Resources
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Final Exchange Rules Part 1
By Joe Touschner This week’s final exchange rule from HHS is unlikely to be the last large package of rules implementing ACA that we will see in the coming weeks–we still expect regulations on Medicaid eligibility, premium tax credits, and risk adjustment, not to mention more on the essential health benefits and other key topics…
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CMS EHB FAQ
By Joe Touschner Despite that title, our blog is not converting to the abbreviated language of texts and Twitter–I promise to type out the words in full when they’re needed. We’re also definitely not moving with Twitter speed in bringing you the news, but on February 17, the Centers for Medicare and Medicaid Services released…
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What’s the Score? CBO’s Updated Baseline Released
By Martha Heberlein I don’t know what you did yesterday, but I spent the day eagerly awaiting CBO’s annual March baseline. As the “official scorekeepers” in Washington, their projections of spending and enrollment in Medicaid, CHIP, and coverage under the exchanges carry a lot of weight. Besides, who wouldn’t love the neat little tables they produce…
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Medical Bills – A Strain to Many Families
By Martha Heberlein Many families are struggling with medical debt. During the first 6 months of 2011, one in three people was living in a family experiencing a financial burden due to medical care, such as having medical bills that they are unable to pay, according to data released by the CDC. The chances of facing…
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HHS Releases Final Exchange Rules
The U.S. Department of Health and Human Services (HHS) announced a set of final rules on Affordable Insurance Exchanges. This set of rules generated quite a lot of interest from stakeholders as more than 24,000 comments were submitted to HHS. Some of the rules announced this week are in interim final status, meaning HHS will…
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HHS Releases Report on ACA’s Lifetime Limit Provision
Twenty-eight million children no longer have to face lifetime caps imposed on their health insurance benefits thanks to the Affordable Care Act, according to an issue brief released this week by the Department of Health and Human Services. Our research has shown that lifetime caps on insurance benefits are a major concern for families with…
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A Double Benefit – More Kids Enrolled and Administrative Savings
We have long been fans of the enormous success that Louisiana has had in improving retention among children in Medicaid and CHIP through administrative renewals and ex parte. I mean, really, who wouldn’t be wowed by the fact that just 1% of children lose coverage at renewal for procedural reasons! Not to mention the low, low…
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Continuous Coverage – Critical for Chronic Conditions
By Tara Mancini Our Say Ahhh! audience is certainly aware of the benefits of implementing continuous coverage, namely, how it can improve health outcomes for beneficiaries while also decreasing administrative and utilization costs. As of January 1, 2012, 28 states offer 12-month continuous eligibility in their CHIP programs (23 in Medicaid). Alabama is one of…
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HHS Gives States an Extension on Exchange Establishment Funding Requests
“Be careful what you wish for” is the adage that came to mind when HHS announced it planned to extend the final deadline for applying for Level II exchange establishment funding from June 29, 2012 to November 3, 2014. The announcement published in the federal register today proposed to set the rolling deadline for Level…
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HHS Signals Approach on Actuarial Value, Cost Sharing
By Joe Touschner In a bulletin released late last week, HHS provided some indication of how it will use the key concept of actuarial value in rating health plans under the Affordable Care Act. The same bulletin shared some clues on the cost-sharing reductions that some moderate income families will receive when they enroll in exchange…
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Public Programs that Work – Good News on Children’s Coverage
By Eugene Lewit, The David and Lucile Packard Foundation Late last year, while official Washington and its pundits were busy deconstructing the failure of the “Super Committee” and the rest of us were planning our holiday celebrations, the National Center for Health Statistics quietly released its 2011 National Health Interview Survey (NHIS) data. Among other…
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Welcoming Children to the World Justice Brennan Style
NPR reporter Nina Totenberg tells the story of how Supreme Court Justice William J. Brennan briefly met her sister the day she learned she was pregnant. He got caught up in the excitement and eight months later, remembered the news and asked Nina about her sister’s due date. When he learned that Nina’s new niece,…
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Child Well Being Index Report Provides Valuable Data to State Advocates
By Tara Mancini As we have reported, the U.S. has recently achieved some of the lowest uninsured rates for children on record. Yet, over the same period of time, children continued to experience increased rates of poverty. Because we know that poverty is distributed unevenly in the country, and in fact is often concentrated, the key message…
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Keeping Care Affordable: CMS Stands up for California Kids
By Michael Odeh, Children Now Earlier this month the federal Centers for Medicare and Medicaid Services (CMS) made an important ruling that truly embraces the “AFFORDABLE” in the Affordable Care Act (ACA). Health care services and economics research over the past four decades has clearly shown that unaffordable cost-sharing in health care can be a…
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A State-by-State Look at Gains in Preventive Care Under the ACA
Since we spend a lot of time looking ahead to 2014 and the promise of significant gains in coverage, it’s always encouraging to see some immediate benefits of the Affordable Care Act. This time: preventive care for families. Last week, amidst the excitement over new Essential Health Benefit information and the Administration’s budget, some good…
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Let the Sun Shine: Section 1115 Medicaid and CHIP Waivers Transparency Rule Finally Issued!
So my children think this is weird, but I was really happy yesterday because CMS issued the final regulations on Section 1115 waivers. CMS also issued final rules on so-called “State Innovation” waivers that will be available through the Affordable Care Act, but since those don’t go into effect until 2017 we will come back…
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Report Finds CHIP Crowd-Out Fears to be Unfounded
Remember all those claims about how private insurers would be “crowded out” if Children’s Health Insurance Program income eligibility guidelines were to be expanded? Now a report by the National Bureau of Economic Research finds that those fears are likely to be unfounded as there is little evidence of any crowd out in the states that…
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Navigating Medicaid, CHIP and the Exchanges
States are busily working to transform their tugboat-type eligibility and enrollment systems into sleek 12-meter racing yachts of the America’s Cup variety. But will simplified, streamlined eligibility and enrollment systems mean smooth sailing for everyone? Not likely. No matter how fast and dynamic these new systems are, it still will take all hands on deck…
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New Study Examines the Impact of Premiums on Enrollment
In the last year, we’ve examined the potential impact of proposed premium changes in Florida and Wisconsin, but a new study in Health Affairs provides some real-world data on what actually happens when premiums rise (not that we in any way condone experiments in children’s coverage of this sort). Healthy Kids in Los Angeles County is…
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Good News for Utah’s Children: CMS Upholds Key Affordability and Benefit Protections
By Lincoln Nehring, Voices for Utah Children In 2011 Utah passed SB 180, Medicaid Reform. As with many Medicaid reform efforts happening across the country, SB 180’s broad theme was good: control costs through improved care management and quality. However, also like many Medicaid reform efforts happening around the country, Utah’s “improved quality” theme came…