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Cynthia Cox

@cynthiaccox

17 Nov

Curious how the Medicaid expansion works in Build Back Better? Here's a quick thread.
In short, BBB would close the Medicaid coverage gap in states like FL and TX that haven't expanded the program by allowing people living under poverty in those states to access ACA subsidies 🧵

2/ People in states that have already expanded Medicaid with incomes under 138% of poverty would still have Medicaid.
Starting in 2022, if BBB passes, 2.2 million uninsured people living in 12 Medicaid non-expansion states could get heavily subsidized coverage through ACA markets

3/ If BBB passes: In states that do not expand Medicaid, people with incomes under 138% of poverty would get free ($0 premium silver plans) that, in 2022, have an actuarial value of 94% (very low deductible) and from 2023-2025 have an actuarial value of 99% (maybe no deductible)

Read 6 tweets

Cynthia Cox

@cynthiaccox

17 Nov

🧵 Here's an updated summary of the major health provisions in Build Back Better.
It has changed from the original version, so I'll walk through the current version in this thread 🧵(1/10)
Click the link for more data on potential costs and impact: kff.org/health-reform/…

2/ Build Back Better would boost ACA Marketplace subsidies through 2025 (original version was permanent). Upper/middle income people would not be priced out of coverage and low-income people would get free platinum-like plans, thru 2025. Over a million people could gain coverage.

3/ Build Back Better would create a new Medicare hearing benefit (no longer dental/vision). Hearing aids would be available every 5 years with 20% coinsurance. There are about 36 million Medicare beneficiaries in traditional Medicare who currently lack this coverage.

Read 10 tweets

Cynthia Cox

@cynthiaccox

1 Jul

With new regulations on #SurpriseBills expected to drop momentarily, a reminder that about 1 in 5 emergency visits results in an out-of-network charge, putting patients at risk of surprise bills healthsystemtracker.org/brief/an-exami…

Even for childbirth -- something patients have months to prepare for, and it's common for new parents to even go on TOURS of hospitals in preparation for -- 1 in 10 in-network hospitalizations comes with an out-of-network charge healthsystemtracker.org/brief/surprise…

Soon, most surprise billing practice should stop with implementation of the No Surprises Act.

But there are holes in these protections, particularly for ground ambulance rides (which are exactly the sort of situations patients feel powerless in). healthsystemtracker.org/brief/ground-a…

Read 12 tweets

Cynthia Cox

@cynthiaccox

18 Feb

NEW on House COVID Relief:

•3.4M+ people would be guaranteed $0 plans with deductibles under $200

•8M ppl are subject to full-priced premiums now. Many in the subsidy cliff would save $500/month

•States with biggest savings include WY, NE, WV, SD

kff.org/health-reform/…

2/ Under the House proposal, most of the ~14 million people buying on the individual market and the ~15 million uninsured people who could be on the ACA Marketplace would see lower ACA premiums. That savings could be used to get lower deductible plans, too.

3/ The House COVID Relief proposal would yield big savings for the older adults buying ACA Marketplace plans, particularly those above 4x the poverty rate (~$52k single income).

But the zero-premium low-deductible plans for low-income people are at least as big of a game changer

Read 5 tweets

Cynthia Cox

@cynthiaccox

10 Nov 20

At her confirmation, #AmyConeyBarrett said the #ACA SCOTUS case is about severability.

That assumes the individual mandate is unconstitutional, and the question before the court is: 𝘾𝙖𝙣 𝙩𝙝𝙚 𝙧𝙚𝙨𝙩 𝙤𝙛 𝙩𝙝𝙚 𝘼𝘾𝘼 𝙨𝙩𝙞𝙡𝙡 𝙨𝙩𝙖𝙣𝙙?

The data shows it can... 1/9

2/ The individual mandate 𝗵𝗮𝗱 been seen as essential to the ACA’s individual market. The thought 𝗵𝗮𝗱 been, if people with #PreexistingConditons can get coverage, people would wait 'til they got sick to get insurance. This would drive up premiums and lead to a "death spiral"

3/ As anyone who has read the ACA knows, it’s a big piece of legislation. There’s a lot that has nothing to do with the individual mandate. Like calorie labeling, biosimilar approval, closing the Medicare donut hole. There was never a risk of a death spiral in Medicaid expansion.

Read 9 tweets

Cynthia Cox

@cynthiaccox

10 Nov 20

Does Biden’s presidential win make the ACA (#Obamacare) more likely to survive tomorrow’s Supreme Court case?

Only marginally, and it would all come down to Georgia.

Here's why: (1/7)

2/ The Trump Admin is arguing in court that the ACA should be struck down. A Biden Admin would change positions to defend the law.

But the Trump admin’s exit has no effect on the plaintiffs in the case – 18 Republican-led states + two individuals – who aren’t backing out

3/ There’s nothing administrative that Biden can do unilaterally as president to reverse the course of the ACA case. Biden can’t simply issue an executive order and make it go away. This case is now up to the largely conservative SCOTUS to decide.

Read 7 tweets

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