Federal Healthcare Reform

Today the federal government announced that it would be taking grant applications for $67 million for navigators to link consumers to federally-facilitated and state-based health insurance exchanges. 

The speakers on the conference call characterized the announcement and posting as part of the "regular grant process" but one has to wonder if this is a sign of the administration's confidence that the Supreme Court will find in their favor in the King v. Burwell case.

The Cleveland Clinic, one of the nation’s largest hospitals, reported a 40 percent drop in charity care and credited the good news to Ohio’s Medicaid expansion, according to Kaiser Health News. Free care costs fell from $171 million in 2013 to $101 million in 2014.

Approximately 7.7 million people living in states with a federally run health insurance exchange purchased health insurance and qualified for monthly premium tax subsidies during the 2014-15 open enrollment period, according to newly released data. The estimated annual value of those tax subsidies tops $24 billion, according to calculations by The Council of State Governments. These premium subsidies are at risk in the King v. Burwell case currently before the U.S. Supreme Court.

I learned a few things last week when I was visiting with Indiana Rep. Ed Clere, one of the new co-chairs of CSG’s Health Public Policy Committee.

  • That week, the state announced the 100,000th person enrolled in the Medicaid expansion waiver, called HIP 2.0 in Indiana, after the program opened less than a month before. Indiana had three Medicaid managed care organizations already engaged in the state and the state Medicaid office and the
  • ...

The future of federal tax subsidies and, perhaps, ultimately health insurance coverage for nearly 8 million Americans are at the heart of the King v. Burwell case argued before the Supreme Court earlier this month. Some state leaders are starting to talk about the potential fallout of the case. In 34 states, 7.7 million people enrolled this winter for health insurance and qualified for tax subsidies to reduce their monthly premiums through the federally run exchange, HealthCare.gov, according to the latest federal data. The average monthly premium for those individuals fell by nearly $300, leaving an average monthly bill of $101.

State leaders are getting more creative with their plans for how to expand Medicaid under the Affordable Care Act as they move away from traditional Medicaid programs, but they might be making it harder for those plans to be carried out. The Affordable Care Act gave states the option to expand Medicaid coverage to people who earn up to 138 percent of the federal poverty level. Several states have filed what are known as Section 1115 waivers which allow states to put their own spin on expansion. The waivers must be approved by the U.S. Department of Health and Human Services before implementation. Jesse Cross-Call, a policy analyst with the Center on Budget and Policy Priorities, said Arkansas was a trailblazer in Medicaid waiver design. Cross-Call was one of the featured speakers on a recent CSG eCademy webcast, “The Latest on Federal Medicaid Waivers.”

For Justice Kennedy it was his questions, for Chief Justice Roberts it was his silence…

Today the Supreme Court heard oral argument in King v. Burwell, where it will decide whether federal health insurance exchanges, operating in 34 states, can offer subsidies to middle and low income purchasers of insurance under the Affordable Care Act (ACA). 

Simply put, the Court must decide whether it agrees with the Internal Revenue Service (IRS) that the following statutory language, “established by the State,” can include federal exchanges too.

March 4 is an important date for anyone who cares about health policy. The Supreme Court justices will hear oral arguments in the case King v. Burwell, challenging tax subsidies for health insurance purchase in states that are not running their own health insurance exchanges.

The potential impact of the case is clear. Approximately 7.5 million Americans in 34 states receive subsidies to offset the cost of health insurance purchased through the federally-run exchange.

On Friday, Feb. 6, the Wyoming Senate voted 19 to 11 to reject a bill to expand Medicaid, WyoFile.com reported.

Majority Floor Leader Sen. Eli Bebout said, according to Wyo.File reporting, “Now is not the time. I think being cautious, and doing it the Wyoming way is the way we do things.”

The Senate Health Committee defeated Gov. Bill Haslam’s proposal to expand Medicaid in a 7-4 vote yesterday, according to the Times Free Press. Later in the day, both the House and Senate voted to adjourn the special session that had been called to consider the measure.

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