The first official press release from the Centers for Medicare & Medicaid Services (CMS) under the Trump 2.0 Administration is out, and not only is it pretty innocuously worded...it's actually complimentary of the Inflation Reduction Act, which is noteworthy given that the IRA was passed & signed into law exclusively by Democrats & President Biden:
CMS Statement on Lowering the Cost of Prescription Drugs
Lowering the cost of prescription drugs for Americans is a top priority of President Trump and his Administration. In accordance with the statutory requirements of the Inflation Reduction Act, the Centers for Medicare and Medicaid Services (CMS) released the list of 15 drugs selected for the second cycle of the Medicare Drug Price Negotiation Program on January 17, 2025.
Health care spending in the US reached $4.9 trillion and increased 7.5 percent in 2023, growing from a rate of 4.6 percent in 2022. In 2023, private health insurance and Medicare spending grew faster than in 2022, while Medicaid spending and enrollment growth slowed as the COVID-19 public health emergency ended. The health sector’s share of the economy in 2023 was 17.6 percent, which was similar to its share of 17.4 percent in 2022 but lower than in 2020 and 2021 during the height of the COVID-19 pandemic.
In October 2024, 79.3 million individuals were enrolled in Medicaid and CHIP.
72.1 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
41.7 million adults were enrolled in Medicaid, and there were 37.6 million Medicaid child and CHIP enrollees.
Medicaid and CHIP Applications Received
In October 2024, Medicaid, CHIP, Human Services agencies, and State-based Marketplaces received 2.6 million applications, or 2 percent more applications, as compared to September 2024.
The number of applications received has increased by 20 percent since October 2023 and increased by 66 percent since October 2022.
Total Medicaid/CHIP enrollment in October 2024 still dropped very slightly from September...by just 55,000 people.
The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)
Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented for the following year.
(sigh) Goddammit. This isn't terribly surprising but it's still pretty disappointing.
As laid out in my prior (repeatedly updated) story about this ongoing saga, the eligibility of up to 100,000 or so uninsured DACA recipients to enroll in healthcare coverage via the ACA marketplaces has been bouncing back & forth for some time now. President Biden originally made a rule change to make them eligible to enroll back in May 2024. Unfortunately, earlier this fall a coalition of 19 Republican state Attorneys General filed a lawsuit to block the Biden Administration from enrolling DACA recipients, and the courts have ping-ponged their status a few times ever since.
Things were looking good a week or so ago when the 8th Circuit Court issued a stay on the injunction...but I just got the most recent ruling from the 8th Circuit Court, and it's bad news:
Under the Inflation Reduction Act, some people with Medicare will pay less for some Part B drugs because the drug’s price increased faster than the rate of inflation.
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today announced that some Medicare enrollees will pay less for 64 drugs available through Medicare Part B. The drugs will have a lowered Part B coinsurance rate from January 1, 2025 – March 31, 2025, since drug companies raised prices for each of these 64 drugs faster than the rate of inflation. Over 853,000 people with Medicare use these drugs annually to treat conditions such as cancer, osteoporosis, and substance use disorder. Since April 1, 2023, people with Medicare have seen savings on over 120 drugs thanks to Inflation Reduction Act’s Medicare Prescription Drug Inflation Rebate Program.
The Deferred Action for Childhood Arrivals (DACA) program was created to protect eligible young adults who were brought to the U.S. as children from deportation and to provide them with work authorization for temporary, renewable periods. As of December 31, 2022, there were roughly 580,000 active DACA recipients from close to 200 different countries of birth residing all over the U.S.
While individuals with DACA status can be authorized to work, they remain ineligible for many federal programs, including health coverage through Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act (ACA) health insurance Marketplaces. These restrictions result in higher uninsured rates among DACA recipients, contributing to barriers accessing health care.
Biden-Harris Administration Announces Medicare Advantage and Medicare Part D Prescription Drug Proposals that Aim to Improve Care and Access for Enrollees
Today, the Centers for Medicare & Medicaid Services (CMS) is proposing actions in the Medicare Advantage (MA) and Medicare Part D prescription drug programs to continue to strengthen protections and access to care for people with Medicare. The Contract Year (CY) 2026 MA and Part D proposed rule aims to hold MA and Part D plans more accountable for delivering high-quality coverage so that people with Medicare are connected to the care they need when they need it.
