Week In Washington: Lawsuits and Enrollment

December 20, 2018

Healthcare.gov Enrollment is Out: HHS released enrollment for the states that it operates Exchanges on behalf of. Overall year over year, on-Exchange enrollment in the healthcare.gov states is down only 4% relative to last year. There is large variation amongst the states. Some states, like Oklahoma, are ahead of last year’s total, and others, like West Virginia, were down almost 20%. As a reminder, one source of variation is that the expansion of Medicaid in Virginia dramatically reduced enrollment in that state.

A few other notes:

  • While re-enrollment (number of enrollees returning for coverage) was up year over year, new enrollment was down (almost 15%).
  • SBM states have generally done well (for example New York is ahead of last year’s mark). Overall, according to Charles Gabba, total Exchange enrollment stands (currently) at 11.16 million.
  • The data does NOT reflect effectuation nor does it necessarily project what the average enrollment will be for 2019 (it’s possible net attrition over the course of the year is higher this year).

Texas v US Update - A quick update on the Texas v. US case, where a Federal Judge ruled that the ACA is unconstitutional. The Judge could still issue a nationwide injunction or an injunction just for the plaintiff states (i.e., the states suing the Federal government). Nicholas Bagley has a map of the plaintiff states here.

Arkansas Work Requirement Update: The Center for Budget and Policy Priorities has a good summary of the effects the Arkansas work requirements have had on Medicaid enrollment. Since the program was enacted in Jun, 17,000 Arkansas Medicaid beneficiaries have lost coverage, which is approximately 22% of beneficiaries’ subject to the requirements.

New Policy Idea of the Week: As mentioned, those jockeying for the Democratic nomination in 2020 will roll out new health policy ideas over the coming months. The latest new policy was unveiled by Senator Elizabeth Warren. The bill proposes for the government to create a new office in HHS that would manufacture generic drugs to compete with drug companies as a way to lower drug costs. While this bill isn’t something that will pass in the next two years, it does show that lowering drug prices is likely to be a topic in the next Presidential campaign.