Thursday, February 16, 2023
Medicaid has expanded by 20 million during Covid
Keeping a lot of people out of the workforce
By Robert Romano
Since Feb. 2020, thanks to the “continuous enrollment” in the Families First Coronavirus Response Act, which prohibited states from disenrolling Medicaid patients when they no longer qualify on the basis of income, Medicaid enrollment has skyrocketed by 20.2 million to more than 91 million since Feb. 2020, according to the latest data from the Centers for Medicare and Medicaid Services (CMS) compiled by the Kaiser Family Foundation.
The mechanism for the expansion was temporary Covid unemployment, when 25 million jobs were lost in the blink of an eye, resulting in lapses in private insurance. When patients got Covid and went to the hospital and other medical providers, this resulted in automatic enrollment so providers could get paid.
The largest increases came from California (2.3 million), Texas (1.5 million), New York (1.3 million) and Florida (1.2 million). With 2.7 million in Texas and Florida alone, were Republican governors Greg Abbott and Ron DeSantis ever made aware of this provision? What about state Republican lawmakers?
Reviewing the gubernatorial websites in Texas and Florida, as well as the official Twitter feeds of both governors, I cannot find a single statement either opposing the “continuous enrollment” provision—which left recipients in state Medicaid programs long after they had returned to work—or even acknowledging it or the rapid expansion of their state’s Medicaid programs.
In fact, the 20 million added during the Covid Medicaid expansion was even larger than the expansion that ultimately occurred under the Affordable Care Act from 2010 to 2019, when the number went from 56 million before the Affordable Care Act was passed, to 71 million in 2019. In 2020 the economy tanked, unemployment skyrocketed and Medicaid enrollment exploded.
That would have happened anyway. The consequential provision was the “continuous enrollment” that prohibited states like Texas and Florida from recertifying patients’ income as was required under prior law.
How is that possible? Maybe someone should ask them. I personally only discovered it when I learned of the disenrollments that are set to begin after March 31 thanks to a provision in the $1.7 trillion omnibus spending bill.
And yet the federal government wasn’t hiding it. Centers for Medicare and Medicaid Services were publishing Medicaid enrollment snapshots under the provision dating back to June 2020.
A Jan. 19 piece from Orlando Sentinel appears to show Florida State House Republicans were similarly not made aware of Medicaid expansion in Florida until the Medicaid disenrollments began, with House Health & Human Services Chairman Randy Fine, (R-Brevard County) stating after being briefed in committee: “The federal government during the pandemic said once you are on, it’s like being on the Supreme Court — you can’t get kicked off… And so we have people who qualified at one moment in time but do not qualify today.”
But they weren’t alone. In my prior look at the issue, I couldn’t find a single statement by House or Senate Republicans specifically about the continuous enrollment provision. There was a House Republican Oversight Committee letter about potential improper payments to Medicaid during Covid in Aug. 2021, but with no mention of the program’s expansion. By then, the program had already expanded by 13 million.
The problem appears to be an apparent lack of information and institutional knowledge by Republicans in Congress, legislatures and state governor’s mansions. In the old king’s cabinet in Great Britain, there was the saying that “the king could do no wrong.” That, if something went wrong, it could not be because of his own failures, but because he had been given poor advice. But that might be too charitable in this case.
The data was there to be found, but you had to know to go look for it.
Moreover, Republicans were complaining about many of the other governmental expansions in the health system during Covid. They opposed Medicaid expansion for more than a decade under the Affordable Care Act, and here was a backdoor expansion of socialized medicine that dwarfed the program’s prior expansion.
Are the GOP elected branches so disconnected from the professional, permanent, administrative state that during Covid they appear to have been asleep at the switch?
And now, states will have to come up with plans to begin disenrollment, which the Department of Health and Human Services says could impact up to 15 million recipients, assuming they went back to work and no longer qualify.
What preparations were made to disenroll these patients from Medicaid at the state level? This is a question for all 50 state governors, not simply Republican governors who you think would have opposed this.
The fact is, even the Medicaid disenrollments will tax state public health systems, too, as resources will have to go to tracking down eligibility. The amount of fraud in the disenrollments alone could be gargantuan, as now there is a perverse incentive to conceal income, but red states might have been ready for it — if they knew about it. The question is, did they know?
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Substantial Meta-Analysis Reveals COVID-19 Vaccine Waning Effectiveness—Further Decline of Performance During Omicron
Canadian researchers affiliated with Concordia University in Montreal conducted a systematic meta-analysis covering what they refer to as living evidence synthesis tracking COVID-19 vaccine effectiveness and durability data associated with the COVID-19 vaccines.
But what is this “living review?” The study team represented by corresponding author Prof. Simon Bacon, PhD, FTOS, FCCS, FABMR, an expert in health behavior report they first search for studies published until September 10, 2021, and thereafter updated the ongoing search on November 19, 2021. Then, beginning on February 25, 2022, the French-Canadian study team updated the synthesis each four weeks until the 13th synthesis when they reported final results.
The group did add additional information including data from the booster studies as well as variant updates. Their work was sponsored by both Canadian Institutes of Health Research and the Public Health Agency of Canada. The evolving findings reveal vaccine effectiveness decreases over time against SARS-CoV-2 infections, hospitalizations, and mortality. This shows durability challenges are a real factor.
Importantly, the overall vaccine quality as measured as effectiveness against Omicron further degraded as compared to other variants of concern as has been evidenced in dozens of other studies chronicled by TrialSite.
The study authors all but concede that the COVID-19 vaccination program as a means by itself isn’t sufficient due to waning effectiveness
What did the authors find?
Out of 16,696 records at the title and abstract level, the group studied 832 full texts, ultimately including 72 (0.4%) studies and excluding five of them for a risk of bias, a total of 68 studies were extracted for analysis.
But the above numbers are across previous variants of concern. What about the Omicron variant which has been in circulation in one form or another for late 2021 and all of 2022 and into 2023?
The study authors report they had not been able to accumulate sufficient data to track mortality data during the Omicron period.
Summary
This study team embraced three-level meta-analytic models which evidenced “marked decreases over time in vaccine effectiveness for SARS-CoV-2 infections for both primary series and booster, and a smaller decrease for hospitalizations and mortality.”
Overall vaccine performance degraded against Omicron due to the mutational changes and ability to better evade vaccine-induced antibodies. The authors extend the necessary statement that “vaccination continues to be an effective measure over time to reduce COVID-19 hospitalizations and mortality,” but they do acknowledge the case doesn’t look great for infections.
The vaccines did help reduce the sharp edges of the pandemic’s deadly knife by temporarily boosting antibody defense in humans, thereby in surges reducing hospitalization and death rates.
But this doesn’t last long and the prospect of boosts every half a year with these vaccines is unlikely—the long-term health effects haven’t been studied. The Centers for Disease Control and Prevention are recommending that they go on the standard immunization schedule meaning they become comparable to the recommended influenza vaccine once per year.
It’s known that the present SARS-CoV-2 vaccines are not sterilizing and already Dr. Anthony Fauci and cohorts published a piece declaring the need to advance beyond the current vaccines to consider intranasal mucosal vaccine development among other activities.
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Also see my other blogs. Main ones below:
http://edwatch.blogspot.com (EDUCATION WATCH)
http://antigreen.blogspot.com (GREENIE WATCH)
http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH) Also here
http://australian-politics.blogspot.com (AUSTRALIAN POLITICS)
http://snorphty.blogspot.com (TONGUE-TIED)
https://immigwatch.blogspot.com (IMMIGRATION WATCH) Also here
https://awesternheart.blogspot.com (THE PSYCHOLOGIST)
http://jonjayray.com/blogall.html More blogs
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