The Supreme Court issued a major ruling this morning. In a 5-4 decision, the justices ruled that the government cannot force private companies to provide the broad insurance coverage for contraceptives called for by the ACA. The ruling favors companies like Hobby Lobby, which have religious objections to covering birth control methods like the morning-after pill and intrauterine devices.
Under a proposed rule issued by HHS, consumers who signed up for coverage through the state and federal exchanges will be automatically re-enrolled in coverage for 2015. HHS hopes the proposal will reduce the likelihood that there will be a large drop-off among the 8 million individuals who signed up for insurance in 2014. According to research, most individuals will not take action on their own initiative and thus would likely let policies lapse. However, this decision may be a potential problem to those plans that struggled to gain customers in 2014 or are planning on competing in the exchanges in 2015 for the first time.
According to California Healthline, Medicaid expansion continues to vary in popularity. Currently, twenty-six states and the District of Columbia plan to expand Medicaid, while four states are considering it and 20 have no plans to do so. The primary reason keeping states from expanding Medicaid is the cost. Some states are worried that the federal government will not hold up its end of the bargain. The federal government will fund 100% of the expansion for the first three years and then 90% after that. Many states believe that paying 10% for a program they do not like will take up too much of their budget.
According to a new Gallup poll, about 5 percent of Americans who were uninsured last year got coverage in 2014, and more than half of those gained coverage through the exchange. Young adults were the largest group out of the general population to gain coverage. According to a different survey released by the Kaiser Family Foundation, about 57 percent of those who bought exchange plans had previously been uninsured. Gallup surveyors concluded that the government “may have to intensify its current outreach strategies to motivate resistant citizens to enroll” due to the fact that there are still millions of Americans who remain uninsured.
Due to the delay in ICD-10 implementation, CMS has released a modified version of the OASIS C-1. The OASIS-C1 data item set was originally scheduled for implementation on October 1, 2014. But, five of the data items contained in OASIS-C1 require the use of ICD-10 codes. CMS has made interim changes to the OASIS-C1 data item set and process for reporting OASIS-C1 data.
To see a summary of the changes CMS has made to OASIS-C1 and the OASIS data submission process, click here.
A new Senate bill would increase Medicaid funds toward home-and-community-based services rather than nursing homes. The “Community Integration Act” would speed up implementation of the Supreme Court’s Olmstead ruling. Olmstead stated that nursing home residents with disabilities have a right to live at home-or community-based settings if they have the ability and if it is their preference. Despite the Olmstead ruling, experts say 200,000 working-age people remain segregated in nursing homes due to “nursing home bias” in Medicaid, which pays for institutional care but often does not cover home-or community-based care services for certain beneficiaries. The bill would address this issue by allowing Medicaid to fund nursing home-level care for people living at home or in the community and would also set requirements regarding how states determine people’s eligibility for home-and-community based services.