Week in Washington is brought to you by Michael Cohen, PhD. Tune in each week to read the latest on healthcare policy and get a glimpse of what’s on the horizon.
Week in Washington
ACA OE Hits a Record High
CMS released data this week showing that a record number of Americans (16.3 million) signed up for ACA coverage during Open Enrollment. The high enrollment is likely driven by the continued enhanced subsidies as well as a larger outreach campaign by HHS. Many Southern states had enrollment increases in excess of 20% (Texas, Georgia, Tennessee, and Mississippi). Conversely, many State Based Marketplaces, especially in the Northeast, did not make enrollment gains.
HHS also released research on the impact of out of pocket caps on insulin. Starting January 1, 2023, insulin costs for Part D beneficiaries were capped at $35 a month. This cap goes into effect for Medicare Part B on July 1, 2023. HHS estimates that 1.5 million Medicare beneficiaries would have saved $734 million in Part D and $27 million in Part B if the caps had been in effect in 2020.
HHS released the 2023 FPL limits last week. Overall, the FPL limits increased 8% relative to prior years, which could make it easier to individuals to qualify for various safety net programs.
Discussions in Congress these days are centered on raising the debt ceiling. There is no timeline on this or concrete negotiating positions, but some Congressmen have raised the issue of limiting spending in Medicare or Medicaid.
Several lawsuits were filed as to whether states can regulate and restrict drugs that have been approved by the FDA. The lawsuits center on abortion bill bans but the results of the case could result in states having greater authority over any prescription drug.
KFF released new research on the experience of individuals that churn off Medicaid. Given the high number of redeterminations that will be occurring shortly, this question will be key for understanding its impact. The research examined the experience individuals had from 2016 to 2019 using MEPS data. The analysis found that 65% of people had some period of uninsurance. Additionally, over 40% of people who disenrolled from Medicaid/CHIP within in a year, re-enrolled with the program.
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