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CMS can expand access to birth control under Medicaid if Roe v. Wade is overturned

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Chiquita Brooks-LaSure testifies before the Senate Finance Committee during her nomination hearing to be administrator of the Centers for Medicare & Medicaid Services in Washington on Thursday, April 15, 2021.

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

Chiquita Brooks–Lasure, the Centers for Medicare & Medicaid Services administrator, has managed to expand government coverage for a record amount of Americans, including those who are eligible for Medicare, Medicaid, and the Affordable Care Act exchange plans.

She wants to be a teacher. keep them insured.

Because of their hard work in enrolling people, we now cover more than 150 million people. So, we are a huge payer, and we help dictate coverage in this country … and have a powerful opportunity to advance health equity,” Brooks-Lasure explained.

The agency will face many challenges in the next year, including ensuring smooth transitions for the millions of Medicaid recipients who might lose coverage due to the Covid Public Health Emergency. The federal emergency has forced states to suspend eligibility redeterminations for the past two years.

LOSS OF INSURANCE

The administration will likely renew the emergency designation in the next month. However, according to a Kaiser Family Foundation study, between 5 and 14 million individuals could lose their eligibility when redeterminations begin.  

Brooks Lasure claims that state Medicaid program administrators will be able to assist those who become ineligible to move to private insurance plans. Medicare is also available for people over 65.  

We now have more participation in plans, particularly for Medicaid coverage. This is a significant improvement on what we had 10 years ago. So they are a key component to helping make sure that we — and by we, I also mean the states — move people to whatever type of coverage they are eligible for,” she said.

Her desire for greater consistency across private and public programs in terms of health coverage extends beyond the emergency.

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

Control of birth

Brooks Lasure, who has just released a new report detailing the priority areas for the agency, stated that the central pillar in her agency’s mission is to address health disparities. Brooks-Lasure has been particularly concerned with improving maternal health coverage. Medicaid currently covers 40% of U.S. births. The American Rescue Plan Act was passed in 2021. This funding will allow the agency to work alongside states to increase Medicaid coverage for mothers born to uninsured mothers from 60 to 12 months.

Brooks Lasure stated that CMS would prioritize accessing contraception through Medicaid and ACA in reproductive care. In the event that Roe v. Wade is ruled invalid by the Supreme Court as was predicted this month, CMS will have limited access to abortion under federal funding rules for Medicaid women.

Brooks-Lasure stated that the agency is focusing on areas where it has jurisdiction, such as contraception and preventive care. In light of any Supreme Court decisions regarding other services, she said CMS encouraged states to make use of Medicaid to guarantee access to birth control.

Medicare premium rollback

After mixed evidence on Aduhelm’s effectiveness, CMS made the most important decision this year to reduce Medicare coverage. The move was made after the actuaries had incorporated the anticipated high price of Aduhelm into the 2022 Medicare premiums. Medicare recipients will see a rollback of their benefits in 2023.

Brooks-Lasure stated, “Because coverage has been lower, we will incorporate it in the premium next year.”

Medicare beneficiaries could get discounts on their drug plans by the addition of biosimilar versions AbbVie’s expensive arthritis medication Humira. Humira sales reached $20 billion by 2021. Amgen will launch its biosimilar version in January in the United States.

Brooks-Lasure states that CMS actuaries are working to calculate the impact of Humira’s biosimilars on the future. They are due to publish their analysis around September to allow for the setting of 2023 premiums.

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