out of Medicaid in response to income fluctuations, increases hospitalizations and costs for Medicaid beneficiaries. The Continuity of Medicaid Coverage: An Update reports that individuals enrolled in Medicaid for 12 months consecutively pay on average $333/month in medical bills, while those enrolled for one month at a time pay $625/month. The study released last week was funded by the Association for Community Affiliated Plans (ACAP).
Medicaid expansion allows for coordination between CMS and HRSA
Posted by Nikki Hurt on May 2, 2013
The Centers for Medicare and Medicaid Services (CMS) and Health Resources and Services Administration (HRSA) released a joint information bulletin detailing the opportunity to coordinate care between Medicaid and the Ryan White HIV/AIDS Program. The expansion of Medicaid under the Affordable Care Act (ACA) will provide health care access to many people living with HIV/AIDS, therefore necessitating the need for CMS and HRSA to ensure that Medicaid and Ryan White HIV/AIDS programs are poised to collaborate and coordinate care for this population. The two federal agencies will offer webinars and training in the following areas: eligibility, enrollment, essential community providers, managed care practices, and integrated care models for those living with HIV/AIDS.
CMS offers higher reimbursement for Medicaid eligibility system update
Posted by Nikki Hurt on April 26, 2013
A provision in the Affordable Care Act (ACA) incentivized state Medicaid agencies to design and develop new eligibility systems by offering a 90% federal reimbursement for the associated costs. A set of FAQ released by the Centers for Medicare and Medicaid Services (CMS) explains that state Medicaid programs will be eligible for an increased federal match rate of 75% for using and maintaining these upgraded eligibility system by January 1st, 2014. To qualify for the enhanced rate for the upgraded systems, states must meet operation and maintenance standards in the following categories:
- personnel costs
- software maintenance
- data entry
- computer operators
- coding clerks
States that choose not to expand their Medicaid program under the ACA will still be eligible for the increased reimbursement if they meet the specified upgrade requirements.
In addition to these stipulations, the FAQ also stated they would not authorize 1115 demonstration waivers that placed enrollment caps or periods of ineligibility for the new Medicaid-eligible adult groups under the ACA.
Tavenner answers Senate Finance Committee Questions
Posted by Nikki Hurt on April 25, 2013
On April 9th, the Senate Finance Committee held a confirmation hearing for Marilyn Tavenner to be the Administrator of the Centers for Medicare and Medicaid Services (CMS). Committee members submitted additional questions to Tavenner post-hearing on topics ranging from consumer outreach in state insurance Exchanges to pediatric dental services. Health Reform GPS has compiled a list of the Affordable Care Act related questions submitted by the Senate Finance Committee members. The list contains the name of the Senator asking the question, the question number, and the relevant ACA topic addressed.
State Health Reform Assistance Network releases Medicaid checklist
Posted by Nikki Hurt on April 16, 2013
The State Health Reform Assistance Network, in conjunction with the National Academy of State Health Policy and the Robert Wood Johnson Foundation, released a checklist detailing Medicaid requirements that each state must meet by 2014, irrespective of whether or not a state expands Medicaid eligibility as described in the Affordable Care Act (ACA). To accompany the outlined requirements and optional provisions detailed in the report, State Health Reform Assistance Network has also included a resource list with tools and analyses that can be incorporated to aid in Medicaid requirement implementation. The checklist is divided into five categories that should be altered in response to pending Medicaid changes, each of which containing various requirements to satisfy the specified category:
- Eligibility and Enrollment
- Medicaid Operations
- Medicaid Financing
- Medicaid Benefits
- Consumer Assistance
Update: Using Medicaid to Provide Premium Assistance for Exchange Coverage
Posted by Nikki Hurt on April 10, 2013
This update to our previous Implementation Brief on states’ option to implement Medicaid coverage by enrolling beneficiaries into Qualified Health Plans sold in Exchanges examines Frequently Answered Questions on Medicaid and Premium Assistance (“FAQ”), released on March 29th by CMS. The FAQ answer some, but not all, questions raised by this approach to implementation of the ACA Medicaid expansion…
Medicaid Expansions Using Private Plans: The Role of Premium Assistance and Cost-Sharing
Posted by Mark Dorley on April 8, 2013
The recent announcement that some states are considering expanding Medicaid using private health insurance through the health insurance exchanges has created a flurry of debate. HHS has said that it is willing to approve a concept submitted by Arkansas, using an approach called “premium assistance,” which lets Medicaid cover the cost of private insurance. The premium assistance option has been available for many years under the Medicaid statute, but linkage to the health insurance exchanges has only become possible with the ACA.
This brief commentary is a follow-up on earlier reports in Health Reform GPS discussing this topic; it focuses on the evidentiary basis that undergird some of these policy issues.
CMS releases FAQs on premium assistance for Medicaid expansion
Posted by Nikki Hurt on March 29, 2013
Today, the Centers for Medicare and Medicaid Services (CMS) released FAQs in response to growing interest in the potential use of federal funding for Medicaid expansion to enroll Medicaid eligible individuals in private insurance plans within state Exchanges. According to CMS, if states want to enroll Medicaid beneficiaries into private plans, they must ensure that the costs are nearly equivalent and that the Medicaid beneficiaries are still entitled to the benefits and cost-sharing protections they would receive under traditional Medicaid.
Manatt brief discusses challenges of using Medicaid funding to purchase private plans
Posted by Nikki Hurt on
A new brief released by Manatt Health Solutions, in partnership with the Robert Wood Johnson Foundation, outlines some of the issues states may encounter in pursuit of using premium assistance to purchase private insurance through the state marketplace for Medicaid-eligible adults. Under the Affordable Care Act (ACA), states have the option to expand their Medicaid eligibility requirements and receive additional federal funding to cover the costs of insuring the newly included population. Several states have been conversing with the US Department of Health and Human Services (HHS) over the possibility of using the federal monies granted to them for expansion to provide their Medicaid population with private insurance. This brief addresses several potential legal, operational and policy issues with this option, including how to ensure that Medicaid participants retain their rights as Medicaid beneficiaries while receiving coverage from a private insurer.