February 05, 2015

This Kaiser Health News column looks at the Mental Health Parity and Addiction Equity Act of 2008, viewed as a landmark step in improving patients' access to mental health services. "There's a lot at stake," writes Lisa Gillespie. CMS regulations will likely determine the extent to which the law applies to Medicaid managed care "carve-out" mental health plans that are frequently paired with separate medical insurance, she suggests.

February 05, 2015

Indiana's Medicaid expansion plan, approved last week by the federal government, creates different tiers of coverage for lower-income residents. The Indiana plan also includes copays for emergency rooms, and requires participants to contribute to a hybrid health savings account or face mandatory copays or loss of coverage. Many of these elements are unprecedented for traditional Medicaid coverage, but have increasingly become part of negotiations between the federal government and Republican-led states, such as Indiana, that are seeking to both expand and change Medicaid.

February 04, 2015

Health costs associated with Alzheimer's disease are projected to skyrocket in the coming decades, a report from the Alzheimer's Association warns. The report projects that as the population ages, Medicare and Medicaid costs for people with Alzheimer's will more than double by 2030 and almost quintuple by 2050, from a level of $153 billion in 2015. The impending cost spike has spurred Congress to advance efforts to finding new treatments.

February 01, 2015

The New York Times reports that many low-income, working adults who are eligible for neither federal subsidies nor Medicaid because they live in states that have declined to expand the program are taking second jobs or working extra hours to increase their incomes, hoping to become eligible for assistance that will enable them to afford marketplace plans. All told, four million adults in nearly two dozen states fall into the gap, and Texas has the most, nearly one million.

February 01, 2015

The number of people enrolled in Medicaid and CHIP hit 10.1 million as of November, a 17.5% increase over the same time period last year. Officials touted the numbers as evidence the ACA's Medicaid expansion is working in states that have adopted it. The Obama administration is working to encourage governors that have not accepted the Medicaid expansion to tailor the policy to their states in 2015. Indiana became the latest state to expand Medicaid on Jan. 27 and will require that enrollees make small contributions to their health insurance premiums.

January 28, 2015
This Brookings opinion piece says whether or not the Supreme Court strikes a blow at the ACA's state exchange subsidies in June, it is essential for Congress to remake Medicaid and CHIP, into a more rational and efficient structure. According to Brookings, such a redesign requires three steps:
  1. Encourage states unwilling to expand traditional Medicaid under the ACA to adopt a well-designed private option;
January 27, 2015

Indiana Gov. Mike Pence (R) has struck a long-awaited deal with the White House that allows the state to move forward with its own plan to expand Medicaid while still receiving a windfall of federal dollars. Pence received a green light for the Healthy Indiana Plan 2.0, which he called the "first-ever consumer-driven healthcare plan for a low-income population." The plan does come with a twist: it bucks the federal government's blueprint for Medicaid expansion by requiring participants to pay a monthly premium to help offset costs.

January 19, 2015

Medicaid expansion in two dozen states remains one of the biggest hurdles for the Affordable Care Act, according to a report from Families USA. Unless the remaining 23 states opt to expand the eligibility for the low-income insurance program, millions of people will continue to lack affordable coverage, the pro-ACA healthcare advocacy group warned.

January 16, 2015

WASHINGTON — Marilyn B. Tavenner, the administrator of the federal Centers for Medicare and Medicaid Services, who helped preside over the rollout of sweeping changes in the nation’s health care system, said Friday that she was resigning.

“February will be my last month serving as the administrator for C.M.S.,” Ms. Tavenner said in an email to agency employees.

January 12, 2015

Research suggests that the expansion of Medicaid under the Affordable Care Act is reducing the number of uninsured patient visits to community health centers. Community health centers provide primary-care services to low-income populations. Under federal funding rules, they cannot deny services based on a person's ability to pay and are viewed as "safety net" clinics. Researchers from Oregon Health & Science University report there was a 40% drop in uninsured visits to clinics in states where Medicaid was expanded during the first half of 2014, when compared to the prior year.

January 12, 2015

CMS is moving beyond its traditional beneficiaries to target a broader population by supporting programs that focus on behavioral, social and environmental factors that determine public health. The initiative, called its Quality Strategy, was set forth in an article in The New England Journal of Medicine, titled Beyond a Traditional Payer - CMS's Role in Improving Population Health.

January 08, 2015

California Gov. Jerry Brown (D) released his fiscal year 2015-2016 budget plan, which included several healthcare proposals. Brown's office said the $113.3 billion budget plan "injects billions of dollars more into schools and healthcare coverage." According to the budget, Medi-Cal will account for two-thirds of overall HHS spending in the coming fiscal year. The plan also notes that unfunded liability in the state's retiree healthcare programs currently is an estimated $72 billion.

January 06, 2015

BeneStream, a New York-based start-up funded partly by the Ford Foundation, uses software to quickly determine which employees are eligible for Medicaid, then helps those workers sign up for the state-federal health program that covers 70 million people. The goal is to help employers and workers make the most of two key provisions of the health law: the Medicaid expansion that's making millions of working adults eligible for Medicaid and the requirement that medium and large-sized employers provide coverage in 2015 or face a penalty.

January 06, 2015

Vermont House Speaker Shap Smith (D) says his top healthcare priority for the 2015 legislative session is increasing Medicaid payments to providers. The program underpays doctors and hospitals by between 37% and 51%, depending on how it's calculated, according to the Green Mountain Care Board. Vermont has tried to address the problem but it must take substantive action, or the problem will persist, Smith said. Doing so would "likely" require new revenue, he added.