ACA Title II, Sec. 2202. Permitting hospitals to make presumptive eligibility determinations for all Medicaid eligible populations. “Ugly” – “Of course you are covered by Medicaid!” This provision gives authority for hospitals to determine the preliminary eligibility of each patient for Medicaid. This opens up the opportunity for hospital admissions staff to presumptively determine that the… Continue Reading ›

ACA Title II, Sec. 2201. Enrollment simplification and coordination with state health insurance exchanges: “Bad” – Streamlining is not always good. This provision requires a streamlining and simplification of eligibility for Medicaid, both the categorically eligible and the CHIP eligible. This makes it easier to qualify for Medicaid while Medicaid itself has almost bankrupted the states.… Continue Reading ›

ACA Title II, Sec. Technical corrections: “Bad” – Further unwisely expands eligibility. This legislative initiative further opens up eligibility for the CHIP program. It relaxes the legal language for residence and expands the eligibility caps. Because those controlling federal expenditure patterns (aka Democrats) did not have to compromise with those who oppose more federal spending (aka… Continue Reading ›

ACA Title 1, Sec. 1562. Conforming amendments: “Good” – Required to consolidate the federal role over both group and individual health plans. This provision standardizes the federal Public Health Service (PHS) Act language regarding the regulation of group and individual health plan. This “clean –up” provision simply amends the language in the Act which allows the… Continue Reading ›