Weekly Medicaid RoundUp: Week of September 19th, 2016

Soundtrack for today’s RoundUp pessimist readers-  http://bit.ly/2d5jGkN


Or you can click the one for optimist readers – http://bit.ly/2d5kvKm


 EVERYTHING’S BIG IN TX, ESPECIALLY THE MCD BUDGET DEFICITS- Medicaid is looking at a $1.3B “shortfall” (translation – the evil legislature has told them they have $1.3B less to spend than they did last year) in the Lone Star State.


“NO DICE,” SAYS THE BIG HOUSE TO BUCKEYE STATE- When costs and enrollment was double what the Good Guvn’r Kasich (anybody seen that guy lately?) promised, Buckeyes left with the tab decided to try and make a few changes: require contributions to HSAs, patient cost-sharing (2% of annual income or $99, whichever is less), a healthy behavior program (like nearly everyone employed by a larger corporation has) and a workforce training program. Where on earth did those evil Buckeyes come up with such hateful ideas? CMS roundly rejected the idea (saying hundreds of thousands – no millions!- would lose coverage), laughed heartily at the request, patted OH on the back and murmured something about how cute it was they thought states had control over their Medicaid programs.


“BUT YOU’RE COOL,” SAYS THE BIG HOUSE TO THE WOLVERINE STATE- Early reports out of MI – where expansion enrollees above 100% FPL have been required to pay premiums and contribute up to 2% of their income into HSAs (where have I heard that before) – suggest that its going great! The majority of the new bennies say they are now healthier. 99% of them agree their coverage is affordable. To be fair, the MI way does not stop coverage if you don’t pay your premiums – but it does allow your tax refunds or lottery winnings to be garnished.


“P.S., YOU’RE PROBABLY SCREWED, TOO, BLUEGRASS STATE,” SAYS BIG HOUSE RIGHT BEFORE MIC DROP- Well, the bipartisan (  🙂  ) Kaiser Health News said it this week, so basically same difference. CMS will say it next week. You guessed it – KY is asking to make similar changes as OH asked for.


THAT ONE CHART, THOUGH- The bruising ACA took a few weeks ago with all that silliness about exchanges imploding and costs being way higher (who the heck cares about cost in Medicaid, anyway?) has just about ended. Forbes did manage to squeeze out one more salvo this week (check the twitter feed). Of special interest is the set of charts showing the 4 (count em’, 4!) CBO estimates (1 original, 3 revised) of ACA costs and enrollment. Try not to pull a Jon Stewart (make sure you put down your coffee before you read it).


BADGER STATE ONLY ASKS FOR HALF-BILLION MORE THIS YEAR; CALLS IT A SUCCESS- Last few years’ requested increases have ranged from $650M to $1.6B, so I guess it is a success?


PEACEFUL PROTESTS (IN THE KEYSTONE STATE)- 4 MCOs that were not awarded LTSS contracts in the recent PA procurement promptly burned down their health plans. Uh – Sorry that was a bad initial report from CNN – I mean they submitted protests using the legal system in place. And you can understand why they protested – there’s a lot of money at stake. Those MCO contracts are worth an estimated $5.4B in annual revenue.


FARRIS’S FANTASTIC FRAUD FOLLIES– Unfortunately not enough room this week. I promise you can get your fix on our twitter feed.


That’s it for this week. As always, please send me a note with your thoughts to clay@mostlymedicaid.com or give me a buzz at 919.727.9231. Get outside (leaves are falling) and keep running the race (you know who you are).


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