Payer Roundup—CMS reports consumers dropping coverage; Mississippi edits work requirement proposal

Health insurance benefits form
Exchange consumers are dropping coverage over time, but it's not as bad as last year. (Getty/michaelquirk)

Exchange coverage dropping over time, but not as much as last year

Over 1 million people have already dropped their exchange insurance in 2018, a trend that's likely to worsen over the remainder of the year.

In February 2018, about 10.6 million people were enrolled in an Affordable Care Act (ACA) exchange plan. That's slightly more than the 10.3 million enrolled in February 2017, according to a report (PDF) by the Centers for Medicare & Medicaid Services (CMS). But participation is likely to continue to drop throughout the year. Only 8.9 million people remained in their plans by the end of 2017.

While the 1.1 million people who dropped their plans represented about 9% of enrollees, this is an improvement from this time last year, when 15.5% discontinued their coverage. The average monthly decline in coverage was higher among people without advanced premium tax credits.

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Insurers in states that have filed proposed rates so far have requested significant premium hikes. At the same time, coverage is expected to be more widely available. (FierceHealthcare)

Mississippi softens work requirement proposal following federal court decision 

Mississippi reinstated a beneficiary protection provision into its work requirement waiver last week, allowing beneficiaries to receive two years of transitional coverage after meeting the requirement.

The state’s draft proposal also provided for two years of transitional coverage, but the final version reduced that to one year.

Some have suggested the state wanted to soften its proposal in response to a federal judge’s ruling against Kentucky’s work requirement on June 29. The judge found Kentucky’s that the proposal was “arbitrary and capricious” and did not fulfill the Medicaid program’s objective of providing medical assistance.

Officials from the Mississippi Division of Medicaid have said Medicaid coverage is meant to be temporary. It estimates the work requirement will bring 20,000 people off the program over the next four years.  

Approximately one in four Mississippians receive Medicaid coverage. However, only about 7% of beneficiaries would be subject to the work requirement, as students, caregivers, and other select populations would be exempt. (The Clarion-Ledger article)

Managed care plan for people with disabilities at risk of shutdown by state

New Yorkers with physical disabilities are working to save Brooklyn-based Independence Care System (ICS), a Medicaid managed care plan, from being shut down by the state.

ICS provides a long-term care plan throughout most of New York City that is tailored to meet its members’ needs. However, ICS receives most of its funding from the state and has run a deficit in recent years.

On its website, ICS lists in-home care, chronic condition management, and care coordination as just a few of the services it provides. Advocates say ICS’s services are high-quality, and its providers treat members with respect and dignity, which, unfortunately, is difficult to find. The company’s headquarters also serves as a community center, bringing members together for social activities, classes and meetings.  

State officials say they will keep ICS members’ needs in mind as they make decisions going forward. (WNYC article)