Jakob Emerson - Friday, May 26th, 2023

Eight states have at least 1 million residents enrolled in Medicare Advantage plans, according to a health coverage report published by insurance trade group AHIP in April.

States ranked by total Medicare Advantage members:

1. California: 3.1 million
2. Florida: 2.6 million
3. Texas: 2.2 million
4. New York: 1.8 million
5. Pennsylvania: 1.4 million
6. Michigan: 1.2 million
7. Ohio: 1.2 million
8. North Carolina: 1 million
9. Georgia: 947,000
10. Illinois: 794,000
11. Tennessee: 696,000
12. Arizona: 682,500
13. New Jersey: 634,000
14. Washington: 627,000
15. Wisconsin: 619,100
16. Missouri: 619,000
17. Alabama: 595,000
18. Indiana: 584,000
19. Minnesota: 551,000
20. Virginia: 541,000
21. Colorado: 479,000
22. Oregon: 474,000
23. Kentucky: 466,200
24. Louisiana: 466,000
25. South Carolina: 465,000
26. Massachusetts: 406,000
27. Connecticut: 377,000
28. Oklahoma: 273,000
29. Nevada: 271,000
30. Arkansas: 250,000
31. Mississippi: 222,000
32. Maryland: 211,000
33. New Mexico: 207,000
34. Utah: 206,000
35. Iowa: 197,000
36. West Virginia: 194,000
37. Maine: 193,000
38. Idaho: 164,000
39. Kansas: 163,000
40. Hawaii: 154,000
41. Rhode Island: 116,000
42. Nebraska: 98,000
43. New Hampshire: 97,000
44. Montana: 64,000
45. Delaware: 63,000
46. Vermont: 44,000
47. Washington, D.C.: 27,000
48. South Dakota: 24,000
49. North Dakota: 14,000
50. Wyoming: 9,000
51. Alaska: 2,000

What do the early data show?

As states begin to unwind the COVID emergency continuous enrollment provision and resume Medicaid disenrollments, early data from a handful of states – highlighted on KFF’s regularly-updated Medicaid Enrollment and Unwinding Tracker

– reveal wide variation in disenrollment rates. While not all states that have resumed disenrollments have publicly posted their numbers, data from 12 states show that over half a million enrollees have already been disenrolled, nearly 250,000 in Florida alone (Figure 1). In nine states that reported both total completed renewals and total disenrollments, the disenrollment rate ranges from 54% in Florida to just 10% Virginia. Among these states, the median disenrollment rate is 34.5%.

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States must take better care not to expel eligible Medicaid enrollees from the program during the re-determinations process, a senior Centers for Medicare and Medicaid Services official said Tuesday.

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Scores of Medicaid recipients will begin to lose their insurance next week as states continue to review whether residents still qualify.

The South Carolina Department of Health and Human Services anticipates close to 250-300,000 members will be dis-enrolled by 2024. That will roll back enrollment numbers from 1.3 million to pre-pandemic levels at just over 1 million.

KFF, a non-partisan health research organization, estimated close to 214,300 Medicaid losses, including over 86,000 children.

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Steve Boucher, Director of Managed Care Services for the South Carolina Alliance of Health Plans presented both in-person and virtual overviews of the Medicaid Annual Review process to hundreds of health insurance professionals. These presentations leveraged Steve’s extensive knowledge of the Medicaid Annual Review process as well as his understanding of the health insurance industry and identified him as a key leadership resource in the Medicaid sector.  The presentations provided the health insurance professionals with trusted information that will enable strategic decisions within their organizations.

       

Dive Brief:

• Half of eligible Medicare beneficiaries are now enrolling in private Medicare Advantage coverage, according to recently released data from the CMS.
• Of the 59.82 million people who qualify for a Medicare Part A and Medicare B private plan, 30.19 million, or over half of those who qualify, enrolled in January 2023, according to a Monday report from the Kaiser Family Foundation.
• Plan A and Plan B enrollment increased by two percentage points from 48% in 2022, according to the nonprofit’s analysis. That means MA now has more enrollees than original Medicaid, a report from Barrons noted.

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COLUMBIA, S.C. (WPSA) -The South Carolina House of Representatives unanimously approved a bill that would repeal the state’s Certificate of Need program.

The Senate had passed the bill earlier this year with a 30-6 vote.

‘Certificate of Need’ regulations were put into place by the federal government in the 1970s. According to DHEC, the purpose of CON laws is to promote cost containment and prevent unnecessary duplication of healthcare facilities and services.

Right now, if a healthcare provider in South Carolina wants to add beds, build a new facility or purchase expensive medical equipment, they need to go state health officials for approval.

Competitors can appeal these requests, slowing down the process.

House members made a change to the bill on the floor before passing it. The bill would repeal nearly all parts of ‘Certificate of Need’ regulations almost immediately.

Health providers looking to build a new hospital must go through the ‘Certificate of Need’ process up until January 2027. After that date, the regulations would be repealed.

The bill received a third reading from the House Wednesday and was sent back to the Senate. There are now four days left in this year’s legislative session.

Long-term care facilities would still need to go through the Certificate of Need process.

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COLUMBIA — Parents of children 5 and younger in South Carolina can fill out a new online application to simultaneously check their eligibility for taxpayer-funded child care assistance, preschool and other government programs.

The May 1 launch of the common application on first5sc.org was celebrated by state agency leaders and early childhood advocates as providing families an easier, quicker way to access services that enable parents to work and children to succeed.

Instead of filling out separate, often lengthy forms — sometimes needing to do so in person during business hours — parents can securely submit information once that will automatically fill out applications across state government.

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Gov. Henry McMaster Announces Michael Wise as Next Director of the S.C. Department of Insurance

Health Coverage Premiums - View Document.pdf