Public Payers News

High Perceived Healthcare Costs Limit Coverage Access for Uninsured

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High perceived healthcare costs are the biggest barrier to health insurance for the uninsured population, according to a survey conducted on behalf of Florida Blue. The online survey polled uninsured...

156M Beneficiaries Receive Health Insurance Through Public Programs

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More than 150 million people receive health insurance through public programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), according to the latest enrollment...

OIG: Cigna Should Refund Feds $5.9M for Medicare Advantage Overpayments

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In its analysis of Cigna-HealthSpring of Tennessee’s risk adjustment program payments, the Office of Inspector General (OIG) found that 195 of the 279 unique enrollee-years did not have medical...

Traditional Medicare to Medicare Advantage Switching Rates Grew in 2020

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The share of beneficiaries who switched from traditional Medicare to Medicare Advantage in 2020 exceeded the switching rate from Medicare Advantage to traditional Medicare, contributing to Medicare...

Affordable Care Act Marketplace Enrollment Up by 1.8M From Last Year

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Affordable Care Act (ACA) marketplace enrollment has grown 18 percent from last year, with 11.5 million people signing up for coverage as of December 15, 2022, HHS announced. “Unprecedented...

Continuous Eligibility Policies Can Reduce Medicaid Churn Among Kids

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Continuous eligibility policies can help reduce Medicaid churn and disenrollment among children, according to an issue brief from the Kaiser Family Foundation (KFF). The year-end spending legislation...

Public Charge Rule Led to Delayed Healthcare Among CA Immigrants

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Avoiding public programs due to the public charge rule, such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP), was linked to higher rates of delayed healthcare among immigrants in...

5 Considerations for Payers before Entering Dual Eligible Market

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The dual eligible market is changing, creating new challenges and opportunities that health plans should take into account when considering entering the market, experts from Manatt Health found in a...

BMA Shares How CMS Can Improve Medicare Advantage Program

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Better Medicare Alliance (BMA) has called on CMS to improve the Medicare Advantage program by auditing all health plans annually, creating best practices for in-home health risk assessments, and...

Number of Uninsured Children Declined by 210K During Pandemic

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The number of uninsured children declined during the COVID-19 pandemic due to Medicaid’s continuous coverage requirement, with 12 states seeing significant decreases, according to a report from...

PHE Expiration Will Lead to Medicaid Coverage Losses for 18M People

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If the COVID-19 public health emergency (PHE) ends in April 2023, 18 million people may lose Medicaid coverage in the 14 months following its expiration, according to a brief from the Robert Wood...

19 States Must Align Medicaid Vaccine Coverage Policies with IRA

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Almost two-fifths of US states—particularly those that have avoided Medicaid expansion—will need to change their Medicaid vaccine coverage policies in order to align with the Inflation...

Plan Value, Expected Care Use Drove ACA Consumers into Uninsurance More than Cost

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Among Californians enrolled in the Affordable Care Act marketplace, perceptions about plan value and expectations about how often they would need healthcare services were more likely to motivate them...

Proposed Rule May Prevent Coverage Losses for Dual Eligible Beneficiaries

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The CMS proposed rule to streamline the Medicaid eligibility process could potentially prevent coverage losses for around a third of dual eligible beneficiaries, according to data from the Kaiser...

NCQA Confers Health Equity Accreditation on Elevance Health Medicaid Plans

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Elevance Health announced that 21 Medicaid plans have achieved health equity accreditation from the National Committee for Quality Assurance (NCQA). “Advancing health equity is a priority for...

How Health Insurance Coverage Varies Across, Within Families

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The Affordable Care Act (ACA) increased access to Medicaid and group health insurance, but the family glitch created a barrier to non-group coverage, leading to variations in health insurance coverage...

Immigrants’ Premium Contributions Exceed Payer Spending on Care

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Immigrants’ premium contributions in 2017 were $58.3 billion higher than what private insurers and public programs spent on their healthcare, suggesting that immigrants help subsidize the US...

Early 2023 Affordable Care Act Marketplace Enrollment Exceeds 2022 Trends

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Since enrollment season began on November 1, the number of signups on the Affordable Care Act marketplace for the 2023 plan year has significantly outpaced the enrollment levels from the same timeframe...

62% of Adults Are Unaware of Medicaid Renewals Resuming Post-PHE

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More than half of adults who are enrolled in or have a family member enrolled in Medicaid were unaware of upcoming Medicaid renewals set to resume after the COVID-19 public health emergency (PHE) ends,...

Top 4 Medicare Advantage Penetration, Access Trends in 2023 Open Enrollment

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Medicare Advantage beneficiaries will have more health plan options available to them now than they have at any point in over a decade, according to data from the Kaiser Family Foundation....