The Department of Homeland Security (DHS) issued a new notice of proposed rulemaking (NPRM), “Deferred Action for Childhood Arrivals,” in late September and the comment deadline of November 29 is fast approaching. The NPRM seeks to codify the DACA policy originally laid out in a memo by then-Secretary of DHS Janet Napolitano in June 2012. […]

It’s been seven months and change since the Biden Administration took office. What it found waiting for it on January 20 was not just a crisis of democracy and a global pandemic and a surge of unaccompanied children at the border, but also a large pile of policy intended to undercut the Administration’s ability to […]

Last month, CMS began taking steps to get rid of Medicaid section 1115 work requirement waivers as my colleague Joan Alker has written about. The Biden Administration sent letters to states with approved work requirements that “preliminarily” disapproved the policy on the basis of the COVID-19 pandemic and uncertainty of its aftermath on health and […]

The Biden Administration has a long list of bad Medicaid policies to unwind.  As chronicled in Episode I, the groundwork for the unwinding was laid in a Presidential Executive Order, “Strengthening Medicaid and the Affordable Care Act,” issued on January 28. Among other things, the E.O. directs the Secretary of HHS to review section 1115 demonstrations and […]

As I was waiting to watch Vice President-elect Kamala Harris start her speech on Saturday night, I tweeted the following: Goodbye and good riddance to Medicaid work requirement waivers. — Joan Alker (@JoanAlker1) November 8, 2020 It proved to be a popular sentiment – at least on my twitter feed. As we have blogged about […]

Today, the Supreme Court rejected the Trump Administration’s decision to terminate Deferred Action for Childhood Arrivals (DACA), finding that the move was a violation of the Administrative Procedure Act (APA) because it was arbitrary and capricious. (This may sound familiar – it’s the same problem the Administration has faced in the litigation surrounding Medicaid work […]

It has been obvious for several months that the wheels have come off the Medicaid work requirements bus.  The Secretary of HHS has approved “demonstrations” of work requirements in nine states; none of these states is currently implementing.  And no state that accepts the 6.2 percentage point increase in its federal Medicaid matching rate made […]

For over two years, CMS Administrator Seema Verma has been on a crusade to impose work requirements on Medicaid beneficiaries.  Her agency has approved ten state “demonstrations” of work requirements under section 1115 of the Social Security Act.   When federal District Court Judge James Boasberg ruled on four separate occasions that the Secretary’s approvals of […]

In a decision which warmed my heart on a cold Valentine’s Day here in Washington, the federal Court of Appeals issued an unanimous opinion striking down the Arkansas work requirements waiver.  In doing so, it upheld district court Judge Boasberg’s decision vacating the Arkansas’ Section 1115 waiver (including most famously Medicaid work requirements) because it […]

For the past 3 years, CMS Administrator Seema Verma has been on a crusade to convert Medicaid from health insurance to a welfare program.  The spear at the point of this attack has been work requirements, which, under the guise of “demonstrations,” she has sought to impose as a condition of eligibility for Medicaid coverage.  […]

I had held out a little sliver of hope that the Trump Administration would not cross this line but today those hopes were extinguished when CMS Administrator Verma traveled to South Carolina to personally deliver the news to South Carolina Governor McMaster that his state would be the first in the nation to apply a […]

CMS Administrator Seema Verma is visibly proud of her agency’s Medicaid and CHIP scorecard, which she claims has ushered in “a new era of accountability and transparency in Medicaid”.  The scorecard includes measures of, among other things, federal administrative accountability; one of those measures reports the percentage of Section 1115 demonstration applications that CMS approved […]

Under the Administrative Procedures Act (APA), federal agencies may not take actions that are “arbitrary or capricious.”  If they do, federal courts are instructed to hold the action unlawful and set it aside.  Late yesterday afternoon, that’s exactly what Judge James E. Boasberg of the U.S. District Court in the District of Columbia did with […]

It turns out that last week was Never Mind Week.  Who would have guessed? On Monday the Administration released its “Budget for a Better America,” proposing to cut federal Medicaid spending by nearly $1.5 trillion (with a “t”) over the next ten years.  These cuts included a mandate that state Medicaid programs require that “able-bodied, […]

In 2009, Congress created the Medicaid and CHIP Payment and Access Commission (MACPAC) to advise it on coverage for low-income Americans through Medicaid and CHIP.  One of MACPAC’s statutory responsibilities is to “review and assess…Medicaid and CHIP eligibility policies, including a determination of the degree to which federal and state policies provide health care coverage […]

Earlier this week, the state of Arkansas released its final round of data for 2018 for its controversial work reporting requirement policy. The data shows that an additional 1,232 adults lost their Medicaid coverage at the end of December, bringing the total Medicaid coverage loss since August to 18,164. The news motivated me to take […]

Yesterday, CMS reapproved the Kentucky work requirement waiver.  The reapproval comes less than two weeks after Congress’s Medicaid and CHIP Payment and Access Commission (MACPAC) wrote a letter to the Secretary of HHS asking for a pause in disenrollments resulting from the Arkansas work requirement waiver, less than a week after Arkansas announced that over […]

About a year ago, the Administration reversed longstanding immigration policy and started separating children from their parents at the US-Mexico border. Over just a few months, thousands of children were separated from their parents. The issue drew a lot of media attention, as medical and child welfare experts pointed out that research shows the Administration […]

The public has spoken! When the public comment period closed on the Kentucky and Mississippi Medicaid waivers this weekend, a whopping 11,700+ comments had been submitted on Kentucky’s and 330+ were submitted on Mississippi’s. While the Mississippi numbers were not as eye-popping as Kentucky’s, it’s important to view that number in context — as only […]

Back in 2014, Arkansas expanded Medicaid through a section 1115 demonstration waiver referred to as the ‘private option.’ Newly eligible Medicaid beneficiaries enrolled in private market plans on the ACA’s Marketplace and the state defrayed the costs and offered wrap-around benefits. A preliminary evaluation of the private option showed that Arkansas cut its uninsured rate […]