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A Health Policy Blog
Child Enrollment in the Marketplaces Rose by Nearly 40 Percent During 2024 Open Enrollment but Increase Offsets Only Modest Share of Child Medicaid Unwinding Enrollment Losses
On March 22, 2024, the Centers for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare and Medicaid Services (CMS) released more detailed information on the nearly 21.5 million people — a historic high by far — who enrolled in the Affordable Care Act’s marketplaces during the 2024 Open Enrollment Period. According to […]
A Deeper Dive into Florida’s Lawsuit Seeking to Undermine the New Requirement for 12-Months Continuous Eligibility for Children in Separate State CHIP Programs
As my colleague Joan Alker explains, the state of Florida recently sued the federal government to block guidance from the Centers for Medicare and Medicaid Services (CMS) implementing the new requirement that all states provide 12-months continuous eligibility for children in Medicaid and the Children’s Health Insurance Program (CHIP) as of January 1, 2024. Specifically, […]
Medicaid Managed Care Appeals and Grievances: GAO Takes a Look
Last week, GAO issued a performance audit of data on Medicaid MCO appeals and grievances. The database GAO examined was the first year of Managed Care Program Annual Reports (MCPARs) submitted by state Medicaid agencies to CMS. MCPARs are one of three reports on which CMS relies to conduct oversight of state managed care programs […]
Latest House Republican Study Committee Budget Plan Again Includes Draconian Medicaid Cuts
On March 20, 2024, the Republican Study Committee (RSC), whose members comprise more than three-quarters of the House Republican caucus, announced its fiscal year 2025 budget plan. The budget plan proposes to cut total federal Medicaid, Children’s Health Insurance Program (CHIP) and Affordable Care Act marketplace subsidy spending by nearly 54 percent over the next […]
CMS Informational Bulletin Calls Out 10 “Do Nots” in Conducting Renewals
In an Informational Bulletin (CIB) released on March 15, 2024, CMS reminds states of their obligation to comply with all existing federal renewal requirements in Medicaid and CHIP. The CIB is the result of questions CMS has received from states, stakeholders, and external partners regarding the permissibility of certain renewal practices. The CIB describes 10 […]
Medicaid Managed Care: Congress Falls Short on Medical Loss Ratios
On March 9, the President signed into law the Consolidated Appropriations Act, 2024 (P.L. 118-122). Buried in the 428-page text is a 3-line provision delightfully, if somewhat obscurely, titled “Promoting Value in Medicaid Managed Care.” This is a classic in the genre of offsets, flying well under the radar to carry out its mission of […]