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health care news United States state update ACA

Health Care News Across the U.S – National & State Update

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In an effort to keep you up to date on proposed and actual changes to our health care system and other hot topics in the law, here is our national and state update:

National Health Care News:

  • We are currently waiting for a ruling from the 5th Circuit Court of Appeals on whether a judge in Texas appropriately rules that the Affordable Care Act is unconstitutional and struck it down in its entirety. Any decision from the 5th Circuit is likely to be appealed to the Supreme Court. Stay tuned to the Triage Cancer blog.
  • Marketplace Open Enrollment ends December 15th in most states!
    • 1 out of 3 people buying plans in the marketplace have a plan option that costs less than $10 per month!!
    • Current enrollees, who do not sign up for a 2020 plan in states that use the federal Marketplace at Healthcare.gov, will be automatically enrolled in the same plan as 2019, or another plan offered by the same insurer that is intended to be similar. If such a plan isn’t available, then they will be enrolled in a plan with a different insurance company. Visit Cancer health insurance for tools on how to pick a health insurance plan.
    • Beware of short-term health insurance plans and other plans that don’t have to comply with the consumer protections in the ACA
  • A recent Gallup Poll found:
    • Nearly 34 million Americans saw a loved one die because they were unable to afford medical care.
    • 9% of people said that they could not afford to pay for a medication prescribed by their health care team.
  • In other news, due to an ACA requirement that insurers who spent less than 80% of premiums on health care to return the difference, those who had individual health insurance are owed $92.3 million in rebates this year.
  • Two bills were recently advanced by the House Ways & Means Committee. The Lower Drug Costs Now Act of 2019 (H.R.3) and the Medicare Dental Act of 2019 (H.R. 4650) add a comprehensive oral health, vision, and hearing benefits to Medicare Part B. These bills now need to be voted on by the House of Representatives, but are unlikely to make it out of Congress this year.
  • Many states have added Medicaid work requirements, where beneficiaries must verify their employment, job search, or participation in job training programs. In order to qualify they must meet the required amount of hours per week or verify an exemption to receive or retain Medicaid coverage. The amount of hours or activity needed to qualify varies by state. This table shows the states that currently have requirements for a waiver as well as which states are pending those requirements.
  • A federal judge has blocked work requirements in Arkansas, Kentucky and New Hampshire, and HHS has also been sued over new rules in Indiana. Many states have been experiencing changes in Medicaid Work Requirements however, due to a recent court ruling that struck down new proposals.
  • A new lawsuit is challenging the Medicaid work requirements in Michigan. Whereas Indiana, Arizona, and Virginia have moved to halt their work requirements, which have not yet gone into effect, in light of these court rulings.

Idaho:

Idaho will start enrollment in its newly expanded Medicaid program on Nov. 1, with benefits starting Jan. 1. If you’re a resident in Idaho, visit medicaidexpansion.idaho.gov for more information and to apply. In order to qualify for Medicaid expansion you must be between the ages of 19 and 64; be a citizen or legal resident; and not be receiving Medicare. There are also income requirements: you can earn up to 138% of the federal poverty level; that’s $17,236 a year for a single person, or $35,535 for a family of four.

Oklahoma:

The people of Oklahoma are joining other states in the hope of expanding Medicaid. 313,000 signatures were recently submitted to Oklahoma’s Secretary of State to add a ballot measure in 2020, to expand Medicaid. Oklahoma joins Missouri in using the ballot to try expand Medicaid. Medicaid expansion has been adopted by voters approval of ballot measures in four other states — Maine, Idaho, Nebraska and Utah.

Wyoming:

Wyoming legislators are again looking at whether to expand Medicaid to nearly 19,000 people in Wyoming, who would benefit from the expanded coverage.

Georgia:

The Governor of Georgia has released a plan to request permission form the federal government to sell individual marketplace plans that do not comply with the consumer protections in the ACA, which leave consumers vulnerable to inadequate coverage and higher out-of-pocket costs.

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Samantha Skelton
ss@triagecancer.org