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Trump's New "Short-term Plans": Buyer Beware of Swiss Cheese Plans with More Holes Than Coverage

West Virginians often move on and off Medicaid eligibility as they struggle to move forward financially.  For example, someone with a part-time job might see their hours fluctuate and this can change whether they are income eligible for Medicaid.  Many West Virginians who rely on Medicaid during hard times find that they transition off Medicaid when their income is restored or goes up – even if they don’t have a job with health insurance benefits.  For these West Virginians, shopping for health insurance is a daunting task.  And unfortunately, as we wrote in yesterday’s blog, the Trump Administration has slashed funding for health insurance navigators who help people understand their health insurance choices.

Now to make the task even more challenging, the Trump Administration has issued a new rule that allows so-called “short-term plans” to be sold.  These plans do not have any of the consumer protections that are part of the Affordable Care Act.  There are no required basic benefits (such as prescription drugs, mental health services, rehabilitation services) and they can charge people with pre-existing conditions more and include “riders” that exclude coverage for pre-existing conditions. They can penalize older people and sicker people (or people who they deem might get sick) with high premiums and copays.

So please buyer beware!  These plans could mean you pay premiums for the privilege of being uninsured.  These plans are really “swiss cheese plans” – more holes than coverage and they melt away when you get sick and need them the most.  And remember, read the fine print. Lower premiums are attractive – but you may end up paying more later out of your own pocket.


Trump Administration Navigator Funding Cuts Leave West Virginians To Find Their Own Way to Affordable Health Insurance

Last week, the Trump administration announced a drastic cut, nearly 90 percent from 2016 funding levels, to Affordable Care Act navigator funding. These grants have provided several years of critical, unbiased, in-person assistance through ‘navigators’ to help individuals and families enroll in health insurance.

WV Navigator is a grant funded program that provides free health coverage enrollment assistance to uninsured West Virginians. Trained and certified navigators help consumers enroll in qualified health plans through the Health Insurance Marketplace or, if eligible, WV Medicaid. Navigators help consumers determine eligibility for health coverage and financial assistance for health coverage. In West Virginia, West Virginia University Research Corporation and First Choice Health Systems received grants of $300,000 each in 2017.

This year the West Virginia total federal navigator program budget will be cut from $600,000 to $100,000 – a 83 percent cut in funding. This funding decision is but the latest in a series of blows to the enrollment community in the past two years. Looking across the country, the inadequate $10 million navigator grant is an 84 percent cut in services since 2016 and a 42 percent cut over last year’s already meager spending levels. 

Cuts of this magnitude stretch the navigator program to the breaking point. It makes it significantly harder for West Virginians to learn about  the availability and affordability of plans, leaving consumers too often with few, if any, resources for understanding their health insurance options.  Consumers in our state will be lost in the forest of health insurance choices without an experienced guide.

Please Call our Congressional Delegation to reverse these cuts by restoring and increasing investments in enrollment and health literacy assistance now and for years to come.

 


WVU Law Professor Sounds Alarm on Judge Kavanaugh

 

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Jennifer D. Oliva, Associate Professor of Law and Public Health, West Virginia University College of Law, in an Opinion Editorial in today’s Charleston Gazette-Mail (Health care, lives will be affected by Supreme Court choice) warned that, “…ACA proponents are wise to be concerned about the future of health care reform in the hands of a high court that includes Brett Kavanaugh.”

The OpEd is worth a read.  Professor Oliva also warns, “Some legal experts argue that Kavanaugh might be inclined to reverse (the Kentucky Medicaid work requirements federal court decision), thereby stripping 400,000 Kentuckians of their Medicaid coverage – based on the legal theory that poor people lack standing to sue the government under the Medicaid statute.”

“In West Virginian, where over half-a-million people receive Medicaid, a legal ruling blocking access to the courts could literally cost lives.”

Professor Oliva concludes, “In sum, ACA supporters should be worried the Senate might confirm Judge Kavanaugh’s nomination to the Supreme Court.  Those who live in Medicaid expansion states, including West Virginia and Kentucky, should be particularly alarmed about that possibility. The future of health care reform hangs in the balance.” (Emphasis added)

Senator Joe Manchin is encouraging West Virginians to send him their thoughts on Supreme Court nominee Brett Kavanaugh.  Constituents can submit their views of Judge Kavanaugh through a form on Manchin’s Senate website or by emailing SCOTUS@manchin.senate.gov.

If Brett Kavanaugh is confirmed, he will be sitting on the Supreme Court when cases are decided that could take away consumer protections for pre-existing conditions and scale back Medicaid. Literally hundreds of thousands of West Virginians could lose their health insurance coverage. The stakes are very high. Please let Senator Manchin know your opinion. 


WARNING: Supreme Court Nominee Is Hazardous to Your Health

Senator Joe Manchin is encouraging West Virginians to send him their thoughts on Supreme Court nominee Brett Kavanaugh.

A website and email address have been set up by Manchin’s office for constituents to comment on the federal judge.

Constituents can submit their views of Judge Kavanaugh through a form on Manchin’s Senate website or by emailing SCOTUS@manchin.senate.gov.

If Brett Kavanaugh is confirmed, he will be sitting on the Supreme Court when cases are decided that could take away consumer protections for pre-existing conditions and scale back Medicaid. Literally hundreds of thousands of West Virginians could lose their health insurance coverage. The stakes are very high.

See this background fact sheet on Judge Kavanaugh.

 


Medicaid Work Requirements Struck Down by Court

On Friday June 29, Federal Judge James E. Boasberg rejected Kentucky Governor Bevin and the Trump administration’s attempt to fundamentally alter Kentucky’s Medicaid program and make it much harder for vulnerable families to receive health care. Specifically, the court ruled that the Center for Medicare and Medicaid Services (CMS) did not have the legal authority to approve a request by Governor Bevin to tie Medicaid eligibility to work requirements and new administrative reporting burdens.

 


The Power of a Story: "My Medicaid, My Life" by Alice Wong

Last summer, people of compassion across the country were fighting to prevent the United States Congress from repealing the ACA and slashing Medicaid funding by billions of dollars. And we won. 

An important part of the strategy that gave us that victory was sharing the stories of people on Medicaid with the media and with Members of Congress. 

Below you can go to an excerpt from the beginning of a piece that appeared in the New York Times on May 3, 2017. Alice Wong tells her story of how Medicaid has changed her life.  Please read the full piece by Alice and send copies to others.

There is no question that Alice is a powerful advocate for people with disabilities.

But anyone who shares their story can share that power and make a difference.

Go to Share Your Story and we will contact you.  You control your story - we will talk to you about if and how you might want to share your story and help protect Medicaid.


Coming Soon: Medicaid the Target for Huge Funding Cuts

In the U.S. Congress yesterday, Rick Santorum and other Republican leaders unveiled yet another plan to repeal the ACA and targeting Medicaid for huge funding cuts. Their full plan can be found here. As was the case with other Congressioal ACA repeal proposals in 2017, Medicaid would be hard-hit. Ironically called the "Health Care Choices" Proposal, it actually threatens to take away the choice to have affordable, quality health insurance from more than 200,000 West Virginians. 


Here We Go Again: Another Bill to Slash Medicaid Funding in Congress

The leadership in the U.S. Congress is at it again. This week leading conservative organizations and Republican leadership will introduce a new version of their ACA repeal bill, which we expect to closely resemble last summer’s Graham-Cassidy bill. (As a reminder, here’s a good summary of what that plan entailed.) While we don’t expect this legislation to go anywhere in the near term, we take this as an effort to put repeal at the top of the agenda for next year, circumstances permitting. This is also another attack on the ACA following close on the heels of President Trump's Administration’s decision not to defend the Texas lawsuit. President Trump has signaled his support by putting the old Graham-Cassidy bill into his 2019 proposed federal budget.

According to the national Center on Budget and Policy, like the other repeal bills that Congress considered and rejected last year, the new bill is very likely to eliminate the ACA’s expansion of Medicaid to low-income adults; make individual market coverage unaffordable for many moderate-income consumers; cap and cut federal Medicaid funding for seniors, people with disabilities, and families with children; roll back nationwide protections for people with pre-existing conditions; and cause millions of people to lose coverage. A new version of Cassidy-Graham would likely leave even more Americans uninsured, because it would likely provide even less federal funding for health coverage than the earlier bill. When a plan is released, we will pass along analyses and other relevant materials.


New KFF Study: Medicaid Work Requirement Hurts Working Enrollees

new analysis from the Kaiser Family Foundation provides illustrative scenarios of potential Medicaid coverage reductions if all states had work requirements similar to those already approved by the Centers for Medicare and Medicaid Services for Kentucky, Indiana, Arkansas and New Hampshire, and sought by several other states.  As the bar chart below illustrates, the analysis finds that a majority of people who would lose Medicaid coverage are likely to be working or able to qualify for an exemption; they would lose coverage due to administrative difficulty reporting their status. Between 1.4 million and 4 million adults could lose Medicaid coverage nationally, the analysis finds.

 

 


A Tough Row to Hoe: How Republican Policies are Leaving Rural Health Care in the Dust

A Tough Roe to Hoe: How Republican Policies are Leaving Rural Health Care in the Dust, is a new report released this week by one of West Virginians Together for Medicaid’s many collaborating organizations, Protect Our Care. The report finds that since 2010, 84 rural hospitals have closed. The vast majority – 90 percent – were in states that had refused to expand Medicaid at the time of the hospital’s closure.  And remember that the Medicaid expansion is a bargain for the states - the federal government pays at least 90 percent of the costs of the program. 

In West Virginia, our legislature had the wisdom and the compassion to be one of the first states to expand Medicaid. The Medicaid expansion in 2014 has allowed more than 180,000 West Virginia adults – of which about 2/3rds work but don’t have health insurance benefits at their low-wage jobs – have quality and affordable health insurance. With Medicaid, these West Virginians can go to a doctor and get the medical care they need to stay healthy and productive.

Rural hospitals financial status improved in Medicaid expansion states:

    • uncompensated care costs fell 43%
    •  Medicaid revenue as a share of total hospital revenue rose 33%
    • operating margins increased by 4 percentage points (difference between total revenues & operating costs)

There is no question that the Medicaid expansion in West Virginia has been a life-line for our rural hospitals. 


West Virginians Together for Medicaid