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
Washington’s focus this week has been on the looming shutdown. Congress must pass a budget before October 1 or the government will shutdown. As a reminder, a government shutdown does not halt mandatory programs (e.g., Medicare payments will still happen) but non-essential activities (e.g., regulations) generally slow down or halt altogether. Additionally, longer government shutdowns would have negative effects on the economy.
Covid was back in the news this week. The annual updated Covid shot is now available for individuals to receive. As opposed to previous years, the cost of the Covid vaccine will generally be borne by insurance (Covid shots are considered preventative services). However, as opposed to prior years, at home Covid test costs will not be borne by insurance. Covid rates currently have accelerated in recent weeks with hospitals seeing an uptick in patients being seen due to Covid.
MSP Rule Finalized
CMS finalized a rule that streamlines enrollment in Medicare Savings Programs (MSP). The rule will make it easier for individuals to be dually eligible. The implications of the rule span from increases in enrollment in individuals dually eligible to implications DSH allotments. The rules estimates an additional 0.44 million people enrollment in the QMB eligibility group and an additional 0.54 individuals enrolled in Medicaid. You can read the press release here and the rule itself is here
Research You can Use
Georgetown released two useful research pieces.
- Rate Review – The first provides an incredible summary of state rate review authority for the individual, small group, and large group markets. It identifies which states’ rate review authority includes prior approval and which states are filed and used.
- Medicaid Redetermination Impact on Exchanges – The second piece provides a good summary of the data we have to date on the migration of individuals from Medicaid to Exchanges as a result of Medicaid redetermination. Data through May shows that around 8% of those being redetermined are selecting Exchange Plans.
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