Morning Briefing
Summaries of health policy coverage from major news organizations
Medicaid Expansion Passes In Missouri
Missouri voters on Tuesday approved Medicaid expansion to many of the state’s poorest adults, making their conservative state the second to join the Obamacare program through the ballot during the pandemic. The Missouri ballot measure expands Medicaid to about 230,000 low-income residents at a time when the state’s safety net health care program is already experiencing an enrollment surge tied to the pandemic’s economic upheaval. The measure was supported by 53 percent of voters. (Roubein, 8/5)
The decision will mean adults between the ages of 19 and 65 whose income is at or below 138% of the federal poverty level will be covered. As of this year, that amounts to $17,608 for an individual and $36,156 for a household of four. The vote comes after repeated rejections by the GOP-controlled Legislature after the passage of the Affordable Care Act in 2010 allowed states to expand who can get coverage. (Erickson, 8/5)
In a few years, the Fairness Project’s ballot campaigns have gone from an untested tactic to the main approach for expanding the Affordable Care Act’s reach. Five states have expanded Medicaid through ballot initiatives since President Trump’s inauguration. A sixth, Virginia, did so after Democrats gained control of the state legislature. (Kliff, 8/4)
The COVID-19 pandemic has stripped millions of people of their jobs and health insurance. So far, those newly uninsured have yet to enroll in Medicaid. Enrollment in the public insurance program has begun to climb in most states in recent months, as expected. But the growth has been driven by states pausing Medicaid eligibility redetermination processes during the public health crisis. Health insurers and states health departments say they have not seen significant enrollment growth among people who have lost job-based health coverage. (Livingston, 8/4)
In Medicare news —
CMS issued a proposed rule on Tuesday that has to do with how it calculates Medicare disproportionate share payment adjustments for hospitals that serve a large number of low-income patients. To square with the law, the agency proposed including Medicare Advantage patient days in the Medicare fraction of the DSH payment adjustment calculation for fiscal years before 2014. This is the same policy that CMS adopted in its 2005 inpatient prospective payment system rule but was later vacated by a district court in 2012 because it didn't engage in notice-and-comment rulemaking. (Livingston, 8/4)
