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Illinois Medicaid companies made record-breaking profits during pandemic, investigation finds

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Early numbers are out for how much MCOs might have to pay back in the IL market due to pandemic-related underutilization.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

An analysis of quarterly and year-end financial statements of five Illinois Medicaid companies by the Better Government Association revealed an unprecedented increase in profits from April through December of 2020.

Meridian Health Plan of Illinois, IlliniCare Health Plan and Molina Healthcare of Illinois experienced a $282 million increase in profits from the same nine-month period in 2019. 

Blue Cross and Blue Shield of Illinois and Aetna Better Health of Illinois reported large profits on a national scale, though exact numbers from the state level have yet to be determined, according to the Better Government Association’s May 24 report

While the number of Illinois Medicaid members increased due to job loss during the pandemic, most members deferred elective treatment, a scenario that occurred across the country and resulted in larger profits for payers.

A spokesperson for the Illinois Department of Healthcare and Family Services told the Better Government Association earlier this month that “initial incomplete figures indicate HFS would recoup over $120 million” from the insurance firms for the 2020 calendar year. 

“We will recoup more from the health plans than we otherwise would,” she said.

 
 

Clipped from: https://www.beckershospitalreview.com/payer-issues/illinois-medicaid-companies-made-record-breaking-profits-during-pandemic-investigation-finds.html

 
 

 
 

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Guam officials eye Medicaid cliff

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Guam’s FMAP will go from 89% to 55% for FY 2022.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

HAGÅTÑA (The Guam Daily Post) — Local health officials are keeping a keen eye on the expiration of expanded Medicaid assistance as they map out their budgetary needs for the next fiscal year.

The federal government covers a certain share of Medicaid expenses based on the Federal Medical Assistance Percentage for the state or territory.

The FMAP for Guam has fluctuated recently but has been 55% in the past, meaning the local government needed to put up a 45% share to get the federal government to cover the rest.

In fiscal year 2019, Congress raised the FMAP to 100%. In fiscal 2020 and 2021, the FMAP was set to 83% and then to about 89%, due to the Covid-19 pandemic. Moreover, the island’s Medicaid cap was lifted to about $130 million for fiscal year 2020 and 2021.

About $122 million of federal funding was spent out of Medicaid in fiscal 2020, while Guam spent only $12 million.

But these expansions last up to the end of this fiscal year, and as Department of Public Health and Social Services Director Arthur San Agustin stated Thursday, the U.S. Congress has not set any additional funding after fiscal year 2021.

This means that for fiscal 2022, Guam is expected to revert to a prior Medicaid cap of about $19 million to $20 million, and a match of 55% for Guam’s 45%.

“An ongoing fiscal challenge of this program is to determine the amount needed to match Medicaid federal funds without knowing the percent of Guam’s required match. Unlike other programs, their match levels have remained constant for years, which allows for better fiscal planning and decision-making,” San Agustin said, referring to the uncertainty about where numbers will ultimately land.

This is just as much a concern for the Guam Memorial Hospital Authority.

“We’re also kind of concerned that, come Sept. 30, if the Medicaid FMAP goes back to the 55%/45%, that’s really going to have a significant impact on our Medicaid reimbursements,” GMHA Administrator Lillian Perez-Posadas told lawmakers Thursday. “So I hope you’re all paying attention to that situation and maybe we can find a way to collectively make sure that doesn’t happen.”

DPHSS noted a drastic decrease in federal funding for its Division of Public Welfare within its fiscal 2022 budget. According to Tess Arcangel, the division director, this was due to lower anticipated Medicaid funding. Arcangel said there is a federal proposal to remove the Medicaid cap but it doesn’t include the FMAP.

She didn’t name the proposal, but may have been referring to the Insular Area Medicaid Parity Act, of which Guam Delegate Michael San Nicolas is a co-sponsor.

San Nicolas did not comment about any specific bills but stated that he and his colleagues are working closely “to secure full and permanent inclusion of Guam and all territories in Medicaid, and are confident that we will achieve that in this 117th Congress.”

When asked if he foresaw at least an interim solution before the Medicaid expansions expire, San Nicolas said an interim solution is “very likely” but so is a permanent one.

Because of concerns caused by temporary fixes to Medicaid issues for the territories, San Nicolas and other territorial representatives have called for a permanent solution.

Meanwhile, a positive note for Guam has been the inclusion of citizens of Freely Associated States in Medicaid, as part of the $900 billion federal relief package signed into law in December. There is no Medicaid cap on residents under the Compacts of Free Association, although the match may still revert to 55%/45%, according to Arcangel.

Currently, DPHSS has about 8,000 COFA migrants under the local Medically Indigent Program. The department submitted a statement amendment to shift them to Medicaid effective Jan. 1, but has not received approval from the Centers for Medicare and Medicaid Services, Arcangel said.

If the transfer occurs, then funding intended for MIP could be used as a local match for Medicaid, she said.

 
 

Clipped from: https://mvariety.com/news/guam-officials-eye-medicaid-cliff/article_8e55d268-bc9b-11eb-9027-2bc01af6fc55.html

 
 

 
 

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Bill cutting procedural roadblocks for kids with Medicaid picks up steam in Texas legislature

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Texas lawmakers are working to make it easier to sign up and stay enrolled for Medicaid kids.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

AUSTIN (Nexstar) — A bill that aims to keep eligible children from getting kicked off Medicaid due to procedural roadblocks is picking up steam at the Capitol.

House Bill 290, authored by State Rep. Philip Cortez (D-San Antonio), has already passed in the House and had its first hearing in Senate committee on Friday.

Right now, Texas Health and Human Services sends requests for Medicaid eligibility verification to families within eight months of qualifying and only gives them limited time to respond.

The clock starts ticking as soon as HHSC mails the paperwork, and families only have 10 days to get the necessary documents and mail it back or lose their child’s coverage.

Dr. Lindy McGee, representing the Texas Pediatrics Society, has been fighting for the bill to help patients like hers.

MOST READ: Texas man sued after leaving negative company review

“This current process is just burdensome and unnecessary at best and harmful to the child’s health and well being at worst,” Dr. McGee said. “They would qualify for Medicaid, they need Medicaid, and they need the services Medicaid offers. But because of paperwork and mail and this process, they end up losing their coverage.”

She explained many times a family doesn’t even realize they missed a deadline.

“The patients show up, they may not realize that they don’t have coverage. They may end up having to pay out of pocket, which can be extremely expensive. Or if we do catch it, it’s a missed appointment, and that they then have to try and get their coverage rescheduled appointment,” Dr. McGee said.

She explained this can lead to even more severe problems for those needing early development specialists.

“I could easily have a two-and-a-half year old come in for a checkup; I’m concerned that patient may have autism. We know that early services makes a huge difference in autism,” Dr. McGee said. “It takes a while to get into the developmental pediatrician. So I make that referral and make speech therapy referrals. But then by the time the appointment comes up the patient, the family has inadvertently lost Medicaid, and so they’re unable to get those important follow up appointments. They have to come back to see me. We start the process all over again.”

MOST READ: Texas Capitol staffer drugging allegations likely fabricated to cover up infidelity, DPS report says

The bill also aims to knock these mid-year checkpoints from four to one.

“Ensuring that fewer of these vulnerable children cycled on and off the program or were forced to go without health insurance,” Republican Senate sponsor of the bill Lois Kolkhorst of Brenham said during Friday’s hearing.

The bill has bipartisan support, with only 16 Republican lawmakers voting it down in the 150-member House earlier this session. That opposition could be related to mere partisan policy.

“The fact that the bill has to do with Medicaid, it’s kind of a hot button issue, but the fact of the matter is, this has to do with kids covered by Medicaid and it doesn’t have anything to do with Medicaid expansion,” Katie Mitten, a health policy associate with Texans Care for Children, said.

She said she hopes the bill will continue to get support from both sides of the aisle.

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“This bill is really important for making sure that kids are healthy, making sure that they’re able to go to the doctor and get any sort of care that they might need,” Mitten said.

The bill still awaits a vote in committee. If approved, it heads to the Senate floor.

 
 

Clipped from: https://www.kxan.com/news/texas-politics/bill-cutting-procedural-roadblocks-for-kids-with-medicaid-picks-up-steam-in-texas-legislature/

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New House, Senate bills aim to make telehealth expansion permanent in Medicare, Medicaid

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Bills have been introduced to continue the telehealth expansions under the pandemic both for Medicare and pediatric Medicaid.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

New bills introduced in the House and Senate signal Congress’ intent to make telehealth flexibilities in Medicare and Medicaid permanent after the pandemic ends. (Getty Images)

A pair of bills recently introduced in the House and Senate aim to ensure that a boom in telehealth use during the pandemic does not go away.

A House bill introduced Monday and a Senate bill introduced Tuesday both aim to make certain telehealth flexibilities permanent for Medicaid and Medicare beneficiaries.

“The pandemic has created challenges for everyone, but it’s also shown us that technology can provide safe and dependable communication between patients and their doctors,” said Rep. Jason Smith, R-Missouri, one of the co-sponsors of the House bill alongside Rep. Josh Gottenheimer, D-New Jersey. “Innovations including telehealth and audio-only capabilities will improve efficiency, reduce costs and increase access to healthcare providers.”

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At the onset of the pandemic, the Centers for Medicare & Medicaid Services waived key barriers to telehealth use, enabling providers to offer audio-only telehealth services and ensuring that originating site requirements were removed. The new flexibility helped greatly expand the use of telehealth as providers could get Medicare reimbursement and help patients scared of going to the doctor’s office or hospital for fear of contracting COVID-19.

But the telehealth flexibilities will only last through the extent of the COVID-19 public health emergency, which will eventually lapse as the pandemic gets under control.

RELATED: 1 in 4 Medicare patients used telehealth during peak of pandemic with majority using only telephones: KFF

CMS officials have said that they need Congress’ help to make the flexibilities permanent.

The House’s Permanency for Audio-Only Telehealth Act would enable audio-only telehealth services for Medicare enrollees.

The legislation would also remove geographic and originating site restrictions to ensure that Medicare beneficiaries’ homes can be telehealth originating sites for audio-only services.

The Medical Group Management Association applauded the legislation.

“During the COVID-19 pandemic, audio-only visits have provided a lifeline to patients who are unable to attend visits in person or participate in telehealth visits due to lack of broadband access or necessary equipment to facilitate the visits,” said Anders Gilberg, MGMA’s senior vice president of government affairs.

The bill builds on similar legislation introduced in the House in March that would enable audio-only telehealth services for Medicare Advantage plans. Currently, providers can offer telehealth services under MA plans but only if they involve a video component.

Congress is not just looking at how to expand access to telehealth for Medicare.

Sens. Tom Carper, D-Delaware, and John Cornyn, R-Texas, introduced legislation on Tuesday that seeks to increase telehealth access for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries, according to a report in Politico.

RELATED: Top health experts talk telehealth regulation, health inequality

The legislation would require the Department of Health and Human Services (HHS) to give guidance to states to increase telehealth access for CHIP and Medicaid. This would include outlining what services can be reimbursed by telehealth.

The bipartisan nature of both the House and Senate legislation underscores the likelihood they could get through Congress and signed into law.

HHS Secretary Xavier Becerra has repeatedly underscored the need for legislative help if the boom in telehealth wants to continue.

“COVID has taught us so much,” Becerra said during his confirmation hearing in February. If we don’t learn from COVID how telehealth can save lives then we are going to be in trouble.”

Clipped from: https://www.fiercehealthcare.com/payer/new-house-senate-bills-aims-to-make-telehealth-expansion-permanent-medicare-medicaid

 
 

 
 

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Bipartisan group of lawmakers reintroduces bill to give inmates Medicaid access

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Efforts to repeal the Medicaid inmate exclusion continue.

 
 

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

© Greg Nash

A bipartisan group of lawmakers on Tuesday reintroduced legislation that would provide inmates with access to Medicaid.

A press release from Rep. Annie Kuster’s (D-N.H.) office stated that passing the Humane Correctional Health Care Act would repeal Medicaid Inmate Exclusion, which keeps incarcerated Medicaid enrollees from accessing benefits and shifts the “cost burden to states and counties.”

 
 

 
 

The Humane Correctional Health Care Act had previously been introduced in 2019.

If passed, the bill would require the U.S. Comptroller General to submit a report three years after its passing that went over how many inmates receive medical assistance under title XIX of the Social Security Act; what access inmates had to health care; the quality of services provided; how health care coverage under a state plan affected an inmate’s chances of reoffending; and other information the Comptroller General deemed relevant to the health of inmates.

A new report every five years would be issued after the first report.

“The Medicaid Inmate Exclusion (MIE) is an outdated, flawed policy which contributes to a vicious cycle of addiction, incarceration, and recidivism that devastates families and communities, and drains state and local budgets while harming public health and our economy,” Kuster said in the press release.

“The Humane Correctional Health Care Act would help break the cycle by investing in adequate treatment and ensuring individuals who are involved in the justice system have the opportunity to heal, recover, and make valuable contributions to our communities,” she added.

 
 

Clipped from: https://thehill.com/homenews/house/555375-bipartisan-group-of-lawmakers-reintroduces-bill-to-give-inmates-access-to?rl=1

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PhRMA files federal lawsuit to get rid of controversial Medicaid drug rebate rule

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A pharma industry association is asking a judge to not include copay assistance to patients in the “best price” calculation used in Medicaid rebate programs.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

Drugmakers are going to court to overturn a rule that requires them to include copay assistance into Medicaid drug rebate amounts. (zimmytws/GettyImages)

The pharmaceutical industry wants a federal judge to ditch a controversial rule that requires drugmakers to factor copay assistance and discounts into rebates offered to Medicaid.

The Pharmaceutical Research and Manufacturers of America (PhRMA), a top pharma lobbying group, sued the Department of Health and Human Services in the U.S. District Court for the District of Columbia on May 21 over the rule finalized back in December 2020. The lawsuit claims that the rule directly contradicts federal law surrounding Medicaid rebates.

“CMS’ final rule contradicts the plain text of the Medicaid rebate statute by improperly requiring manufacturers to treat financial assistance that they provide to patients to help defray their co-pays and other out-of-pocket costs as part of the ‘price’ a manufacturer offers to commercial insurers,” the lawsuit said.

If the lawsuit is successful, it will roll back an effort by the Trump administration to target assistance such as copay cards that the agency has said does not fully help patients. The rule does not go into effect until Jan. 1, 2023.

The rule touched on a major battle between insurers and pharmacy benefit managers (PBMs) and the drug industry.

Drugmakers that want Medicaid coverage of their products must agree to provide those drugs at the same costs as those given to commercial purchasers. Manufacturers agree to pay rebates to the states to make up the difference.

RELATED: MACPAC calls for Congress to eliminate the drug rebate cap

The program requires manufacturers to report to states the “best price” of a drug that is calculated based on the lowest price available to a wholesaler, retailer or provider and the average manufacturer sales price, which is the average price paid to wholesalers and retail pharmacies. The rebate for brand-name drugs is based on the difference between the best price and average manufacturer price for a product. A generic drug rebate is based on 13% of an average manufacturer price.

But the rule now makes clear that copay assistance cards and other cost-sharing assistance offered by the drugmaker must be counted in the best price calculation.

“This change will help ensure that when patients use a copayment assistance card provided by a drug manufacturer, the value is passed through to the patient’s deductible or cost-sharing obligation in full, as opposed to offsetting what the health insurance company would have to normally reimburse the pharmacy,” according to a CMS press release from December on the final rule.

The rule also comes as insurers and PBMs have adopted copay accumulator programs that limit the impact of a manufacturer’s assistance on a patient’s deductible or out-of-pocket cost limit.

The pharmaceutical industry argues the accumulator programs seek to undermine patient assistance tools, while the PBM industry counters the programs could cause patients to choose more expensive drugs over cheaper options and increase healthcare costs for employers.

RELATED: Insurers worry drug companies could game changes to Medicaid rebate program in new rule

PhRMA argued in the legal filing that the rule directly contradicts the best price text in the Medicaid rebate program’s statute.

The law defines the best price as the lowest price made available to any “wholesaler, retailer, provider, health maintenance organization, nonprofit entity or governmental entity within the United States.”

But drugmaker assistance is not part of the price available to any of those purchasers, PhRMA argued.

“Manufacturer assistance to patients is not part of the ‘price’ available from the manufacturer to any best-price-eligible purchaser, with or without an accumulator adjustment program,” the lawsuit said. “Accumulator adjustment programs deploy only after a drug has been paid for and dispensed and diverts the assistance that the manufacturer provided to the patient, against the manufacturer’s will and often without its knowledge.”

The Centers for Medicare & Medicaid Services did not immediately return a request for comment on the lawsuit.

Clipped from: https://www.fiercehealthcare.com/payer/phrma-files-federal-lawsuit-to-get-rid-controversial-medicaid-drug-rebate-rule

 
 

 
 

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Wisconsin Republicans to quickly kill Medicaid expansion

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State lawmakers refuse the Governor’s last attempts to force them to pass expansion legislation.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Story By AP
Local News Published 05/25/2021 12:40PM

Madison Republicans who control the Wisconsin Legislature planned Tuesday to convene then immediately end a special session called by Democratic Gov. Tony Evers to expand Medicaid.

Rejecting expansion means Wisconsin will miss out on a one-time bonus of $1 billion in federal money provided under the federal coronavirus relief bill.


Both the Senate and Assembly planned to gavel into the session at 1 p.m. and end it straight away with no debate.


Democrats have for years advocated to expand eligibility for the state’s Medicaid program known as BadgerCare Plus. But Republicans have resisted full expansion, even though 38 other states have done it and taken the federal money that comes with it.


Evers last week called a special session for Tuesday, promising to use $850 million of the $1 billion in federal money the state would receive for a host of economic development projects. He called for saving the other $150 million.


“Don’t let politics get in the way of our economic recovery,” Evers tweeted Tuesday. “Expand BadgerCare so we can invest $1 billion into bouncing back from this pandemic.”


Republicans have said if Evers wanted to fund those projects, he could instead tap some of the $2.5 billion coming to the state under the coronavirus stimulus bill.


Accepting federal money available through the Affordable Care Act would increase the minimum income threshold to qualify from 100% of the federal poverty rate to 138%, which would increase the income eligibility for a single person from $12,880 a year to $17,774.


That would make about 91,000 more people eligible for BadgerCare Plus in Wisconsin.


Evers and Democrats have said it would be foolish for Wisconsin to pass up the additional federal money that comes with accepting Medicaid expansion. In addition to the one-time $1 billion approved under the coronavirus stimulus bill, Wisconsin would see about $635 million in additional savings over the next two years due to a higher federal reimbursement under Medicaid expansion, based on estimates from the nonpartisan Legislative Fiscal Bureau.


Wisconsin would have seen an additional $2.8 billion in savings between 2013 and 2019 had it accepted full Medicaid expansion, according to the Fiscal Bureau.

 
 

Clipped from: https://www.wjfw.com/storydetails/20210525124053/wisconsin_republicans_to_quickly_kill_medicaid_expansion

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Judge sets Medicaid expansion trial date

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The Missouri effort to fund voter-approved expansion has moved to the courts.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Judge Jon Beetem hears oral arguments Thursday, Aug. 30, 2018, in a hearing in Cole County Circuit Court. Photo by Julie Smith / News Tribune.

The lawsuit seeking to force Missouri to expand Medicaid coverage under a voter-approved constitutional amendment will go to trial June 18 in Cole County.

On Wednesday morning, Circuit Judge Jon Beetem met in a conference call with Attorney General Eric Schmitt’s office and attorneys for the three people suing for coverage. In an online notation with the case, Beetem ordered a “hearing on Stipulated Facts.”

That means there is no dispute about what is happening. Instead, it is a dispute about how the law should be applied.

“Both sides will make their case to the judge, and the judge will issue a decision in due course,” Marianna Deal, spokeswoman for Schmitt’s office, wrote in email. “Beyond that, we aren’t going to comment further on pending litigation.”

The lawsuit filed May 20 seeks an order for the Department of Social Services to allow newly eligible Missourians to enroll and receive coverage starting July 1. The quick trial date means it is possible Beetem will rule before that date, said attorney Lowell Pearson, who is representing the plaintiffs along with Chuck Hatfield.

“Certainly, on the plaintiff’s side, we want to move the case forward,” Pearson said.

The initiative approved in August 2020 directed that Missourians ages 19-64 would become eligible for Medicaid coverage if their household income is below 138 percent of the federal poverty guideline, or $17,774 a year for a single person. For a household of four, the limit is $36,570.

Before passage of the initiative known as Amendment 2, Missouri was one of 14 states that had not expanded Medicaid under the Affordable Care Act. The law originally made expansion mandatory, but the U.S. Supreme Court ruled in 2012 penalty provisions that made Medicaid an all-or-nothing program were unenforceable.

Adults who have no other qualifying condition such as a disability are only eligible currently if they have children and income lower than about $4,800 a year for a family of four.

Under the Affordable Care Act, often referred to as Obamacare, the state would pay 10 percent of the expense with the federal treasury underwriting the remainder.

In his January budget proposal, Gov. Mike Parson recommended adding $1.9 billion to the state budget to cover the cost of the approximately 275,000 people who would become eligible. That amount included about $130 million in state general revenue.

The budget delivered to Parson by lawmakers, however, did not include the spending. Opponents argued the long-term cost was too much for the state to bear and constitutional provisions in place when the initiative went before voters made the amendment void because it did not include a revenue source for the state’s share.

Pearson and Hatfield argued in their filing the initiative did not violate any other constitutional provision because it did not direct the state spend any specific amount on the expansion group or Medicaid as a whole.

The General Assembly cannot predict with certainty the number of individuals who will enroll in MO HealthNet during the next fiscal year or the health needs that those individuals will have during the next fiscal year,” the lawsuit states.

The state can decide how much it is willing to spend and spread the amount over the entire population, they wrote. Or, they wrote, lawmakers could, as they do every year, add enough money through a supplemental appropriation bill to pay for all required services.

The decision Wednesday means both sides will work on a document stating the facts of the case. Each side will also file briefs setting out their view of the laws and precedents that will determine the outcome, Pearson said.

There is unlikely to be any witness testimony in the trial, which is set to begin at 3 p.m. on a Friday afternoon, Pearson said.

“The lawyers will argue what that means, and Judge Beetem will decide,” he said.

Pearson said he thinks a ruling by July 1 is likely.

“We did discuss the July 1 eligibility deadline and asked for a hearing as soon as possible,” Pearson said.

However Beetem rules, it is unlikely it will be the final word on the case. The losing side is almost certain to appeal.

If the state does not expand Medicaid coverage, it will give up a chance to receive about $1.2 billion in federal support for the traditional Medicaid program. The American Rescue Plan passed in March increases the federal share of the traditional program by 5 percent for states that expand Medicaid in the next two years.

The Missouri Independent is a nonprofit, nonpartisan news organization covering state government and its impact on Missourians.

 
 

Clipped from: https://www.newstribune.com/news/local/story/2021/may/27/judge-sets-medicaid-expansion-trial-date/872737/

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Medicaid Enrollment Spikes During Pandemic

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Medicaid rolls have surged 17.7% since February 2020.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

In the 12 months ending in March 2021, nearly 8.5 million more Americans enrolled in Medicaid, the federal-state health program for low-income people, according to a new analysis by the Georgetown University Center for Children and Families.

Nationwide, that’s a 17.7% increase since February 2020, the month before the coronavirus pandemic hit the United States. Medicaid enrollment continues to rise, according to the analysis, which includes data from 36 states as of March 2021.

The biggest annual increases were in Utah (37%) and Nebraska (31%), where expanded Medicaid was offered to low-income adults for the first time in 2020.

Among the states that already had expanded Medicaid to low-income adults under the Affordable Care Act, Florida, Illinois, Indiana, Kentucky, Minnesota and Missouri experienced the steepest increases, with enrollment rising 24% or more in all six states. The lowest rates of increase, 12% or less, were in Alaska, Arkansas, Maryland, Michigan and Tennessee.

In addition to pandemic-related job and income losses, which resulted in millions more Americans qualifying for the low-income health program, the study’s authors attributed the substantial spike in enrollment to expansions for adults in three states: Idaho, Nebraska and Utah. A March 2020 congressionally mandated freeze on kicking people off Medicaid rolls also contributed to the higher enrollment number.

According to the Kaiser Family Foundation, nationwide Medicaid enrollment totaled 78.9 million as of November 2020.

 
 

Clipped from: https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2021/05/26/medicaid-enrollment-spikes-during-pandemic

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Texas Senate passes bill extending Medicaid coverage for new moms

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TX added extended maternity coverage to its Medicaid program this week.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

AUSTIN (Nexstar) — After a marathon day debating legislation with the end of session deadlines looming, the Texas Senate approved a measure early Thursday morning to increase Medicaid coverage for new mothers.

The committee substitute to House Bill 133 would raise Medicaid coverage for new Texas moms to six months after the birth of her baby. Currently, two months are covered.

The bill passed out of the Senate in a 30-1 vote.

“We will become one of the first states in the nation to extend it beyond two months,” State Sen. Lois Kolkhorst, R-Brenham, who chairs the chamber’s Health and Human Services Committee, said during the bill layout after 3:00 a.m. Thursday. She noted Illinois has 12 months, Georgia has six months and Missouri only allows 12 months for substance abuse and mental health. According to Kolkhorst, four states have pending waivers with the federal government.

“We are one of only two states that have state-funded 12 month postpartum services— us and California,” Kolkhorst said.

The version passed by the House proposed a full year. The bill’s author, State Rep. Toni Rose, D-Dallas, hoped her legislation would be approved with the full year intact, but was optimistic about its movement earlier in the session.

“There are some concerns but we’re working them out,” Rose acknowledged in April, explaining that she had already been working with Senators to compromise at that point.

“Women without comprehensive health care is the number one cause of death amongst women after pregnancy,” Rose said last month. “This legislation will save lives.”

During the pandemic, federal waivers allowed new moms to remain on Medicaid longer than two months. HB 133 would make permanent some of the changes granted by the waivers.

HB 133 was part of a legislative healthcare package supported by Speaker Dade Phelan, R-Beaumont.

Supporters of HB 133 believe it would help cover finances for critical care. Opponents of the bill expressed concerns about the cost to fund the extended coverage.

The legislation returns to the House for approval before it can advance to the Governor’s desk.

 
 

Clipped from: https://www.conchovalleyhomepage.com/news/texas-politics/texas-senate-passes-bill-extending-medicaid-coverage-for-new-moms/