Expansion of health coverage is top priority for new Medicare / Medicaid official
The new head of the federal agency that oversees health benefits for nearly 150 million Americans and $ 1 trillion in federal spending said in one of his first interviews that his top priorities will be to expand the insurance coverage and ensuring health equity.
“We have seen through the pandemic what happens when people don’t have health insurance and how important that is,” said Chiquita Brooks-LaSure, who has been confirmed by the Senate to lead them. Centers for Medicare & Medicaid Services on May 25 and sworn in on May 27. “Our goal will be to ensure that regulations and policies are focused on improving coverage.”
This approach is a brutal shift from the Trump administration, which pushed the agency to do what it could to help repeal the Affordable Care Act and cut the Medicaid program, the federal state’s program for people low income.
Brooks-LaSure, whose agency oversees the ACA markets in addition to Medicare, Medicaid and the children’s health insurance program, said she was not surprised by the sharp increase in the number of people signing up to ACA insurance since President Joe Biden reopened registration in January. Since last month, the administration says, over a million people had registered.
“Over the past two years, I’ve worked with many state-based markets and we’ve been able to see the difference in listings when states actively push for coverage,” said Brooks-LaSure. A former congressman and Obama administration health worker, she most recently served as managing director of consultancy firm Manatt Health. “I believe most people who are not signed up want coverage,” but may not understand what is available or how to get it, she said. “It’s about knowledge and affordability.”
Brooks-LaSure also suggested that the Biden administration would support congressional efforts to provide coverage for the millions of Americans who fall into what has been called the Medicaid gap. These are people in the dozen states that have not extended Medicaid under the Affordable Care Act who earn too little to qualify for ACA market coverage. Georgia Democratic Sens. Jon Ossoff and Raphael Warnock, whose GOP-led state has not expanded the program, are calling for a new federal program to cover people who fall into this category.
Brooks-LaSure said she would prefer states to use the additional incentive funding provided in the recent US bailout to expand their Medicaid programs, “because ideally states are able to make policies in their own states; they’re closest to the ground.” But if states fail to expand Medicaid (none have accepted the offer in the new provision, so far), “the public option or other coverage would certainly be a strategy to ensure that people in those states have coverage, ”she said.
Also on its radar is the need to deal with the looming insolvency of the trust fund that finances much of the Medicare program. Last year’s economic downturn – and declining tax revenues from employee payroll deductions – is likely to accelerate when Medicare Hospital Insurance Program will not be able to cover all of their bills.
Brooks-LaSure said she was sure she and Congress would spend time on the issue over the next year or so, but these discussions could also provide officials with an opportunity to reconsider the Medicare program and consider expanding the benefits. Democrats in Congress are considering both lowering the age of Medicare eligibility and adding benefits the program currently lacks, including dental, hearing and vision coverage.
“I hope that we, when we look at solvency, will really focus on the strength of the Medicare program,” said Brooks-LaSure. “And that can mean changes that strengthen the program,” she said.
Kaiser Santé news is a national, editorial independent newsroom and program of the Kaiser Family Foundation, and is not affiliated with Kaiser Permanente.