Enrollment in Affordable Care Act plans is unlikely to increase in 2019; the outgoing Republican governor of Idaho has announced his support for expanding Medicaid; a new state audit has found that California spent $4 billion on people who were ineligible for Medi-Cal, the state’s Medicaid program.
From 2017 to 2018, enrollment in Affordable Care Act (ACA) plans was mostly unchanged, and it is unlikely that enrollment will increase in 2019. According to The Hill, experts expect that the expansion of less expensive plans that don’t meet the ACA’s requirements and the repeal of the penalty for people who don’t have coverage will likely cause more people to leave the exchanges. Individuals who do not qualify for federal subsidies are most likely to drop out of the exchanges.
The outgoing Republican governor of Idaho has announced his support for expanding Medicaid. Expansion will be available as a ballot measure for Idahoans to vote on next week and could cover up to 62,000 people, according to The Washington Post. Governor C.L. “Butch” Otter has said that expanding the program will help keep rural hospitals and clinics open. The Democratic gubernatorial candidate also supports the measure and the Republican gubernatorial candidate said he will support the outcome of the ballot measure vote.
A new state audit has found that California spent $4 billion on people who were ineligible for Medi-Cal, the state’s Medicaid program. The Los Angeles Times reported that 453,000 beneficiaries were marked as eligible in the state’s system but were not in the counties’ systems, which may mean they had not been eligible. The reason for those individuals not being eligible could be because they died, moved, or made enough money that they no longer qualified for the program. Despite the discrepancy, the state paid $4 billion to health plans and doctors for those patients’ care over 4 years.
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
CMS released a final rule to help patients obtain Children’s Health Insurance Program (CHIP) coverage and issued a proposed rule to update Medicare payment policies and rates for inpatient rehabilitation facilities; debate over if gift card incentives are acceptable in health care marketing.
Read More
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Dr Chakra Chaulagain: PFS Is the "Bare Minimum," but OS Is Ideal for Choosing Between MM Therapies
March 28th 2024Response rates are important when choosing between therapies to treat multiple myeloma (MM), but improvement overall survival (OS) is the ideal, said Chakra Chaulagain MD, FACP, hematologist/oncologist, Maroone Cancer Center of Cleveland Clinic Florida.
Read More