On July 15, CMS proposed to repeal—but not replace—the Access Rule.  Repeal of this important rule will leave children in Medicaid fee-for-service, as well as their providers, with no systematic assessment of their access to services and no procedural protections against arbitrary payment cuts.  (This could be especially problematic in the event of a recession, when states look for ways to reduce Medicaid spending).  The impact will likely be greatest in the ten states with fee-for-service Medicaid programs—Alabama, Alaska, Arkansas, Connecticut, Idaho, Maine, Montana, Oklahoma, South Dakota, and Wyoming—but children and providers remaining in fee-for-service in managed care states will also be affected.

The proposed repeal is the product of the anti-regulatory crusade of CMS Administrator Seema Verma (except when it comes to heaping work requirements red tape on beneficiaries).   The Administrator’s action aligns comfortably with the President’s January 2017 Executive Order, which takes a cookie cutter approach to governing by directing agencies to repeal two regulations for every new regulation issued.  In March 2018, the Administrator published a proposed rule that would gut the Access Rule.  In the face of overwhelming opposition to that proposal (over 90% of public comments opposed weakening the Access Rule), she is now doubling down and seeking complete repeal.

This isn’t reasoned decision-making; it’s policy by ideology. Comments are due Friday, September 13. You can find our comments posted here.