Tag: Medicaid expansion
Commonwealth paper explores preventive health services expansion
Posted by mmcdowell on April 23, 2012
The Commonwealth Fund recently published a paper in Medscape Public Health regarding preventive health services under the Affordable Care Act (ACA). The law has already extended coverage to dependents through age 26. By 2014, Medicaid will expand to cover most low-income adults and the exchanges will extend insurance to many small business and individuals. This eminent expansion of health insurance coverage will greatly increase in the use of preventive services in the United States. ACA provisions also eliminate cost sharing associated with the provision of preventive services, which will also likely impact use. Finally, the movement toward medical homes will also augment the use of preventive services. The paper discusses these relationships in the context of delivery system reforms.
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Supreme Court hears Medicaid expansion oral argument
Posted by mmcdowell on March 28, 2012
In the afternoon on the the third and last day of oral arguments, the Supreme Court heard whether the Affordable Care Act’s (ACA’s) expansion of Medicaid is unlawful. Medicaid is a state-federal program that provides health insurance coverage to the disabled and poor, including families with dependent children. To increase participation rates in the program, the federal government allocates money to states that voluntarily create Medicaid programs that meet federal standards. The ACA expands Medicaid coverage to include single adults that fall within federal poverty standards.
Mr. Paul Clement, representing the challengers, opened the afternoon arguments. Mr. Clement’s allotted 30 minutes ran over, as Justices continued to fire questions well after the time had expired. The majority of Mr. Clement’s argument was spent on the coercion question, which suggests that because the federal government has the option of pulling all the state’s Medicaid funding if a state doesn’t want to participate in the law’s Medicaid expansion, states will thus be coerced to participate in the expansion.
Solicitor General Donald Verrilli followed, representing the Obama Administration.
To end the ACA oral arguments, Chief Justice Roberts gave Mr. Clement 5 minutes to make a final rebuttal.
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Update: Highlights from the Final ACA Medicaid Eligibility Regulations
Posted by Mark Dorley on March 23, 2012
On March 16, 2012 the Centers for Medicare and Medicaid Services (CMS) released a final rule regarding Medicaid eligibility under the Affordable Care Act. A summary of the final rule was previously posted on healthreformgps.org. This Update summarizes the key provisions of the final regulation, which also contains certain interim final rules on which further comment is sought.
The Final Rule, which takes effect January 1, 2014, addresses a wide array of issues raised in the 2011 proposed rule.
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HHS releases final rule on Medicaid eligibility
Posted by mmcdowell on March 16, 2012
Today the U.S. Department of Health and Human Services released the final rule for Medicaid program eligibility changes under the Affordable Care Act (ACA). Similar to the exchange final rule, certain provisions of the Medicaid final rule were issued as interim final, with a 45 day comment period. Under the ACA, individuals between ages 19 and 64 with incomes up to 133 percent of the federal poverty level (currently $14,856 for an individual and $30,656 for a family of four) are eligible for Medicaid coverage. Medicaid expansion will become effective in 2014 when the Exchanges begin operation. The federal government will pay 100 percent of the association expansion cost for the first three years and at least 90 percent after that.
The final rule announced today deviates from the August 2011 proposed rule enrollment rules. The proposed rule would have given the Exchanges the responsibility of determining who is eligible for Medicaid in order to facilitate “one-stop shopping” for coverage options. Under the final rule, however, states will now be able to choose whether the Exchange will enroll people in Medicaid or whether the state Medicaid agency alone will have that power.
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Supreme Court grants request for more time
Posted by mmcdowell on February 21, 2012
The Supreme Court justices announced that they would lengthen the time allotted to hear the Anti-Injunction Act issue from 60 to 90 minutes. This issue surrounds whether the justices have the authority to decide whether the Affordable Care Act’s (ACA’s) minimum coverage provision is constitutional. This will bring the case to a total of six hours, making it the longest Supreme Court case in modern history. For the Anti-Injunction Act, the court will hear from a third-party attorney for 40 minutes, the Justice Department for 30 minutes, and the NFIB and the states will get 20 minutes. Next, the justices will hear two hours regarding whether the insurance mandate is constitutional. This issue of the severability of the individual mandate from the rest of the ACA will receive two and a half hours. The court will finally spend an hour on the states’ challenges to Medicaid expansion.
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The Center for Medicare and Medicaid Innovation: A Year’s Progress
Posted by Mark Dorley on January 26, 2012
Improving the quality of care delivery and reducing explosive growth in healthcare costs is a cornerstone of The Patient Protection and Affordable Care Act (ACA). It reflects the shared understanding that the current silo-based approaches to care delivery that focus on settings of care (e.g., physician office, hospital) rather than care delivery across multiple providers and setting (e.g., episodic) are not working. Costs are increasing at an unsustainable pace, and evidence from leading researchers collectively points to serious deficiencies in health care quality and the disconnect between high spending and health care quality.
To foster the development of more collaborative and…
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Prominent Republican Discusses Importance of Medicaid on Senate Floor
Posted by Mark Dorley on December 19, 2011
Senator Charles Grassley (R-IA), Ranking Member of the Senate Judiciary Committee, gave a speech on the Senate floor warning members of the dire consequences to Congressional powers if the Supreme Court finds in favor of States on the ‘Medicaid Commandeering’ argument. The Court has agreed to hear oral arguments on multiple challenges to the Affordable Care Act (ACA) over a three day stretch in late March of 2012. These challenges include an objection by States of the Medicaid expansion provisions of the ACA, which require States to expand Medicaid eligibility to 133% of the federal poverty level (FPL) in order to receive additional federal dollars.
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Supreme Court agrees to hear health reform challenges
Posted by mmcdowell on November 14, 2011
The U.S. Supreme Court has granted writ of certiorari (cert) to three appellate court cases involving multiple issues related to the constitutionality of the Affordable Care Act (ACA). The Court set aside 5-1/2 hours for oral arguments, which will likely take place in March. The justices will hear arguments on four issues: (1) the constitutionality of the individual mandate; (2) whether other provisions of the ACA should be severed (and remain in effect) if the individual mandate is found to be unconstitutional; (3) the applicability of the Anti-Injunction Act on whether the Court has jurisdiction to hear the cases, and; (4) the legality of the ACA’s Medicaid eligibility expansion.
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UC Berkeley policy brief addresses health coverage maintenance during transitions
Posted by mmcdowell on October 31, 2011
UC Berkeley, funded by grants from the Robert Wood Johnson Foundation and The California Endowment, recently released the brief, “The Promise of the Affordable Care Act, the Practical Realities of Implementation: Maintaining Health Coverage During Life Transitions,” which discusses seamless health coverage under the Affordable Care Act for individuals and families who lose health insurance because of a work or life transition. While outreach and education are essential for enrollment, such efforts are not sufficient to assure that those eligible will enroll in programs during these transition periods. This policy paper addresses the question, “How can implementation of the Affordable Care Act build on institutional connections and develop widespread cultural knowledge of the availability of coverage during life transitions that precipitate the loss of private coverage?”
Health Affairs article warns of contingencies and uncertainties under Medicaid expansion
Posted by mmcdowell on October 27, 2011
An article recently published in Health Affairs, “Policy Makers Should Prepare For Major Uncertainties in Medicaid Enrollment, Costs, And Needs For Physicians Under Health Reform,” presents findings from a simulation model using two nationally representative data sets to estimate Medicaid eligibility, participation, and population growth. The article warns that the number of Medicaid enrollments, associated costs, and number of new physicians needed could vary hugely under Medicaid expansion. The estimated number of people enrolling in Medicaid for the first time could vary by more than 10 million when the program changes are implemented in 2014. Additionally, costs could range from anywhere between $34 billion to $98 billion per year. The new enrollments could necessitate at least 4,500 and at most 12,100 new physicians. The study results indicate that policy makers should prepare for a great deal of unpredictability associated with Affordable Care Act’s (ACA’s) Medicaid reform.
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