Helpful KFF FAQ on the $716 billion in Medicare “cuts.”
August 21, 2012
Kaiser Health News recently published a helpful FAQ on “Decoding the $716 Billion in Medicare Reductions.” This FAQ addresses some of the questions being raised in the Medicare debate, including where the $716 billion figure came from, where reductions in Medicare spending are expected, and more. It’s a good read and we invite your comments.
http://www.kaiserhealthnews.org/Stories/2012/August/17/faq-716-billion-medicare-reductions.aspx
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GAO Report on Medicaid Expansion
August 10, 2012
The GAO recently released the new report title Medicaid Expansion: States’ Implementation of the Patient Protections and Affordable Care Act. The report contains results of research conducted to see what states are doing to implement Medicaid expansion, learn what their responsibilities are, and identify what challenges they face. It addresses the following issues relating to implementing Medicaid expansion:
- State responsibilities
- Actions taken to prepare
- States’ views on the financial implications of expansion
The GAO conducted a web-based survey and interviewed Medicaid officials in six states: Colorado, Georgia, Iowa, Minnesota, New York, and Virginia. They selected these states based on:
- Size of expected enrollment
- Enrollment rates
- Geographic dispersion
- Insurance coverage provided to childless adults
The ACA requires Medicaid eligibility to be expanded to non-elderly people with incomes at or below 133% or the federal poverty level (FPL). It also specifies that each state must change how it determines Medicaid eligibility, as well as streamline eligibility and enrollment systems that will coordinate enrollment across Medicaid, Children’s Health Insurance Program (CHIP) and the state health insurance exchanges.
The bill allows states to opt out of the expansion, but stipulates that they will lose their existing federal Medicaid funds if they do so. When the Supreme Court ruled on the constitutionality of the health care law in June of 2012, it modified the provision on Medicaid expansion by allowing states to opt out without losing their existing federal Medicaid funding. This change prompted the Congressional Budget Office (CBO) to update its budget estimates, reflecting projections that fewer people will be covered by Medicaid and CHIP, while more people will be enrolled through state health insurance exchanges and uninsured than in its previous estimate. The GAO completed its field work on this study prior to the Supreme Court’s ruling, so the impact of that decision was not included in their analysis. However, the requirements for states that choose to participate in the Medicaid expansion have not changed as a result of the Supreme Court decision and the report is still a useful snapshot of how these states are getting on with preparations for it.
Requirements for states that participate in Medicaid expansion
By January 1, 2014 states must:
- Expand eligibility to non-elderly people with incomes at or below 133% of FPL
- Streamline their enrollment process
- Transition to Modified Adjusted Gross Income (MAGI) to determine income eligibility
- Identify those who are newly eligible to obtain federal matching funds
- Simplify and streamline the eligibility determination process
Table 1: ACA provisions included in the GAO study.
|
ACA Provision |
Description |
| Medicaid eligibility | Expand eligibility to non-elderly people with incomes at or below 133% of FPL. |
| Modified adjusted gross income (MAGI) | Transition to using MAGI to determine income eligibility. |
| Early expansion option | States can expand coverage to newly eligible people prior to January 1, 2014. |
| Maintenance of effort | States must maintain eligibility standards until an exchange is fully operational. |
| Federal matching | Federal matching funds will be provided to states for newly eligible adults. |
| Streamlined eligibility and enrollment systems | “States must provide a process for individuals to apply for or renew their Medicaid eligibility through a website that enrolls individuals in the appropriate program (Medicaid, CHIP, or exchanges) no matter to which program they originally apply.” |
The GAO found that the states studied are taking steps to prepare for Medicaid expansion, but they face some challenges including the need for additional federal regulations and guidance. CMS has issued a final Medicaid rule and indicated that more guidance will be forthcoming. In addition, the majority of state budget directors interviewed believe the following factors will contribute to the cost of expanding Medicaid.
- Administration required to manage Medicaid enrollment
- Acquisition or modification of information technology systems to support Medicaid
- Enrolling people who were previously eligible, but have not so far enrolled in Medicaid
They also expressed uncertainty about:
- The impact of shifting exiting Medicaid enrollees into health benefit exchanges
- Fiscal capacity and the state’s share of Medicaid expenditures
- Guidance needed to develop budget estimates
- Additional regulations and/or guidance needed on
- How to apply MAGI
- Conversion of Medicaid eligibility standards
- Access to eligibility data through the Federal Data Services Hub
After reviewing and commenting on the study, HHS agreed to provide states with additional regulations and/or guidance on MAGI conversion and FMAP computation. HHS also reiterated that the decision to participate in Medicaid expansion is up to the state – there is no deadline date for their decision – and federal matching funds are available to help states cover information technology costs for modernizing eligibility systems, which don’t have to be paid back if the state decides not to expand Medicaid.
Previous blog post: CBO update estimates $84 billion savings from SCOTUS decision
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
Tweet Chat on Health Care Costs
August 10, 2012
Extend Health held a tweet chat today on health care costs. There were some great questions and excellent answers from John Barkett, Dir. of Policy Affairs at ExtendHealth fielded questions. John worked in congress on health care and his wealth of knowledge was evident in the answers he provided.
If you missed our tweet chat you can read a complete recap of the event. Hope to see you at the next one!
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
Way to go Garland Senior Fair!
August 8, 2012
Extend Health exhibited at the Garland Senior Fair in Texas this past Sat, Aug 4. There was a great turnout of over 350 people from the community and surrounding areas including seniors, their families, community leaders and service providers like us, who care about seniors and senior issues.
State Representative Angie Chen Button thanked Dwight and Ivory in person for exhibiting at the fair, fulfilling an invitation that she extended to Bryce Williams, Towers Watson Managing Director of Extend Health, at the ribbon-cutting of the first Extend Health service center in Richardson this past May.
Richardson Mayor Bob Townsend encouraged everyone to make good use of the resources available. And many other community leaders, including City of Rowlett Senior Advisory Board members Pamela Bell and Wayne Baxter, met with attendees and the community groups and companies exhibiting.
Dwight Turner and Ivory Rooks, both senior benefit advisors for Extend Health, who have years of experience helping seniors choose the best Medicare plans for them, served as Extend Health ambassadors. They answered people’s questions about Medicare and shared resources with them, explaining the role Extend Health can play in helping to connect people with the best coverage for their needs.
According to Dwight, “We put the care into shopping for Medicare!“
Ivory added, “It was great to be able to connect in person with people and extend a helping hand.”
Extend Health contributed a Texas-themed gift basket, which was raffled off to a lucky winner. The day was welcome chance to connect in person with many in a community that is very important to Extend Health.
We recently announced that Extend Health is bringing over 500 jobs to the community with the opening of its second service center in the Richardson Telecom Corridor.
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
On June 28, 2012 the Supreme Court announced its decision on the health care law, which upheld the constitutionality of the individual mandate and allowed states to opt-out of Medicaid expansion. The Congressional Budget Office (CBO) recently released an updated budget estimate to reflect changes in the insurance coverage provision of the ACA resulting from the Supreme Court’s decision.
While SCOTUS upheld the constitutionality of the ACA’s individual mandate that requires people to purchase insurance or pay a penalty tax, this is not the reason why the CBO revised its budget estimate. The update was necessary to reflect projections stemming from the SCOTUS decision that fewer people will be covered by Medicaid and CHIP (6 million), and more people will be enrolled in and exchanges (2 million) and uninsured (4 million) than their previous estimate. As a result of these changes, CBO estimates net costs will be $84 billion less than originally projected.
| CBO Budget Estimates for(2012 – 2022) | Net Costs (billions) |
| March 2012 | $1,252 |
| July 2012 – Post SCOTUS update | $1,168 |
| Savings | $84 |
|
Changes In Insurance Coverage (millions) |
|||
| March 2012 | July 2012 | Difference | |
| Medicaid & CHIP |
13 |
7 |
-6 |
| Exchanges |
8 |
9 |
+2 |
| Uninsured |
-18 |
-14 |
+4 |
Numbers may not add up to totals because of rounding.
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
Extend Health tweet chat on health care reform
July 26, 2012
Extend Health held its very first tweet chat today. The topic was health care reform, and there were some really great questions – and a bit of humor tossed in too. John Barkett, Dir. of Policy Affairs at ExtendHealth fielded questions. John worked in congress on health care and his wealth of knowledge was evident in the answers he provided.
If you missed our tweet chat you can read a complete recap of the event. Hope to see you at the next one!
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
We surveyed seniors on Medicare to learn how they feel about the Supreme Court and its recent ruling on the health care law. The results are very interesting, and we hope you’ll enjoy reading about it in the press release below. Thanks!
July 17, 2012 03:00 PM Eastern Daylight Time
Extend Health Survey: Seniors on Medicare Respond to U.S. Supreme Court Decision on Healthcare Reform Law: 46% of Senior Women View the Decision as “Positive”; 27% of Senior Men
Survey fielded within 24 hours of ruling reveals “gender divide” among seniors
SAN MATEO, Calif.–(BUSINESS WIRE)–A survey of 441 seniors on Medicare fielded from June 29-July 2, 2012, showed that 46% of female respondents view the U.S. Supreme Court ruling upholding the constitutionality of the healthcare reform law as “positive,” compared with just 27% of male respondents. In addition, 40% of senior women said that the fact that the ruling upheld provisions closing the Part D prescription drug coverage gap, known as the “donut hole,” influenced how they felt about the ruling, compared to just 26% of senior men who felt similarly.
The survey was fielded by Extend Health, operator of the nation’s largest private Medicare exchange. The company has been surveying seniors on their attitudes about retirement, healthcare and Medicare since December 2009. Extend Health is a Towers Watson company.
Under the healthcare reform law, individuals who fall into the donut hole receive a 50% discount on the cost of brand-name prescription drugs, with that discount increasing in future years until it reaches 75% in 2020. If the Supreme Court had ruled the law unconstitutional, that provision would have been overturned.
Said Bryce Williams, Managing Director of Extend Health, “The healthcare reform law is a divisive issue for many Americans, but seniors on Medicare apparently line up along gender lines. Based on comments made by our survey respondents, the reason for the different views of women versus men is based in part on women’s experience as caregivers to multiple generations: their children, their parents and their spouses. Perhaps this accounts for the difference in how women view the healthcare reform law and its goal of insuring more Americans.”
Questions and detailed results from the survey are as follows:
On June 28, 2012, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act, with some clarifications. All of the provisions of the law that affect Medicare remain unchanged.
What do you think about the Supreme Court ruling overall?
| Men | Women | |||
| I think it is positive | 27.3% | 46.1% | ||
| I think it is negative | 61.7% | 38.3% | ||
| I don’t have an opinion | 11.0% | 15.7% |
Under the Affordable Care Act, individuals who fall into the Part D coverage gap (“donut hole”) receive a 50% discount on the cost of brand-name prescription drugs, with that discount increasing in future years until it reaches 75% in 2020. If the Supreme Court had ruled the law unconstitutional, that provision would have been overturned.
How does the fact that the Part D coverage gap provision was upheld influence how you feel about the ruling?
| Men | Women | |||
| I feel more positive | 25.7% | 39.7% | ||
| I feel more negative | 19.9% | 17.2% | ||
| It makes no difference | 54.4% | 43.1% |
Extend Health has helped hundreds of thousands of seniors compare and choose private Medicare plans. Extend Health is the only place seniors can compare thousands of plans from more than 75 carriers side by side and find plans that best meet their needs. Licensed benefit advisors are available to help seniors evaluate their Medicare coverage and explore new options quickly and easily.
About Extend Health
Founded in 2004, Extend Health operates the largest private Medicare exchange in the country. Extend Health is a Towers Watson company. For more information, visit Extend Health on the web at http://www.extendhealth.com.
Extend Health is a registered trademark of Extend Health, Inc. Other names may be trademarks or servicemarks of their respective owners.
Contacts
For Extend Health, Inc.
Rob Wyse, 212-920-1470
rob@WT221.com
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
Back in December of 2011 the U.S. Department of Health and Human Services chose 32 organizations to participate in the Pioneer Model test initiative that stated on January 1, 2012. On July 9th, HHS announced 89 new ACOs that will serve 1.2 million people with Medicare in 40 states and Washington, D.C. The program overall now includes 154 ACOs that are providing care to 2.4 million people.
ACOs consist of doctors, hospitals and other health care providers that work together to deliver high-quality health care and reduce costs. Participation in this shared savings program under the ACA is voluntary, and providers are incentivized by the opportunity to share in the savings they help create. ACOs must meet 33 quality measures to insure that the savings generated result from improving the coordination and quality of care.
Not all ACOs are large organizations. Nearly half are physician-driven with less than 10,000 beneficiaries. The program is estimated to save the federal government up to $940 million over four years.
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
New from Bryce Williams, “ACA Survives: Supreme Court Rules Individual Mandate Constitutional.”
June 28, 2012
Here’s and excerpt from a new post just published on Bryce Williams’ blog “Watch This,” about today’s ruling by the Supreme Court on the ACA:
“With Chief Justice Roberts siding with the majority, the Supreme Court decided in a 5-4 vote to uphold the individual mandate as a tax. The case before the court on Medicaid expansion was upheld narrowly, with the Court ruling that the federal government may not cut off all of the Medicaid funding of states that opt out of Medicaid expansion . . .”
Read the full post on Watch This.
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
Here’s an excerpt from a new post just published on Bryce Williams’ blog “Watch This,” on the need for transparency in health care pricing:
“Knowledge is power — the power to think, to act, to buy, or even to not do any of the above. Our nation’s health insurers and health care providers need to figure out how to put power back into the hands of consumers. Consumers today have too many constraints when it comes to accessing decision-critical information about the cost of health care. That’s a hard pill to swallow when there’s so much at stake.”
Read the full post on Watch This.
Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.
