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Week of August 17, 2015
Almost 1 million people signed up for health insurance after the open enrollment season ended on February 22, helping to drive the percentage of uninsured Americans below 10 percent. One government survey found that 7 million fewer people were uninsured in the first three months of this year, compared to the average for all of 2014.
However, a report from the Urban Institute last week warned that progress could stagnate if affordability is not addressed. The report said that private coverage provided through the exchanges remains a financial stretch for many families, even with subsidies, and that disenrollment rates could increase over time.
Federal
Congress is now recessed until early September.
States
CALIFORNIA: Covered California, the state-based exchange, announced it will add two new carriers to its plan selection in 2016. United Health Group will be limited to offering five policies in underserved regions. Oscar Health Plan is planning to sell coverage in larger Southern California markets.
A study conducted by The Taylor Feldman Group found that if just 10 percent of Californians with Hepatitis C are treated with newer, more costly specialty drugs, costs over the next year would top $4.77 billion, with $2.05 billion of that spent on the state-funded population. “This report shows how just one new treatment can blow a hole in state and federal budgets,” said Charles Bacchi, president and CEO of the California Association of Health Plans.
DELAWARE: The state Department of Health and Social Services informed the Centers for Medicare and Medicaid Services (CMS) that the state will maintain its state-federal partnership exchange for 2016. The state will withdraw its application to become a state-based exchange and instead will maintain the plan management and consumer outreach functions under a partnership exchange.
KENTUCKY: State officials have released data showing that Kentuckians on Medicaid were far more likely to get cancer screenings, physicals and dental check-ups. The Department for Medicaid Services presented the data during a recent meeting of the oversight team for a state effort to improve the health of state residents and reduce deaths from chronic disease. The data show that breast cancer screenings rose 111 percent, to 51,292; cervical cancer screenings rose 88 percent, to 78,281; and colorectal cancer screenings rose 108 percent, to 35,633. Preventive dental services also more than doubled, by 116 percent, to 159,508; and physical examinations were up 187 percent, to 63,888.
NORTH CAROLINA: The State Senate has passed a substitute version of the House Medicaid reform bill. The Senate’s version includes a role for managed care companies, as well as provider-led entities, in reforming the state’s fee-for-service Medicaid model. The Senate’s version also includes additional language calling for the creation of a new Department of Medicaid. The bill will now return to the House for consideration.
Almost 1 million people signed up for health insurance after the open enrollment season ended on February 22, helping to drive the percentage of uninsured Americans below 10 percent. One government survey found that 7 million fewer people were uninsured in the first three months of this year, compared to the average for all of 2014.
However, a report from the Urban Institute last week warned that progress could stagnate if affordability is not addressed. The report said that private coverage provided through the exchanges remains a financial stretch for many families, even with subsidies, and that disenrollment rates could increase over time.
Federal
Congress is now recessed until early September.
States
CALIFORNIA: Covered California, the state-based exchange, announced it will add two new carriers to its plan selection in 2016. United Health Group will be limited to offering five policies in underserved regions. Oscar Health Plan is planning to sell coverage in larger Southern California markets.
A study conducted by The Taylor Feldman Group found that if just 10 percent of Californians with Hepatitis C are treated with newer, more costly specialty drugs, costs over the next year would top $4.77 billion, with $2.05 billion of that spent on the state-funded population. “This report shows how just one new treatment can blow a hole in state and federal budgets,” said Charles Bacchi, president and CEO of the California Association of Health Plans.
DELAWARE: The state Department of Health and Social Services informed the Centers for Medicare and Medicaid Services (CMS) that the state will maintain its state-federal partnership exchange for 2016. The state will withdraw its application to become a state-based exchange and instead will maintain the plan management and consumer outreach functions under a partnership exchange.
KENTUCKY: State officials have released data showing that Kentuckians on Medicaid were far more likely to get cancer screenings, physicals and dental check-ups. The Department for Medicaid Services presented the data during a recent meeting of the oversight team for a state effort to improve the health of state residents and reduce deaths from chronic disease. The data show that breast cancer screenings rose 111 percent, to 51,292; cervical cancer screenings rose 88 percent, to 78,281; and colorectal cancer screenings rose 108 percent, to 35,633. Preventive dental services also more than doubled, by 116 percent, to 159,508; and physical examinations were up 187 percent, to 63,888.
NORTH CAROLINA: The State Senate has passed a substitute version of the House Medicaid reform bill. The Senate’s version includes a role for managed care companies, as well as provider-led entities, in reforming the state’s fee-for-service Medicaid model. The Senate’s version also includes additional language calling for the creation of a new Department of Medicaid. The bill will now return to the House for consideration.
