WHITE HOUSE VIDEO: PRESIDENT OBAMA SIGNS THE MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT

WHITE HOUSE REPORT ON CONSEQUENCES OF STATES NOT EXPANDING MEDICAID

FROM:   THE WHITE HOUSE 

White House Report: Missed Opportunities and the Consequences of State Decisions Not to Expand Medicaid

 Today, the Council of Economic Advisers released a report, Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid, which details the effects of state decisions regarding Medicaid expansion on access to care, financial security, overall health and well-being of residents, and state economies. 

The Affordable Care Act has expanded high‐quality, affordable health insurance coverage to millions of Americans. One important way in which the Affordable Care Act is expanding coverage is by providing generous financial support to States that opt to expand Medicaid eligibility to all non‐elderly individuals in families with incomes below 133 percent of the Federal Poverty Level.

To date, 26 States and the District of Columbia have seized this opportunity, and since the beginning of the Affordable Care Act’s first open enrollment period, 5.2 million people have gained Medicaid or Children’s Health Insurance Program (CHIP) coverage in these States, a tally that will grow in the months and years ahead as Medicaid enrollment continues. In contrast, 24 States have not yet expanded Medicaid—including many of the States that would benefit most and sometimes because State legislatures have defied even their own governors—and denied health insurance coverage to millions of their citizens. Researchers at the Urban Institute estimate that, if these States do not change course, 5.7 million people will be deprived of health insurance coverage in 2016. Meanwhile, these States will forgo billions in Federal dollars that could boost their economies.

This analysis uses the best evidence from the economics and health policy literatures to quantify several important consequences of States’ decisions not to expand Medicaid. That evidence, which is based primarily on careful analysis of the effects of past policy decisions, is necessarily an imperfect guide to the future, and the actual effects of Medicaid expansion under the Affordable Care Act could be larger or smaller than the estimates presented below. However, this evidence is clear that the consequences of States’ decisions are far‐reaching, with implications for the health and well‐being of their citizens, their economies, and the economy of the Nation as a whole.

HHS SECRETARY ANNOUNCES DELIVERY SYSTEM REFORM FOR HEALTH CARE

FROM:  U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

New funding gives states and innovators tools and flexibility to implement delivery system reform

Health and Human Services Secretary Kathleen Sebelius today announced new delivery system reform efforts made possible by the Affordable Care Act that offer states and innovators tools and flexibility to transform health care. 

HHS announced twelve prospective recipients receiving as much as $110 million in combined funding, ranging from an expected $2 million to $18 million over a three-year period, under the Health Innovation Awards program to test innovative models designed to deliver better care outcomes and lower costs.  Examples include projects to provide better care for dementia patients, improve coordination between specialists and primary care physicians, and to improve cardiac care. Round two of the Health Care Innovation Awards program focuses on four priority areas: rapidly reducing costs for patients with Medicare and Medicaid; improving care for populations with specialized needs; testing improved financial and clinical models for specific types of providers, including specialists; and linking clinical care delivery to preventive and population health.  The twelve prospective recipients will test models in all four categories and spanning 13 states.  Additional prospective recipients will be announced in the coming months.

Also today, HHS made up to $730 million available as part of the State Innovation Model initiative to help states design and test improvements to their public and private health care payment and delivery systems.  Project goals are to improve health, improve care, and decrease costs for consumers, including Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries.

“As a former governor, I understand the real sense of urgency states and local communities feel to improve the health of their populations while also reducing health care costs, and it’s critical that the many elements of health care in each state – including Medicaid, public health, and workforce training – work together,” Secretary Sebelius said.  “To help, HHS will continue to encourage and assist them in their efforts to transform health care.

“These efforts will strengthen federal, state, and local partnerships, encourage broad stakeholder engagement, and capitalize on federal resources to ensure greater transformation of delivery of health care services,” said Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner.

The twelve innovative projects announced today represent the first batch of prospective recipients for round two of Health Care Innovation Awards program funding.  In 2012, 107 organizations located in urban and rural areas, all 50 states, the District of Columbia and Puerto Rico received awards through round one of the initiative.  

As part of the State Innovation Model initiative, states, territories and the District of Columbia can apply for either a Model Test award to assist in implementation or a Model Design award to develop or enhance a comprehensive State Health Care Innovation Plan.   Up to 12 states will be chosen for state-sponsored Model Testing awards ($700 million available) and up to 15 states will be chosen for state-sponsored Model Design work ($30 million available).

Examples of ongoing state-led health care innovations include development of advanced primary care networks supported by statewide health information technology systems and models that coordinate care seamlessly across providers.  The second round of the State Innovation Models will continue to support and advance this good work.

HHS SAYS "95% OF UNINSURED LATINOS COULD QUALIFY FOR LOWER COSTS ON HEALTH CARE COVERAGE"

FROM:  HEALTH AND HUMAN SERVICES DEPARTMENT 

Eight in 10 uninsured Latinos may qualify for Medicaid, CHIP or lower costs on monthly premiums in the Health Insurance Marketplace

95 percent of uninsured Latinos could qualify for lower costs on coverage if all states expanded Medicaid

A new report issued today by the Department of Health and Human Services (HHS) finds that that nearly 8 in 10 uninsured Latinos may qualify for Medicaid, the Children’s Health Insurance Program (CHIP),  or lower costs on monthly premiums through the Health Insurance Marketplace.  If all states took advantage of new opportunities to expand Medicaid coverage under the Affordable Care Act, 95 percent of uninsured Latinos might qualify for Medicaid, the Children’s Health Insurance Program (CHIP), or tax credits to help with the cost of premiums in the Marketplace.

“The health care law addresses longstanding inequalities that have affected minority communities across the nation, including lack of access to affordable health insurance coverage,” said Health and Human Services Secretary Kathleen Sebelius.  “Thanks to the Affordable Care Act, 10.2 million uninsured Latinos have the opportunity to purchase quality, affordable coverage through the Marketplace, and as many as 8 million of those could get a break on costs.”

According to today’s report, 1 in 4 uninsured individuals who are eligible for the Marketplace nationwide are Latino (10.2 million out of 41.3 million individuals).   The majority (62 percent) live in California, Texas, and Florida; about half (4.6 million or 46 percent) are between the ages of 18 and 35.

Among those Latinos who are eligible for Marketplace coverage nationwide, about 3.9 million may be eligible for lower costs on monthly premiums, and 4.2 million may be eligible for Medicaid or CHIP.  The report details uninsurance rates by state and provides several examples of what premiums might look like for Latinos living in major metropolitan areas.  For example, a 27 year old with an income of $25,000 living in Miami, Florida could pay as little as $87 for a bronze plan.  In Houston, Texas he or she could pay as little as $99 after factoring in premium tax credits.

The majority (63 percent) of uninsured Hispanic Americans who are eligible for coverage in the Marketplace either speak English as a first language, or “very well” as a second language. About one-third (37 percent) rely on Spanish, and 27 percent live in a household without an English-speaking adult present. This is why from the beginning HHS’s outreach has been a bilingual effort.  Since October 1, the diverse Latino community has had access to multiple resources to help with enrollment in the Marketplace, including applying by phone with trained call center staff offering bilingual help, or in person with trained specialists in local communities.

Latinos can enroll in Spanish through CuidadodeSalud.gov where consumers can create accounts, complete an online application, and shop for health plans that fit their budget and needs.

HHS ANNOUNCES OVER 100,000 AMERICANS SELECTED HEALTH PLANS IN FIRST REPORTING PERIOD

FROM:  U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 
106,185 Americans selected health plans in first reporting period of open enrollment
975,407 customers through the process but have not yet selected a plan; an additional 396,261 
assessed or determined eligible for Medicaid or CHIP

Detailing results of the first reporting period (Oct. 1-Nov. 2, 2013) of the Health Insurance Marketplace’s Open Enrollment, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that 106,185 individuals have selected plans from the Marketplace, and another 975,407 have made it through the process by applying and receiving an eligibility determination, but have not yet selected a plan.  An additional 396,261 have been determined or assessed eligible for Medicaid or the Children’s Health Insurance Program (CHIP).

“The promise of quality affordable coverage is increasingly becoming reality for this first wave of applicants to the Health Insurance Marketplaces,” Secretary Sebelius said. “There is no doubt the level of interest is strong. We expect enrollment will grow substantially throughout the next five months, mirroring the pattern that Massachusetts experienced. We also expect that the numbers will grow as the website, HealthCare.gov, continues to make steady improvements.”

The following key findings are among many newly available data reported today in an issue brief from HHS that highlights national and state-level enrollment-related information:

502,466 Americans, in just the first month of implementation, are positioned to have health coverage in 2014;
Of those, 106,185 Americans have selected plans from the state and federal Marketplaces; and
396,261 Americans have been determined or assessed eligible for Medicaid or CHIP;
975,407 have made it through the process by applying and receiving an eligibility determination and have not yet selected a plan.
Today’s report includes breakouts of enrollment-related data by state, including each of the 50 states and the District of Columbia. The report groups the states into the Federally-facilitated Marketplace (FFM) (defined as those states where HHS is running the Marketplace or states where HHS is doing so in partnership), and state-based Marketplaces (SBMs). In some cases only a partial SBM dataset was available.

In total, 106,185 Americans selected a Qualified Health Plan (QHP) through the Marketplace during the first reporting period of Open Enrollment. Enrollment figures include those who have selected a plan and have or have not yet paid the first month’s premium. Of the people who have selected a plan, 79,391 (74.8 percent) enrolled though a SBM, while the other 26,794 people (25.2 percent) enrolled through the FFM.  Additionally, 396,261 Americans have been assessed or determined eligible for Medicaid or CHIP. SBMs that provided data for the report accounted for 212,865 (53.7 percent) of those determinations, while the FFM accounted for 183,396 (46.3 percent) of them.  Forthcoming data will enumerate those who applied directly to a state Medicaid/CHIP office.

The report characterizes past experiences in health insurance enrollment patterns, noting typical low initial enrollment in, for example, the Federal Employees Health Benefits Program Medicare Part D, Massachusetts’ Commonwealth Care, the Children’s Health Insurance Program and the Pre-existing Condition Insurance Plan created under the Affordable Care Act.

The report also addresses Marketplace customer service, outreach and web traffic.  It found that there have been an estimated 26,876,527 visitors on the SBM and FFM websites. There have also been an estimated 3,158,436 calls to the SBM and FFM call centers.