25.8 C
New York

Agency can expand contraception access under Medicaid if Roe v. Wade is overturned


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. | Getty Images

In her first yr as administrator of the Centers for Medicare and Medicaid Services, Chiquita Brooks-Lasure has overseen the expansion of presidency health coverage to a record variety of Americans under Medicare, Medicaid and personal Inexpensive Care Act exchange plans.

Now, she desires to keep them insured, and expand access to services for ladies.

“We cover over 150 million people because of this of the entire exertions of the agency really enrolling people in coverage. So, we’re an enormous payer, and we help dictate coverage on this country … and have a robust opportunity to advance health equity,” Brooks-Lasure said.

Within the yr ahead, one in every of the agency’s biggest challenges shall be to create a smooth transition for tens of millions of Medicaid members who could lose coverage when the Covid public health emergency ends. Under the federal health emergency, states have put eligibility redeterminations on hold for the last two years.

Lack of coverage

While the administration is predicted to renew the present emergency designation next month, a Kaiser Family Foundation study estimated that between 5 million and 14 million people may very well be disenrolled when redeterminations resume.  

Brooks-Lasure says health insurers that administer state Medicaid programs will play a very important role to assist those that lose eligibility to transition to non-public exchange health plans, or Medicare in the event that they’ve turned 65.  

“We now have more plan participation, particularly in Medicaid coverage, than we did, say, 10 years ago. In order that they are a key component to helping be sure that we — and by we, I also mean the states — move people to whatever form of coverage they’re eligible for,” she said.

Even beyond the general public health emergency, she wants health coverage to be more consistent across private and non-private programs.

“Because whether it’s talking about maternal health otherwise you’re in the course of cancer treatment … you wish to stay focused on the condition itself moderately than having to fret about what modified in your coverage,” she said.


In a latest report outlining priorities for the agency, Brooks-Lasure says addressing health disparities is a central pillar of the agency’s mission. It has been especially focused on improving maternal health coverage; Medicaid programs now cover 40% of births within the U.S. With funding from the American Rescue Plan Act, passed in 2021, the agency is working with states to expand Medicaid coverage for brand new moms who’re uninsured from 60 days to 12 months.

In relation to reproductive care, Brooks-Lasure said CMS may even prioritize improving access to contraception in Medicaid and ACA health plans within the yr ahead. If the Supreme Court overturns Roe v. Wade, as expected this month, the agency shall be limited in its ability to supply access to abortion for ladies on Medicaid under federal funding rules.

Brooks-Lasure said the agency was focused on areas it has authority over, akin to preventative care and contraception. She said CMS is encouraging states to make use of Medicaid to make sure men and ladies have access to contraception, “in light of regardless of the Supreme Court decision is regarding broader services.”

Medicare premium rollback

One in all the largest decisions CMS issued this yr was to limit Medicare coverage for the Alzheimer’s treatment Aduhelm, after mixed data on the drug’s efficacy. Nevertheless, the move got here after actuaries had factored within the expected high cost of the drug into 2022 Medicare premiums. Medicare recipients can expect a rollback in 2023.

“Because coverage is lower, we’re going to incorporate that within the premium for next yr,” Brooks-Lasure said.

Medicare recipients could also get a break on drug plan premiums with the introduction of several biosimilar versions of AbbVie’s high-priced arthritis treatment Humira over the following yr. Humira sales topped $20 billion in 2021. Amgen’s biosimilar version shall be the primary to go on sale within the U.S., in January.

Brooks-Lasure said CMS actuaries are calculating the potential impact of the transition to Humira biosimilars and are expected to release their evaluation in early September, in time for setting 2023 premiums.

Get the latest Sports Updates (Soccer, NBA, NFL, Hockey, Racing, etc.) and Breaking News From the United States, United Kingdom, and all around the world.

Related articles


Recent articles