The Centers for Medicare and Medicaid is funding five additional states and territories to expand access to home and community-based services through Medicaid’s Money Follows the Person (MFP) demonstration program.
The percentage of Americans who lack health insurance hit an all-time low of 8% in the first quarter of this year, reflecting an increase of 5.2 million people who gained coverage since 2020, according to a report by the federal Department of Health and Human Services (HHS) released on Tuesday.
Using data from the National Health Interview Survey and the American Community Survey, the report from the HHS Assistant Secretary for Planning and Education (ASPE) shows the effect of better subsidies for health insurance that consumers buy on the Affordable Care Act’s marketplaces, increased federal efforts to encourage the uninsured to enroll, the continuous enrollment provisions in the federal-and-state Medicaid program and recent decisions in several states to increase enrollment in Medicaid, HHS said in a press release.
Since 2019, seven states have expanded enrollment in the federal-and-state funded Medicaid program, according to Louise Norris at HealthInsurance.org. Those states are: Virginia and Maine in 2019; Utah, Idaho, and Nebraska in 2020; and Oklahoma and Missouri last year, she wrote.
The HHS announcement is significant for three reasons. First, the all-time low 8% rate means that about 26.4 million people lack health insurance, down from 48 million in 2010, according to an ASPE report last year. Second, the report includes a table showing changes in the uninsured rates in each state for low-income adults ages 18 to 64 from 2018 to 2020. In 18 states (15 of which expanded Medicaid), the uninsured rates for this population dropped in those years.
Federal officials intend to give hospitals a break in quality scoring due to pandemic strains, by halting reporting of a measure known as the PSI 90 score. Patient-safety and business groups are fighting this plan, arguing it would erode quality of care.
Journalists may find good stories in looking at this battle over a quality measurement that pits Medicare and hospitals against patient-safety and employer groups.
The American Hospital Association (AHA) and the Federation of American Hospitals supported this proposal, which was one of myriad policy changes included in Medicare’s draft fiscal year 2023 rule on payments for inpatient services. They agree with Medicare officials who said they feared the effects of the pandemic might result in distorted results that might prove unfair to hospitals that served many people at highest risk from COVID-19.
Opposition to PSI 90 proposal
Among the leaders of the opposition to the PSI 90 proposal is nonprofit Leapfrog Group. Founded in 2000 by business organizations, Leapfrog has become a major force in lobbying for greater transparency about the quality and cost of health care.
“Suppressing PSI 90 would be a giant leap backward in patient safety and transparency, literally life-threatening, and an outrageous violation of the trust Americans place in the Medicare program,” wrote Leah Binder, M.A., M.G.A., chief executive officer of Leapfrog Group, in a June 17 comment letter to the Centers for Medicare and Medicaid Services (CMS).
Seema Verma, administrator of the Centers for Medicare and Medicaid Services, invited reporters to the agency’s Washington, D.C., headquarters on Thursday to take questions on the record, the latest open press meeting in a continued shift since AHCJ began calling for better access to the official.
The Centers for Medicare & Medicaid Services does not have adequate procedures in place to ensure potential abuse or neglect of Medicare beneficiaries in nursing homes are identified and reported, according to recent testimony from the HHS Office of the Inspector General (OIG).
While the agency has taken some action, based on earlier OIG recommendations, it has not yet acted on the other suggestions to help consumers better understand nursing home quality and make distinctions between nursing homes. Continue reading