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The Health 202: Republican-backed ACA lawsuit also threatens Medicaid as enrollment grows during pandemic

But the health-care law’s Medicaid expansion played a bigger role in extending health coverage – and is now enrollment is surging amid the coronavirus pandemic. Coverage for Americans enrolled in this program is also threatened by the lawsuit, a detail getting far less attention on the campaign trail. 

Nearly 4 million more people enrolled in the health insurance program for the low income between February and June. 

Medicaid enrollment grew 6.2 percent over the spring and early summer, the Centers for Medicare and Medicaid Services reported this week. 

It’s an abrupt reversal of the direction enrollment had previously been moving as it trended downward over the last several years. Yet the surge isn’t terribly surprising, given the nation’s widespread job losses during the first wave of the pandemic and subsequent lockdowns. More than one in five Americans – about 75 million – now rely on Medicaid or the Children’s Health Insurance Program for their coverage.

Many states have seen double-digit percentage increases in their Medicaid enrollment during the pandemic. 

In Nebraska, enrollment climbed from fewer than 644,000 in February to about 731,000 through August, my colleague Amy Goldstein reported.

“That 13.5 percent increase places Nevada among at least three states, along with Kentucky and Minnesota, where the cadre of people on Medicaid has spiked that much,” Amy wrote. “But increases are widespread: Caseloads had risen on average 8.4 percent through July in 30 states for which researchers have enrollment information. And in 14 states with enrollment data through August, the average is 10 percent.”

Around 15 million of Medicaid enrollees nationwide are eligible for the program because of the Affordable Care Act, which gave states dollars to expand their programs to earners up to 133 percent of the federal poverty level.

The outcome of the ACA lawsuit could affect their coverage. 

Just days after the election, the court is scheduled to hear a lawsuit challenging the ACA’s constitutionality. The confirmation of conservative nominee Amy Coney Barrett – a process the Senate is embarking upon in 10 days – could increase the court’s chances of knocking down some or all of the 2010 health care law.

Some ACA advocates have noted the much broader impact of tossing out the health care law, beyond those with preexisting conditions.

Charles Gaba, an ACA analyst, has been tweeting out how many people in each state could get kicked off Medicaid expansion:

It’s understandable why Democrats are focusing on the preexisting condition protections over Medicaid expansion.

Preexisting condition protections are especially popular, with 72 percent of Americans saying it’s “very important” they stay in place.

And were the court to toss out any part of the ACA, the preexisting condition protections would be the first to go. It’s harder to imagine the court ruling that the entire law including its Medicaid expansion must fall. 

Still, rarely does presidential nominee Joe Biden speak without mentioning preexisting conditions, and the phrase shows up constantly in Democrats’ campaign ads and speeches.

“We’ll show America which party stands

Mark Farrah Associates Assessed 2nd Quarter Health Insurance Enrollment Trends

Mark Farrah Associates (MFA), www.markfarrah.com, released a mid-year 2020 health insurance segment enrollment update. Based on membership data filed with statutory financial reports from the NAIC (National Association of Insurance Commissioners), the CA DMHC (California Department of Managed Health Care), and data from MFA’s ASO estimates, insurance companies provided medical coverage for 274 million people, as of June 30, 2020. This number is up from 268.2 million or approximately 5.8 million members, from a year ago.

  • Second quarter enrollment trends indicated membership gains for Individual, Medicare Advantage (MA), Managed Medicaid, and Employer-Group ASO (administrative services only for self-funded plans) business, while the Employer-Group risk segment experienced a year-over-year decline.

  • Over 15.3 million people are currently enrolled in Individual, Non-Group medical plans, representing a 2.8% increase between 2Q19 and 2Q20.

  • Managed Care Organizations (MCOs) now provide coverage for approximately 52.8 million beneficiaries, representing 6% growth, year-over-year. According to CMS reports, nearly 73.5 million people rely on Medicaid as their source of health insurance coverage.

  • Second quarter membership in Medicare Advantage (MA) plans increased to over 24.8 million, from 22.2 million in the prior year.

To read the FREE full text of “Mid-Year Trends in Health Insurance Enrollment and Segment Performance“, visit the Analysis Briefs library on Mark Farrah Associates’ website.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, 5500 Employer Health Plus, Medicare Business Online™, Medicare Benefits Analyzer™, and Health Plans USA™. For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website or call 724-338-4100. MFA will continue to monitor enrollment changes and competitive shifts across all healthcare segments.

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Contacts

Mark Farrah Associates
Ann Marie Wolfe, [email protected]

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Award-Winning Alignment Healthcare Expands Plans & Benefits, Available to 5.9 Million Seniors This Medicare Enrollment Season

Medicare Advantage company offers seniors new 24/7 virtual care plan, new social benefits such as pet-sitting, acupuncture and personal emergency response systems

Alignment Healthcare, a mission-based Medicare Advantage insurance company founded in 2013, announced today new plans and benefits to give seniors more care options during Medicare’s annual enrollment period for 2021, which runs Oct. 15 through Dec. 7, 2020. Through Alignment Health Plan, the company is offering 36 Medicare Advantage options in three states, including a virtual-first health plan that includes a $50 monthly premium rebate, as well as a host of new benefits such as pet-sitting, pest control and acupuncture to ensure their social and lifestyle needs are met.

Seniors are increasingly turning to Alignment each year due to its “senior first” model, which earned Alignment numerous accolades including the 2020 Senior Choice Gold Award and 2020 U.S. News & World Report “Best Insurance Companies for Medicare Advantage” recognition.

“As more Americans enter their senior years, it is critical for us to continue providing not only the best of clinical outcomes but also the best customer experience that seniors need and deserve,” said John Kao, founder and CEO, Alignment Healthcare. “Our new plans and benefits reflect the innovation and compassion that sets Alignment apart as we continue to grow and serve seniors nationwide.”

Among Alignment Health Plan’s 14 new plan offerings available starting Jan. 1, 2021, is the AVA™ HMO plan, a virtual-first plan that gives members a dedicated primary care provider and specialists – accessible by phone or video on the company’s proprietary AVA™ data and technology platform – as well as providers available in person to see the patient at home or in the doctor’s office as needed. The virtual plan also comes with a monthly $50 premium rebate and $100 per month over-the-counter credit, redeemable at Walmart, Walgreens, CVS and other retailers.

In addition to this virtual option, Alignment is offering new HMO dual-eligible special needs and HMO point-of-service plans. In select plans, Alignment is introducing new benefits as part of its ACCESS On-Demand Concierge program for eligible members to address social needs such as food instability, loneliness and lack of transportation, that directly impact clinical outcomes. In 2021, new social benefits include pet sitting, pest control, personal emergency response systems, and acupuncture services to further extend the program’s existing benefits such as grocery allowance, non-emergency clinical transportation and “grandkids on demand” companion care.

“Putting the seniors first is what we do each day at Alignment,” said Dawn Maroney, president of consumer and markets, Alignment Healthcare. “That’s why around COVID-19, we delivered thousands of masks and meals, hosted virtual town hall meetings to answer questions, and proactively checked in on our highest-risk members. We bring this same spirit to open enrollment. No matter which plan they choose, Alignment members have a dedicated 24/7 care and support team available to create the best outcomes and experience for each and every one of them.”

Alignment announced in August its expansion into new counties and new