CMS may extend access to Medicaid birth control if Roe v. Wade is revoked

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Chiquita Brooks-LaSure testified before the Senate Finance Committee during a hearing on her appointment as trustee of Medicare & Medicaid Services Centers in Washington on Thursday, April 15, 2021.

Caroline Brehman CQ-Roll Call, Inc. | Getty Images

In her first year as director of the Medicare and Medicaid Services Centers, Chiquita Brooks-Lasure oversaw the expansion of government health insurance to a record number of Americans through Medicare, Medicaid, and private affordable care exchange plans.

Now he wants to let them be insured.

“We cover more than 150 million people as a result of all the hard work of the agency, which really involves people in coverage. So we are a big payer and we help dictate coverage in this country … and we have a strong opportunity to improve health equity,” Brooks explained. Lasure.

Next year, one of the agency’s biggest challenges will be to create a smooth transition for the millions of Medicaid members who could lose coverage when the Covid public health emergency ends. In line with the federal health emergency, states have postponed re-eligibility for the past two years.

Loss of coverage

While the administration is expected to renew its current emergency appointment next month, a study by the Kaiser Family Foundation estimates that between 5 and 14 million people could be deregistered once renewed decisions continue.

Brooks-Lasure says health insurers that run Medicaid state programs will play an important role in helping those who lose eligibility to switch to private health exchange plans, or Medicare if they turn 65.

“We have more involvement in the plans, especially in Medicaid coverage than we said 10 years ago. So they are a key component to help ensure that we – and I mean countries – move people to whatever type of coverage they are entitled to,” she said.

In addition to the public health emergency, he wants health coverage to be more consistent in public and private programs.

“Whether it’s maternal health or you’re in the middle of cancer treatment … you want to stay focused on the condition itself, instead of having to worry about what’s changed in your coverage,” she explained.

Birth control

In a new report outlining the agency’s priorities, Brooks-Lasure says addressing health differences is a central pillar of the agency’s mission. He was particularly focused on improving maternal health insurance; Medicaid programs now cover 40% of U.S. births With funding from the U.S. Rescue Plan Act of 2021, the agency is working with states to expand Medicaid coverage for new mothers who are not insured from 60 days to 12 months.

When it comes to reproductive care, Brooks-Lasure says CMS will also prioritize improving access to contraception in Medicaid and ACA health plans next year. If the Supreme Court overturns Roe v. Wade, as expected this month, the agency will be limited in its ability to provide access to abortion for women on Medicaid under federal funding rules.

Brooks-Lasure said the agency has focused on areas it has powers such as preventive care and contraception. She said the CMS encourages states to use Medicaid to provide men and women with access to contraception, “according to the Supreme Court’s decision on wider services.”

Medicare premium rollback

One of the biggest decisions CMS issued this year, according to mixed data on the drug’s effectiveness, was to limit Medicare coverage for the treatment of Alzheimer’s Aduhelm disease. However, this move came after actuaries took into account the expected high price of the drug in Medicare premiums for 2022. Medicare recipients can expect a refund in 2023.

“Because the coverage is lower, we’ll include that in next year’s premium,” Brooks-Lasure said.

Medicare recipients could also get a discount on premiums for drug plans by introducing several biologically similar versions of AbbVie’s expensive drug Humira to treat arthritis next year. Humir sales in 2021 exceeded $ 20 billion. Amgen’s biologically similar version will go on sale in the US in January.

Brooks-Lasure says CMS actuaries are calculating the potential impact of the transition on biologically similar Humira products and are expected to publish their analysis in early September, in time to set premiums for 2023.

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