States with Medicaid Expansions and State-Based or State Partnership Marketplaces Have Greater Reductions in Uninsured Rate

States that expanded Medicaid and operate a State-based or State Partnership Marketplace have the lowest rates of uninsurance in the United States, according to new data by Gallup. Since the beginning of 2014, Arkansas and Kentucky have had the steepest reductions in uninsured rates, of 13.4 and 11.4 percentage points, respectively. Oregon, Rhode Island, and Washington have also seen at least a 10 percentage point reduction in uninsured rates. Of the 10 states with the highest reductions, the top 7 have both expanded Medicaid and established a State-based or State Partnership Marketplace. The average reduction in the uninsured rate across states that implemented both measures is 7.1 percentage points, compared to 5.3 percentage points across the 28 states that implemented only one or neither of the measures.

Despite Technology Improvements, Study Finds Consumers Still Seek Enrollment Guidance From Assisters

According to assister programs surveyed by the Kaiser Family Foundation, consumers continued to have a substantial need for assistance during the most recent open enrollment period. Nearly 80% of assister programs reported that most consumers who sought help said they lacked the confidence to apply on their own—similar to reports after the first open enrollment period. Improvements in Marketplace websites resulted in a decline in assistance related to Marketplace technical difficulties: just 38% of assister programs reported that most consumers sought assistance because of technical difficulties, compared to 65% in the first open enrollment period. In the second open enrollment period, more than 4,600 assister programs, with 30,400 full time staff and volunteers, served 5.9 million consumers.

HHS Inspector General Finds Terminated Medicaid Providers Participating in Other States

HHS's Office of the Inspector General (OIG) released a report finding that 12% of providers who were terminated from state Medicaid programs in 2011 for reasons of fraud, waste, or abuse participated in other states’ programs, despite the ban on such practices in the Affordable Care Act. According to the analysis, states paid a total of $7.4 million to 94 providers for services after the provider was terminated from Medicaid in a different state. Based on its findings, OIG reiterated its recommendation from a 2014 report that CMS require state agencies to report all terminations. Additionally, OIG newly recommended that CMS develop uniform terminology to identify a reason for termination and require state Medicaid agencies to directly enroll all providers in Medicaid managed care networks, as states that currently do not are not able to terminate these providers. The latter is a provision required in CMS’s proposed new Medicaid Managed Care rules. CMS agreed with all recommendations.