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Celebrating 35 years of making Medicare more accessible, affordable, and equitable!

Julie Carter

Senior Federal Policy Associate

Block Grants Cut Medicaid and Put Millions at Risk

Today, the Trump administration released guidance to help states convert some of their federal Medicaid funding into a block grant. In exchange for accepting this capped funding, states will receive more power to cut care and restrict coverage.

This new structure, billed as a voluntary demonstration for states, can apply to funding for optional Medicaid populations: low-income adults under the age of 65 who wouldn’t otherwise be eligible for the program. This includes adults in the Medicaid expansion population, though non-expansion states that voluntarily cover other adults—such as low-income parents with incomes above the traditional Medicaid threshold and adults with dependent children—may also participate.

Kaiser Family Foundation Compares Proposals Intended to Lower Prescription Drug Costs

Last month, the Kaiser Family Foundation (KFF) released a series of charts that explain and compare various legislative proposals to lower prescription drug costs. Such proposals are in the limelight because many Americans identify drug pricing as a significant problem and support government action to address it. According to one KFF poll, high drug costs have kept 30% of Americans from taking their medicine as prescribed.

Lawmakers Raise Medicare Plan Finder Concerns

This week, a bipartisan group of leaders from the U.S. House of Representatives Committees on Energy & Commerce and Ways & Means sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concerns with the redesigned Medicare Plan Finder (MPF). The letter points to errors that advocates and Medicare counselors experienced when using the new tool to help beneficiaries compare and select Medicare Advantage and Part D prescription drug plans during Fall Open Enrollment. In the letter, the leaders urge CMS to ensure that people with Medicare who relied on MPF information to choose a plan this year are held harmless and have the opportunity to make changes to their coverage in 2020.

New Data Show Very Few People with Medicare Choose to Switch Plans Each Year

A new data note from the non-profit Kaiser Family Foundation (KFF), however, reveals that very few people with Medicare end up switching plans during the fall. Among MA and PDP plan enrollees who did not receive low-income subsidies, fewer than 8% of people enrolled in MA plans chose to switch to another MA plan in 2016. The pattern is similar for standalone drug plans–just over 8% switched from one PDP to another. This could mean that beneficiaries have reviewed and are happy with their coverage, but it might highlight a more troubling reality– people may not know they can switch plans or may find the process of comparing plan options too burdensome.

Poll Finds Many Americans Worried about Health Care Costs and Struggle to Afford Care

A recent poll and study by Gallup and West Health found that most Americans are worried about rising health care costs, and many are also concerned about bankruptcy from major health events. Older adults have somewhat more confidence about their access to quality care than younger people, but they still experience difficulty with affordability, especially when it comes to paying for prescription drugs. These findings and more are an important indicator that more must be done to bring down health care costs.

Upcoming Medicare Additions for Treatment for Opioid Use Disorder

The Centers for Medicare & Medicaid Services (CMS) recently finalized a rule that expands Medicare coverage for Opioid Use Disorder (OUD). Recent legislation, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, established a pathway for this more comprehensive Medicare coverage of OUD services. Beginning on January 1, 2020, Medicare Part B will cover OUD treatment—including methadone for Medication Assisted Therapy (MAT)—furnished by an Opioid Treatment Program (OTP) under a bundled payment mechanism. This means a significant improvement in access to OUD care for people with Medicare, including for those who are dually eligible for Medicaid.

Court Blocks Sweeping Rule that Would Negatively Impact Patient Access to Care

This week, a federal court blocked a Trump administration rule that would have allowed health plans and providers to refuse to provide certain types of care they disagreed with on moral or religious grounds. Set to take effect on November 22, the rule would have permitted individuals to deny care even in circumstances where performing the refused service was a significant portion of their jobs, and even where the refusal could prevent patients from receiving the service altogether.