June 14, 2023
Access & Coverage | Tea Leaves
  • The Affordable Care Act’s (ACA’s) preventive care mandate remains in effect as a federal appeals court mulls a legal challenge to the requirements. A panel of judges at the Fifth Circuit Court of Appeals issued a stay Tuesday that partially halts a lower court ruling striking down the mandate. As part of the order, the Biden administration can continue to enforce the preventive service mandate nationwide aside from against the case’s named plaintiffs, a group of Texas companies who sued the government arguing that they should not be required to cover HIV prevention medication because it violated their religious freedoms. (Articles here, here, and here)
  • The Biden administration is rolling out new flexibilities that aim to prevent procedural coverage losses as states work through a backlog of Medicaid eligibility determinations. The Department of Health and Human Services announced that managed care plans can take on a more direct role in assisting members in completing renewal forms. This extends to filling out certain parts of the paperwork on behalf of the member. In addition, states are able to delay administrative disenrollments by a month for further outreach, which will allow for greater time to fill out necessary forms and paperwork. The agency will also allow pharmacies and community-based organizations to assist in getting coverage reinstated for people who are still eligible but lost coverage for procedural reasons. (Article here)