MA growth continues but the pace is slowing
While still positive, this year demonstrates a marked deceleration in Medicare Advantage growth, according to Chartis’ 2023 Medicare Advantage Competitive Enrollment Report. According to the report, in 2020, 2021, and 2022, Medicare Advantage enrollment grew by 1.9 million, 2.2 million, and 2.3 million beneficiaries, respectively. This year, Medicare Advantage enrollment grew by just 1.5 million.
“This is still remarkable growth, but it does point to a deceleration,” researchers said. “At the same time, Original Medicare continues to decline, losing 339,000 enrollees this year—a significant but smaller loss than previous years.”
Other findings:
- Special Needs Plans enrollment accounted for two-thirds of total market growth. Enrollment is up 20 percent from 2022.
- Overall, start-up plans participating in Medicare Advantage notched 7 percent growth this year. While this growth exceeds the market average, it pales in comparison to previous annual membership growth of 25 percent.
- California, Illinois, Connecticut, and the District of Columbia all saw Medicare Advantage enrollment declines for the first time in recent history.
Senators renew call for HHS to limit availability of ‘junk’ health plans
A group of 32 senators, led by Sen. Tammy Baldwin (D-Wis.) and Chris Murphy (D-Conn.), is urging the Department of Health and Human Services (HHS) to take immediate action and address short-term limited duration insurance (STLDI) plans, otherwise known as junk plans, which they say, fail to provide adequate, comprehensive health insurance coverage. Last year, a group of 42 Democrats made a similar appeal and urged President Biden to ban these junk plans.
A federal final rule issued in August 2018 under the Trump Administration allows states to sell short-term plans from 90 days up to 364 days and may be renewed for up to three years. These health plans are often inexpensive but do not cover as many medical services and can deny coverage to consumers with pre-existing conditions. These yearly, renewable plans also compete with plans that comply with the Affordable Care Act (ACA).
“Now, more than ever, the Department of Health and Human Services must act. Beginning in April, millions of Americans will likely lose the Medicaid coverage that they have relied upon during the COVID-19 pandemic. We must protect those who will be looking for coverage in the near future, and take steps to ensure that these plans are not allowed to further proliferate,” wrote the senators. “It is past time for your Department to step up and address the expansion and proliferation of junk plans.”
Most people are unaware about the return of the regular Medicaid renewal processes
A recent report by Urban Institute finds that in December, more than six in 10 adults in Medicaid-enrolled families were not aware of an upcoming return to the regular Medicaid renewal processes, a rate that has not changed significantly since June 2022. Specifically, 64 percent of adults enrolled in Medicaid or with an enrolled spouse, partner, or child had heard nothing at all about the upcoming change in December 2022. An estimated 5 percent had heard a lot, nearly 14 percent had heard some, and 16 percent had heard only a little.
The findings indicate a need for widespread outreach and education efforts to alert Medicaid enrollees about the renewal process. States can begin disenrolling Medicaid enrollees beginning April 1 for the first time since March 2020, under the provisions of the Consolidated Appropriations Act that unwind the pandemic-related Medicaid continuous coverage requirement and allow states to resume regular renewal processes. Enrollees who are unaware of the change may be less prepared to complete the necessary steps to maintain coverage or, if they are no longer eligible, to obtain other coverage.
Other findings from the analysis:
- Awareness was low across the country, regardless of region, state Medicaid expansion status, or type of Marketplace operating in a state. Though fewer adults in the West were unaware of the upcoming change than in the Northeast (61 percent versus 66.5 percent), lack of awareness of the change was above 60 percent in all four regions of the country.
- Awareness was similar in state groups based on whether states had or had not adopted the Affordable Care Act’s Medicaid expansion (with 64.5 percent in expansion states and 64 percent in nonexpansion states unaware) or whether states used state-based or federally facilitated marketplaces (64 and 64 percent, respectively).
- Most adults in enrolled families had heard nothing about change and awareness did not vary widely by state characteristics.
Unwinding of Medicaid continuous enrollment provision could lead to a sharp rise in child uninsured rate
A new report from The Center for Children & Families, part of the Health Policy Institute at the McCourt School of Public Policy at Georgetown University, also looked at the impact of the unwinding of the Medicaid continuous enrollment provision and finds that as many as 6.7 million children are at risk of losing health coverage.
In March 2020, during the COVID-19 public health emergency, the federal government increased its contribution to state Medicaid programs while requiring states to maintain continuous coverage for all Medicaid beneficiaries, the Consolidated Appropriations act phases down that funding over the course of this year. States have from April 1, 2023 until May 2024 to conduct Medicaid eligibility checks for 83.5 million people, including more than 34.2 million children, who are now enrolled in the program. In addition, approximately four million children enrolled in CHIP-financed Medicaid will need to be renewed.
Seventy-two percent of the children enrolled in Medicaid will remain eligible for the program but are likely to lose coverage due to “bureaucratic snafus,” according to the report.
“The uninsured rate for children could easily more than double if states have inadequate staffing levels and overwhelmed call centers and do not take the time and care needed to properly conduct eligibility checks after the federal protects lift,” researchers said.
Senators urge CMS to protect children from losing Medicaid, CHIP coverage
In the wake of news about the child uninsured rate, a group of senators are urging the Centers for Medicare & Medicaid Services (CMS) to ensure that the gains made in reducing the number of uninsured children are not lost as states begin to unwind some Medicaid policies that have been in place since the start of public health emergency.
U.S. Senator Sherrod Brown (D-Ohio) and 14 Senators asked CMS Administrator Chiquita Brooks-LaSure in the letter to work with the states that have yet to adopt the children’s continuous eligibility state option for both Medicaid and CHIP to take up this option before Medicaid redeterminations begin.
“Making continuous eligibility a nationwide policy will ensure continuous coverage and access to essential health care services for the nearly 45 million children enrolled in Medicaid and CHIP, even as the MOE phases out. Unfortunately, as nationwide continuous eligibility for children will not be effective until January 1, 2024, there will be a gap where children in the remaining holdout states could once again be at risk of churning when redeterminations begin,” they wrote. “Therefore, we urge you to take steps to work with each of these states to ensure that children across the country have continuous coverage as the MOE soon comes to an end and eligibility redeterminations commence and prevent the potential for coverage losses among children across the nation.”