A busy week of news –
Medicaid Survey
KFF released its annual survey of Medicaid Directors. Overall the survey found that Medicaid programs are expected to contend with serious revenue pressures. More than half of Medicaid directors surveyed said they saw at least a 50% chance of budget shortfall next year. They also noted that enrollees retained coverage during unwinding were having higher utilization than those disenrolled, increasing costs per enrollee.
MA Lawsuits
United Health Group, Humana, and Centene filed lawsuits against CMS this week over their star ratings. The insurance companies allege that CMS unfairly rated their call center/secret shopper related calls.
Preventative Services Regulation
CMS released a proposed regulation that would enhance preventative services requirements, specifically around contraceptive services. If finalized as proposed insurance companies would have to cover over-the counter birth control, including the hormonal drug Opill, emergency contraception like Plan B and condoms — with no cost-sharing and more kinds of prescribed contraception than mandated by law. The proposed rule will be finalized by the next Administration and is likely to be subject to litigation. More generally, many of the preventative service requirements are currently under litigation and could be subject to change in the coming years.
Uninsured Rate Research
Given the resumption of Medicaid redetermination and dramatic reduction in Medicaid enrollment, an outstanding question is to what extent did the US uninsured rate increase. A new Health Affairs piece suggests that the uninsured rate may only have marginally increased as many of those with Medicaid coverage had additional sources of coverages.
Humana Cigna Merger Talks
Reports circulated this week that Humana and Cigna resumed merger discussions. Reports stated that the discussions were still early-stage and significant work still needed to be done before a potential deal could be completed.
