California Likely to Ban Junk Insurance

The Final Rule issued on August 1 by the Trump administration allows short term insurance policies provide coverage for 364 days but also permits insurers to extend such policies up to a maximum duration of 36 months. The New York Times reports that Mr. Trump described these policies as “much less expensive health care at a much lower price,” without noting that lower price is because they do not have to cover pre-existing conditions, prescription drugs or maternity care, and do not comply with the Affordable Care Act requirements.

On August 20, the California Legislature (Senate and Assembly) passed Senate Bill 910, a ban on the sale of such short-term plans in California. According to the Sierra Sun Times, the bill’s Prime Sponsor, Senator Ed Hernandez, described these short-term policies as “dangerous because they subject people to huge health care bills, barely cover any services and give people a false sense of security.” Governor Brown is expected to sign the bill into law.

Maine Still in Limbo on Medicaid Expansion

Maine, as the Associated Press put it, is still “in limbo” with regard to Medicaid Expansion. Last November, Maine voters passed a ballot referendum for it by almost 60%. As the Press Herald reports, the expansion will provide coverage for about 70,000 Mainers “who earn up to 138 percent of the federal poverty level, or $16,753 for a single person, $25,100 for a family of four.”

But Governor Paige (a vehement opponent of Medicaid Expansion) rejects the decision and refuses to allow the state Medicaid office to process applications for residents earning more than the pre-expansion Medicaid eligibility limit. Paige was also supposed to apply to CMS for an 1115 waiver to implement Medicaid expansion by April 3. That application has not yet been filed.

Maine Equal Justice Partners, with other referendum supporters, took legal action last April that resulted in Maine’s Superior Court ordering expansion implementation by June 11, 2018. The Governor appealed that ruling and Maine’s Supreme Court is expected to rule on this case soon.

The Maine Supreme Court’s ruling, as an example of the consequences of staunch resistance by a state administration, could have implications for other states now contemplating Medicaid expansion. Among these are Utah, Nebraska and Idaho, each of which will vote on Medicaid expansion this November.

Louisiana Embraces Medicaid Expansion

On August 20, Governor John Bel Edwards of Louisiana announced that the number of non-elderly, uninsured Louisianans had dropped by half — from 23% of the population to in 2015 to 11% in 2017 — as a result of the state’s decision to expand Medicaid. The state’s previous Governor, Bobby Jindel, rejected Medicaid expansion. Edwards noted in his remarks that, “we are bringing our federal tax dollars back to Louisiana to save lives and improve health outcomes for the working poor people of our state. Not only are we saving hundreds of millions of dollars and creating thousands of jobs because of expansion, we are also saving lives by having more people insured”.

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