CMS to Reimburse New York, Minnesota for Health Care Expenses

New York and Minnesota, the only two states to establish Basic Health Programs (BHPs) under the Affordable Care Act (ACA), will now receive promised federal funding after suing the Trump administration. Basic Health Programs are state-operated insurance providers for residents earning between 138 percent and 200 percent of the federal poverty level — the population earning […]

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Kentucky Fails to Get Medicaid Work Requirement Restored

A federal judge in the state capital of Frankfort has dismissed a lawsuit by the governor of Kentucky seeking to restore the Medicaid work requirement that a Washington, D.C. judge threw out earlier this summer. Gov. Matt Bevin had sued the same 16 individuals whose lawsuit against the newly instituted work requirement for Medicaid eligibility […]

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Maine Receives Waiver to Establish ACA Reinsurance Plan

The Centers for Medicaid and Medicare Services (CMS) has issued a Section 1332 Waiver to Maine to allow the state to set up a reinsurance plan to help pay the medical costs of residents with certain qualifying conditions, thus helping lower the health insurance premiums of all consumers in Maine. Gov. Paul LePage has subsequently […]

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CMS Cuts Obamacare Navigator Funding from $36M to $10M

The Affordable Care Act (ACA) Navigator program, which funds groups and individuals to help walk people through the Obamacare sign-up process, is being cut financially once again by the Trump administration, this time from $36 million to $10 million. In 2017, funding stood at $63 million. Regardless of the federal outlay, the Navigator program has […]

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ACA Risk-Adjusted Payments Halted after Judge’s Ruling

UPDATE: On Tuesday, July 24, the Trump administration restored the risk-adjusted payments to prevent “chaos” in the health insurance market. Risk-adjusted payments, a principal component of the Affordable Care Act (ACA, or Obamacare) that seeks to level the playing field among insurers, have been put on hold by the Centers for Medicare and Medicaid Services […]

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CMS Proclaims a ‘Death Spiral’ for Unsubsidized Obamacare Policyholders

Though the actual number of open enrollment Obamacare policyholders who paid their premiums the first month rose over 2017 by 3 percent — standing at 10.6 million people for 2018 — those seeking policies who didn’t qualify for subsidies fell by as much as one-third in many states, the Centers for Medicare and Medicaid Services […]

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Federal Judge Strikes Down Medicaid Work Requirement in Kentucky

BREAKING NEWS: Kentucky on July 2 eliminated vision and dental benefits from its Medicaid program in response to a judge’s striking down of its work requirement. Amid the heightened tensions in the nation’s capital over filling a vacant Supreme Court seat, a federal judge has struck down Kentucky’s Medicaid requirement that the able-bodied must work, […]

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CMS to Step Up Scrutiny on State-Run Medicaid Programs

The Centers for Medicare and Medicaid Services (CMS) says it will crack down on Medicaid fraud through a renewed analytical effort “to hold states accountable” following Office of Inspector General (OIG) findings in California, Kentucky and New York. Thanks to a provision in the Affordable Care Act (ACA) that allows states to expand the ranks […]

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CMS Releases State-by-State Medicaid Scorecard

The Centers for Medicare and Medicaid Services (CMS) has released what is being called a “Medicaid & CHIP Scorecard” that attempts to compare the timeliness and quality of medical care of the two programs state by state, but a major problem is that reporting by the states is mostly voluntary. “Despite providing health coverage to […]

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CMS Administrator Reaffirms Opposition to Medicaid Caps

At a health care symposium this week, Seema Verma, administrator of the Centers for Medicare and Medicaid Services (CMS), reaffirmed her agency’s commitment to keeping Medicaid available to its recipients without any lifetime limits or caps. Her statement follows her earlier rejection of a request by Kansas to cap Medicaid services in the state. “We’ve indicated […]

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