Enrollment

On March 1, 2023 KFF released a brief titled “FAQs on Health Spending, the Federal Budget, and Budget Enforcement Tools”. The brief reviews basic questions about health spending and the federal budget and budget enforcement tools, including the debt limit and sequestration. As discussions on the federal deficit and debt continue, the KFF resource provides an explanation of federal spending for domestic and global health programs and services.

AARP’s Public Policy Institute released a report titled “Underused Medicare Savings Programs Can Help Many More Older Adults Afford Health Care”. Medicare Savings Programs or MSPs provide financial assistance with certain Medicare costs for eligible low-income Medicare beneficiaries, and are administered by state Medicaid agencies. According to the report, about 16 percent of all Medicare beneficiaries are enrolled in MSPs; however, the number of individuals eligible for these programs is estimated to be much higher. The paper discusses the findings from the organization’s analysis and research, and proposes areas states can consider to increase enrollment and expand eligibility.

On Monday, February 27th, CMS released a fact sheet titled “CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency”. The fact sheet includes information on several topics including COVID-19 vaccines, testing, and treatments, telehealth services, health care access, including continued flexibilities for health care professionals, and information on the Inpatient Hospital Care at Home initiative. CMS reports that in the coming weeks the agency will host stakeholder calls and office hours to provide additional information.

This past Tuesday, the Centers for Medicare & Medicaid Services (CMS) announce the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). As of October 24, 2022, over 65.2 million people are enrolled in Medicare, an increase of 132,757 since the last report. More than 35 million people are enrolled in Original or Fee-for-Service Medicare, and more than 30.2 million are enrolled in a Medicare Advantage or other health plan. Over 91.3 million enrollees have Medicaid (84.3+ million) and Children’s Health Insurance Program (CHIP) (7.0+ million), an increase of 462,322 since the last report. More than 12 million enrollees are eligible for both Medicare and Medicaid and are counted for both programs.

This publication finds meaningful variation in disenrollment and churn across Medicaid beneficiary categories. Specifically, beneficiaries with Supplemental Security Income-related eligibility have low rates of disenrollment and high rates of reenrollments. In this research, Mathematica uses data from the Transformed Medicaid Statistical Information System Analytic File to examine rates of disenrollment, churn, and continuous coverage among categories of children and adult Medicaid beneficiaries whose eligibility is related to a disability.

The Medicaid and CHIP Payment and Access Commission (MACPAC) released the 2022 edition of the MACStats: Medicaid and CHIP Data Book, with updated data on national and state Medicaid and State Children’s Health Insurance Program (CHIP) enrollment, spending, benefits, and beneficiaries’ health, service use, and access to care. As of July 2022, almost 90 million people were enrolled in Medicaid or CHIP.

The annual Medicare open enrollment period for Medicare Advantage and Part D plans ends Wednesday, December 7, 2022. To assist individuals who counsel Medicare clients, the National Council on Aging or NCOA developed a “Medicare Open Enrollment Toolkit”. The Toolkit includes many useful resources designed for professionals, advocates, caregivers, and/or older adults, including a fact sheet on changes to Medicare in 2023; information on Medicare Part A and Part B premiums and cost-sharing in 2023; a 2023 Medicare Part D cost-sharing chart; and other helpful information and guidance.

On Monday, June 13, 2022 CMS released the 2020 Medicaid Managed Care Enrollment and Program Characteristics and Data Tables. This national data is broken down by program, population, and individual state. The enrollment data provides a snapshot of Medicaid managed care enrollment as of July 1, 2020.

When the federal declaration of a public health emergency (PHE) expires, many of the flexibilities initiated during COVID-19 will need to be rolled back, including changes in Medicaid enrollment and eligibility. ACL has developed a fact sheet to help grantees prepare for these changes ahead and continue to support older adults and people with disabilities who currently rely on Medicaid Coverage.

On Thursday, February 17, 2022 CMS released a request for information (RFI) regarding access to Medicaid and CHIP Services. The RFI is broad and extends beyond prior CMS access inquiries, which largely focused on eligible beneficiaries ability to receive covered Medicaid services. This RFI includes topics such as how beneficiaries enroll in and maintain access to coverage, access to the actual services, and payment rates.