Say Ahhh!
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New Federal Rules Seek To Strengthen Mental Health Parity
By Maanasa Kona, Assistant Research Professor at the Center on Health Insurance Reforms On July 25, 2023, the Departments of Labor, Health and Human Services, and the Treasury (the tri-agencies) proposed a new rule to strengthen the enforcement of the federal Mental Health Parity and Addiction Equity Act (MHPAEA) and ensure that patients can access mental health and substance…
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Marketplace Enrollment Rises Again in July But Still Represents Only Small Share of Those Losing Medicaid Coverage During Unwinding
As readers of Say Ahhh! know, I have been tracking monthly data (here, here, and here) from the Centers for Medicare and Medicaid Services (CMS) on the number of people who were either previously enrolled in Medicaid or had experienced a denial or termination who then selected a marketplace plan. CMS has just issued new…
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Updated List of Flexibilities Highlight Variety of Approaches States Are Taking to Promote Continuity of Coverage During the Unwinding
To meet the unprecedented moment of the unwinding of the Medicaid continuous coverage protection, states have implemented a range of innovative policies to make the renewal process smoother for enrollees as well as state eligibility workers. One tool that states have increasingly used is Section 1902(e)(14)(A) waivers, or “e14s,” which we have written about previously…
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Medicaid Enrollment is Down by Five Million Including Two Million Children
We’ve been tracking changes in Medicaid enrollment for everyone including children. Sadly, today our tracker of net child Medicaid enrollment losses went over two million nationwide and exceeded five million for adults and children combined. And states are not done yet! According to KFF’s recent estimates, we’re only about one-third of the way through the…
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What’s New for 2024 Marketplace Enrollment?
By Emma Walsh-Alker, Georgetown University Center on Health Insurance Reforms The annual open enrollment period for Affordable Care Act (ACA) Marketplace coverage kicks off November 1 in most states. A number of new and ongoing policy changes will impact the Marketplace in 2024, including special enrollment opportunities tied to the Medicaid “unwinding,” continuing enhanced financial…
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Eliminating CHIP Premiums Could Help with Child Transitions from Medicaid to CHIP
Last week, Joan Alker and Jade Little blogged about the troubling trend of children losing Medicaid as enrollment declines near 2 million. Leading up to the unwinding, researchers estimated that 57% of children losing Medicaid would be eligible for CHIP based on income. There are many reasons why children don’t successfully transition seamlessly from Medicaid…
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Response to American Academy of Pediatrics New Policy Statement
The following is a statement by Joan Alker, Executive Director of the Center for Children and Families at Georgetown University’s McCourt School of Public Policy in response to American Academy of Pediatrics New Policy Statement: “I applaud the new policy statement by the American Academy of Pediatrics outlining the direction that Medicaid and the Children’s Health Insurance…
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What Does 12-month Continuous Eligibility for Children Mean for CHIP Pregnancy Coverage?
Several weeks ago, I blogged about the federal guidance CMS sent to states on the implementation of 12-month continuous enrollment (CE) for children starting on January 1, 2023, as required by the Consolidated Appropriations Act of 2023 (CAA). In the guidance, CMS provided details on how implementation of 12-month CE impacts the group of individuals…
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Almost 2 Million Fewer Children are Enrolled in Medicaid: Are They Moving to CHIP?
We’ve been tracking net child enrollment losses in Medicaid with state administrative data and our tracker is going to hit two million soon. In reality the number is certainly at two million already given that these numbers don’t include three states (Michigan, New York, and Oregon) and that Texas data, a state which has disenrolled…
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Medicaid Managed Care: Transparency of Performance on Maternal Health
Our nation is in the midst of an ongoing maternal health crisis, one that particularly affects Black women. The causes are complex, the need to address them is urgent, and there is no single solution. One of many potential solutions that has not received enough attention is Medicaid managed care. Medicaid, the nation’s largest health…
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Marketplace Enrollment During Medicaid Unwinding Ticked Up in June but Remained Modest
I have been regularly reporting on monthly data (here and here) from the Centers for Medicare and Medicaid Services (CMS) on the number of people who were either previously enrolled in Medicaid or had experienced a denial or termination who then selected a marketplace plan. At the end of September, CMS issued new data for…
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CMS Makes the Right Call on Utah’s Medicaid Waiver: Where Do Things Stand on Postpartum Coverage?
In a little-noticed but important action, CMS recently notified the Utah Medicaid agency that it should proceed with extending postpartum coverage from 60 days to 12 months under the state plan amendment (SPA) option rather than continuing to pursue its Section 1115 waiver request. At first blush, this seems like a distinction only the most…
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How Did We Get Here? A Recent Legislative History of Medicaid Managed Care
Just over 25 years ago, Congress enacted a major change in federal policy on Medicaid managed care. It eliminated the 75/25 rule—the requirement that no more than 75 percent of the enrollees in a Medicaid managed care organization (MCO) could be Medicaid or Medicare beneficiaries. The logic of the rule was that if an MCO…
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Black Maternal & Mental Health Summit Highlights the Urgency for Policy and Practice Change
In July, I had the chance to attend the Black Maternal & Mental Health Summit hosted by the Shades of Blue Project. Founder Kay Matthews established Shades of Blue in 2013 after the loss of her stillborn daughter. With worsening maternal morbidity rates in the United States, Kay has turned to advocacy as a way…
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Unwinding Data Recap: What Do We Know So Far?
Last Friday marked the end of the month, which meant the release of new unwinding data from CMS. This time, though, CMS not only published data on renewal outcomes for June, but also posted preliminary outcome data for July, cutting the time lag to two months. As a result, there is now unwinding data available…
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CMS Releases Guidance on 12-Month Continuous Eligibility for Children
CMS has released long awaited guidance to states on implementing 12-month continuous eligibility (CE) for all children in Medicaid and the Children’s Insurance Program (CHIP) under the age of 19 as enacted by Congress in the Consolidated Appropriations Act. As of January 2023, 26 states cover some or all children in Medicaid for a full…
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HHS Takes Action on Maternal Mental Health Initiatives, Requests Input on Medicaid/CHIP Parity Compliance
Last week, the Administration announced a number of actions related to mental health with a focus on maternal health as well as parity in Medicaid and the Children’s Health Insurance Program (CHIP). Here’s a readout of the latest actions: Maternal Health Funding: HHS announced awards of more than $103 million to support and expand access…
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AAP and CCF Release 2023 State Snapshots on the Importance of Medicaid for Children’s Coverage
Starting back in 2017 we created state snapshots with our colleagues at the American Academy of Pediatrics that show who Medicaid covers in each state, with a particular emphasis on Medicaid’s role in covering children. After a hiatus during the pandemic, we’ve updated the easy-to-understand 2-pagers with all the latest data on how Medicaid helps…
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New Resource Helps Pediatricians Inform Families on How to Keep Eligible Children Enrolled in Medicaid
We recently learned that one of the most effective tools for keeping eligible people enrolled in Medicaid – automated or “ex parte” renewals – has not been set up correctly in 30 states, including DC, while other states, such as Texas, are barely using automated systems at all. As Say Ahhh! readers know, Medicaid eligibility…
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Looming Government Shutdown Could Undermine Federal Oversight of Medicaid Unwinding
[Editor’s Note: On September 30, Congress approved a last-minute measure to fund the government through November 17, 2023, which temporarily averted a government shutdown. CCF experts will continue to monitor the funding debate and its impact on health care programs and the people who rely on them.] Sadly, we’ve been here before and it’s highly…
