On April 18, 2019, the Trump Administration finalized the Notice of Benefit and Payment Parameters for 2020 (NBPP). This rule will govern health insurance marketplaces and set the framework for insurance companies to propose plans and premium rates for 2020. Consumer advocates achieved several important victories in the final 2020 NBPP. Contrarily, the final rule also establishes harmful changes that will decrease access to high-quality, affordable coverage and care for families across the country.
The Return of Churn: State Paperwork Barriers Caused More Than 1.5 Million Low-Income People to Lose Their Medicaid Coverage in 2018
In 2018, enrollment in Medicaid and the Children's Health Insurance Program decreased by about 1.6 million enrollees, 744,000 of which were children. There is strong evidence that a driving factor of the decline in enrollment is state policy decisions to engage in punitive annual (or even monthly) eligibility redetermination processes in which large percentages of Medicaid enrollees lose coverage.
Surprise billing, also called surprise out-of-network balance billing, is a common problem when, through no fault of their own, families receive medical treatment from an out-of-network provider. The surprise comes in the form of doctor bills for the difference between what a provider charges and what the insurer pays that provider. Congress is currently considering legislation to address this problem for families all over the country. This piece describes the legislation under consideration in Congress and Families USA’s recommendations for a Congressional fix to this problem.
On March 26, 2019, the chairs of three House committees with jurisdiction over core health care issues jointly introduced legislation that would lower health care costs for millions of people. The "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019," would: increase financial assistance for families who buy their own insurance, without help from Medicaid, Medicare, or an employer; protect people with preexisting conditions by repealing Trump administration policies that sabotage the safe operation of insurance markets; and take other steps to help consumers understand and sign up for coverage.
The Administration’s proposed budget is in part a return to policies that Americans have overwhelmingly rejected. It proposes to gut core insurance protections, end the expansion of Medicaid to low income adults, and block grant the Medicaid program, cuts amounting to over a trillion dollars over ten years. But the budget also signals new and deeply concerning policy changes including mandatory new work documentation requirements in Medicaid, and increasing the cost of health insurance premiums for low income people in the non-group market.
The partial government shutdown enters its 27th day and no end is in sight. Although major health care programs like Medicaid and Medicare are funded, this is not true for the Indian Health Services (IHS). The IHS is a health care agency run by the Department of Health and Human Services but funded by the Department of the Interior (DOI).
UPDATE: 1/8/19 - Links to Families USA's comments on the proposed Program Integrity Rule are available here.