I haven't written much about the ACA's Basic Health Plan (BHP) program for awhile, aside from noting that it's well past time for the Centers for Medicare & Medicaid Services (CMS) to start including BHP enrollment in their official Open Enrollment Period reports, seeing how over a million people in Minnesota & New York now have healthcare coverage via BHP policies.

As a refresher, here's Louise Norris' summary explainer:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

Hot on my announcement that I've been asked to join the board of directors of Doctors For America, I have some less pleasant personal news to report as well: After dodging it for nearly 2 1/2 years and obsessively tracking cases & fatalities connected to it for most of that time, I finally tested positive for COVID-19 myself a few days ago.

I actually started feeling slightly off about two weeks ago, but I also happened to get my 4th vaccination shot (or 2nd booster, if you prefer) right around the same time, so for the first few days I just assumed I was having stronger-than-usual side effects from the shot.

By last Wednesday, it was clearly something more serious, but a home-based COVID test came back negative so I figured it was just a really nasty head cold + seasonal allergies. By Friday my wife was also experiencing symptoms and she ended up having a miserable Mother's Day weekend...while I was starting to recover.

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From the Doctors for America (DFA) website:

Doctors for America mobilizes doctors and medical students to be leaders in putting patients over politics on the pressing issues of the day to improve the health of our patients, communities, and nation.

We believe:

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via the Centers for Medicare & Medicaid Services:

Today, the Centers for Medicare & Medicaid Services (CMS) announced that Tennessee and South Carolina can begin offering Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months postpartum to an estimated 22,000 and 16,000 pregnant and postpartum individuals, respectively, through a new state plan opportunity made available by the American Rescue Plan.

Tennessee and South Carolina join Louisiana, Michigan, Virginia, New Jersey, and Illinois in extending Medicaid and CHIP coverage from 60 days to 12 months postpartum. CMS is also working with another nine states and the District of Columbia to extend postpartum coverage for 12 months after pregnancy, including California, Indiana, Kentucky, Maine, Minnesota, Oregon, New Mexico, Pennsylvania, and West Virginia. As a result of these efforts, as many as 720,000 pregnant and postpartum individuals across the United States could be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy. 

Joint post by Charles Gaba & Andrew Stokes

As noted a couple of weeks ago, I've decided to ease up on my obsessive COVID vaccination & death rate tracking. I'm not abandoning it entirely, mind you; I'm just dropping the updates from weekly to monthly.

There's two reasons for this: First, the weekly updates have been monopolizing my time & energy, making me fall behind on a whole mess of other important healthcare policy stuff; after all, this is ACASignups.net not COVIDTracker.net. Secondly, I think it's fair to say that after meticulously tracking the data for nearly two years (in the case of COVID deaths) or one year (in the case of vaccination rates), I've more than made my point.

However, there's one other important factor which I haven't delved into...because I never had access to the data, at least not at the county level: Excess deaths. For this, I've enlisted the assistance of Andrew Stokes, Asst. Professor at the Boston University School of Public Health, to the point that I'm giving him co-author credit for this entry.

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Last week the Centers for Medicare & Medicaid posted a new press release about a new report from the HHS's Assistant Secretary for Planning & Evaluation (ASPE) which has updated ACA-specific enrollment data current as of October 2021 - March 2022:

New Reports Show Record 35 Million People Enrolled in Coverage Related to the Affordable Care Act, with Historic 21 Million People Enrolled in Medicaid Expansion Coverage

Via email, no link yet:

Today, Health and Human Services Secretary Xavier Becerra released the following statement on the heels of a Politico report, claiming to include a draft Supreme Court opinion on Roe v. Wade --

Patients make their own decisions about their own bodies. That’s their right.

I strongly believe in protecting and promoting access to health care — that includes sexual and reproductive health care, and that includes safe and legal abortion care. 

Abortion remains legal today and patients can access care. The laws we have seen coming out of states that deny care are dangerous.

HHS has taken several meaningful actions under the Biden-Harris Administration to protect and bolster reproductive health, rights, and justice, including:

Georgia

Back in November I put out a Break Glass In Case Of Fire-style call to action:

About 2 years ago, GOP Georgia Governor Brian Kemp submitted an ACA Section 1332 Waiver request to the Centers for Medicare & Medicaid Services. As Katie Keith of Health Affairs explained at the time, it consisted of two parts...the first of which was fairly noncontroversial, the second of which was...well, not good:

The application reflects a two-phase approach: a state-based reinsurance program to begin in plan year 2021, followed by a transition to the “Georgia Access” model beginning in plan year 2022. Both components of the waiver application would extend through plan year 2025.

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Last June, the U.S. Health & Human Services Dept. confirmed my estimate that total enrollment in healthcare policies either specifically created by (or expanded to more people by) the Affordable Care Act had broken 31 million Americans:

Today, the U.S. Department of Health and Human Services (HHS) released a new report that shows 31 million Americans have health coverage through the Affordable Care Act – a record. The report also shows that there have been reductions in uninsurance rates in every state in the country since the law’s coverage expansions took effect. People served by the health Marketplaces and Medicaid expansion have reached record highs.

HHS's breakout was fairly close to mine, though they had enrollment a bit higher in some categories and a bit lower in others:

And there it is:

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via the Centers for Medicare & Medicaid Services (CMS), by email:

Today, the Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.

Medicare

As of January 2022, over 64.2M people are enrolled in Medicare. This is an increase of 52K since the last report.

  • 34.9M are enrolled in Original Medicare.
  • 29.3M are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.
  • 49.8M are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage.

Nearly 11.9 million individuals are dually eligible for Medicare and Medicaid, so are counted in the enrollment figures for both programs.

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