August 16, 2018
A relatively quiet week so a few odds and ends…..
ACA
- The deadline for the court case Texas v. United States was set for September. As a reminder, Texas and a few other states are suing on the basis that, the repeal of the individual mandate means that the market reform rules such as a prohibition of underwriting in the individual market should be nullified. You can read more about the court case here.
- The New Mexico co-op, the litigant that initially caused the delay in risk adjustment payments this summer, is suing to the block the emergency regulation HHS released to get them restarted. We will update as needed on this topic.
- Interesting analysis on year over year differences in the on-Exchange enrollment. All FPLs decreased except for the 250-400% FPL group. Presumably silver-loading and increase in APTC benefited this group the most. Interestingly enrollment in 100-250% FPL declined despite being unaffected by premium increases. You can read more here.
Medicare
- CMS posted inpatient hospital utilization and payment data here.
- Recently CMS proposed revamping Medicare payments for office visits (specifically collapsing the evaluation and management codes). An article in the New England Journal of Medicine argues this policy change will result in extra payments. You can read the article here.
Medicaid
One potential regulation that bears keeping an eye on is a regulation that would penalize non-citizens for accessing Medicaid (or ACA subsidy credits). In effect, if an individual or family member uses Medicaid, CHIP, Marketplace Coverage, etc. it could result in the individual or family member having their green card denied. This may mean significant effects for the CHIP program as 10.4 million citizen children have a one non-citizen parent (in this scenario even if the child is a citizen, their usage of Medicaid would result in the parent being denied a green card). According to Kaiser Family Foundation this could lead to an estimated 875,000 to 2 million citizen children with a noncitizen parent dropping Medicaid/CHIP coverage. You can read the analysis here.