This week, the Commonwealth Fund’s Affordable Care Act Tracking Survey showed recent coverage declines among 19-to-64-year-olds. The survey’s focus is on adults who gained coverage through the ACA’s marketplaces and Medicaid.

The findings show that an estimated four million people have lost coverage since 2016. Significant changes can be seen for lower income households and people aged 35-49, and the losses are even more pronounced in states that have not expanded Medicaid—especially southern states—and among people who self-identify as Republican. For example, among Republicans surveyed, the uninsured rate has risen from 7.9% in 2016 to 13.9% in 2018, with self-identified Democrats seeing no change.

This week, the National Council on Aging (NCOA) and the Council for Affordable Health Coverage’s Clear Choices Campaign released a long-anticipated report on the Medicare Plan Finder (MPF) tool. The Modernizing Medicare Plan Finder Report highlights some of the issues Medicare beneficiaries, their families, and their caregivers encounter while using the MPF tool as well as future considerations for the tool’s development and recommendations for improvement.

On January 11, 2018, the Centers for Medicare & Medicaid Services (CMS) issued guidance announcing a new policy that, for the first time, will allow states to make participation in a work or “community engagement” program a condition for Medicaid enrollment. The next day, CMS approved a Medicaid waiver in Kentucky that will allow the state to test this new policy.

Over the past few months, the Medicare Rights Center has been actively engaged in considering and commenting on proposals from the Centers for Medicare & Medicaid Services (CMS) that could have significant effects on people who are enrolled in Medicare Advantage (MA) and Part D plans. Last week, CMS released both the Contract Year 2019 Final Rules for Medicare Advantage and Part D (Final Rules) and the 2019 Call Letter. CMS also released fact sheets for the Final Rule and the Call Letter. As we continue to analyze the Final Rules and Call Letter, as well as the impact of the recent two-year budget deal, here is a preview of the issue areas we intend to spotlight, which focus on regulatory trends, anticipated implementations, and practical changes that will impact people with Medicare and those who help them navigate coverage decisions.

Health care in the United States is very expensive, and many experts believe one thing contributing to that expense is the abundance of unnecessary or “low-value” health care services provided to patients. Policymakers typically believe that patients receive this unnecessary care because they expect or demand it. However, this month, the University of Michigan revealed new polling data that turns that assumption upside down.

The Kaiser Family Foundation recently released a report with new data on how much people with Medicare paid for health care in 2016 as a share of their total spending. These data show that Medicare households spend a higher proportion of their incomes on health care coverage, services, and drugs than non-Medicare households. This is important information when discussing what policies should be enacted to protect or improve Medicare’s affordability, especially for those with tight household budgets and fixed incomes.

Last week, Medicare Rights explored some of the looming risks to health coverage and affordability created by recent administrative efforts to undercut the Affordable Care Act (ACA). As we noted then, the Trump administration has proposed several new rules that would allow insurers to offer coverage that does not meet the standards set by the ACA. In addition, Congress has taken steps to undermine the ACA’s coverage by repealing the individual mandate in last year’s tax bill, despite evidence that doing so would cause millions to lose coverage. Together, these changes threaten to undermine the design and achievements of the ACA. Now the Urban Institute, a nonpartisan research organization, and Avalere, a nonpartisan health consulting firm, have released studies that add concrete numbers to these risks.

This week, economist Austin Frakt outlined the economic and health impacts associated with Medicaid’s lack of dental coverage for adults in many states. These associations range from an increased risk of cancer and heart disease, to complications for pregnancy, to social stigma and difficulty finding work.
While Medicaid requires dental coverage for children, coverage for adults is optional. Currently, there are 17 states that offer comprehensive adult dental benefits.
Medicaid’s lack of a comprehensive adult dental benefit in most states makes the health and well-being of people with Medicaid less robust. But Medicaid’s sparse dental coverage is still superior to the coverage Medicare offers most beneficiaries.

Congress is trying to pass a new budget this week that includes many important Medicare provisions. One of these provisions is a worrisome extension of past practices: increasing the amount some people must pay for their Medicare benefits.

This week, the Senate Special Committee on Aging held a hearing titled Turning 65: Navigating Critical Decisions to Age Well to examine issues that older adults face as they near retirement age. In Medicare, two decisions are especially important for those who are newly eligible: when to enroll and what coverage option to choose. As the hearing highlighted, these issues have attainable solutions, namely the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act and the State Health Insurance Assistance Program (SHIPs).