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New GAO Reports – Medicaid, Private Health Insurance

  • MEDICAID: Information on Inmate Eligibility and Federal Costs for Allowable Services, GAO-14-752R: Published: Sep 5, 2014. Publicly Released: Oct 6, 2014: “In 2013, the Medicaid program financed health care services for more than 72 million individuals, and an additional 7 million beneficiaries are expected to enroll in 2014 as a result of states choosing to expand Medicaid eligibility as allowed under the Patient Protection and Affordable Care Act (PPACA). Most of these newly eligible individuals will be low-income adults, a population that may include individuals who are inmates in state prisons and local jails. In the 27 states that opted to expand Medicaid eligibility as allowed under PPACA, the majority of inmates are likely to have incomes that would qualify them for Medicaid—a circumstance that did not generally exist before 2014, since Medicaid eligibility for adults has generally been limited to certain categories of low-income individuals, such as pregnant women and individuals who are aged or disabled.”
  • PRIVATE HEALTH INSURANCE: The Range of Base Premiums in the Individual Market by County in January 2013, GAO-14-772R:  Published: Sep 5, 2014. Publicly Released: Oct 6, 2014: “GAO is reporting the range of base premiums prior to underwriting for individual market health insurance plans as displayed on the HealthCare.gov Plan Finder in January 2013 for every county in each of the 50 states and the District of Columbia. The base premiums reflected information from data submitted by insurers to the Center for Consumer Information and Insurance Oversight (CCIIO) within the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS). The data represent the base premium amount, rather than the actual premium amount, an individual may have been charged, because in 2013 insurers could have imposed different premiums on individuals on the basis of a variety of factors. Actual premiums could have been higher because they would have been determined after more complete underwriting for health conditions and other individual factors, and some consumers could have been denied any coverage, for example, due to preexisting conditions.”
 

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