Blog
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Parents Talk About Social Needs Screening – Identify Trust as a Major Issue
“First, more than anything else, the pediatrician should earn your trust.” — Parent from Queens, New York Unmet basic needs, such as food insecurity, in childhood can have long-lasting and wide-ranging consequences for kids, including increased risk for chronic health conditions, behavioral problems and poor academic performance. For these reasons the American Academy of Pediatrics…
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Senate Finance Committee Considers Bipartisan Bill to Lower Federal and State Medicaid Drug Costs
Editor’s Note: The Senate Finance Committee reported the bill on July 25, 2019 (without substantive changes to its Medicaid provisions.) On Thursday, July 25, the Senate Finance Committee is scheduled to consider bipartisan drug pricing legislation (known as the Prescription Drug Pricing Reduction Act). While much of the bill focuses on provisions related to Medicare…
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CMS Guidance Spotlights Ways Medicaid Can Support Mental Health and Substance Use Disorder Services in Schools
The Centers for Medicare and Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) recently released a Joint Informational Bulletin that offers a helpful roadmap to states and schools on the ways certain Medicaid authorities can help support school-based mental health and substance use disorder services for children and adolescents. As…
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Research Update: Medicaid Expansion Associated with Decrease in Cases of Reported Child Neglect
This week, I am highlighting a study suggesting that Medicaid expansion was associated with reductions in number of reported cases of child neglect. This study builds on prior research finding that Medicaid expansion is associated with greater parental financial stability and access to mental health care. In this study, researchers compared reported cases of child…
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MACPAC Releases FactSheet on CHIP Health Services Initiatives
Not everyone knows that states are allowed to use a limited amount of CHIP funding to implement health services initiatives (HSIs) – activities that protect the public health, promote a state’s capacity to deliver public health services, or accomplish public health goals relating to improving the health of children, including children in Medicaid and CHIP.…
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Call for Public Comments on Annual Review of the Core Sets of Health Quality Measures in Medicaid and CHIP
Each year, a multi-stakeholder group is selected through a nomination process to review and make recommendations on the child and adult core sets of health care quality measures in Medicaid and CHIP. This year, I was pleased to participate as a member of the workgroup, which was facilitated by a great team at Mathematica. It’s…
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New Study Finds Medicaid Per Capita Caps and Block Grants Would Lead to Deep Cuts to Children’s Coverage and Access
Avalere Health issued a new study conducted for the Children’s Hospital Association, estimating how much a per capita cap or block grant could significantly cut federal Medicaid spending on children nationally and on a state-by-state basis, relative to current law. The study models the impact of four illustrative per capita caps and block grants. It…
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Medicaid Work Requirements: Is Momentum Stalling?
Last week marked the 18-month anniversary of CMS guidance urging states to apply for Section 1115 Medicaid waivers to impose work reporting requirements as a condition of eligibility. One day after issuing the guidance (January 12, 2018) CMS approved the first state, Kentucky, to go forward with work reporting requirements along with numerous other harmful…
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CMS Administrator Verma Proposes to Repeal the Medicaid Access Rule
For the past two years, CMS Administrator Seema Verma has wanted to “rollback” the Medicaid Access Rule. That’s the CMS regulation that implements the requirement in the Medicaid statute that rates paid to physicians and other providers be “sufficient” so that enough participate in Medicaid to give beneficiaries access to covered services. In the…
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Child Enrollment in Medicaid and CHIP Slips Again
We continue to closely monitor the trends in child enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) following our report on the precipitous enrollment decline in 2018. As of March 2019, overall child enrollment in Medicaid and CHIP was down an additional 41k children in the first quarter of 2019. However, the national…
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Trump Administration Withdraws Harmful Drug Rebate Safe Harbor Rule
On July 10, the Trump Administration announced that it would withdraw a proposed rule to eliminate the safe harbor in the federal anti-kickback law for rebates negotiated by pharmacy benefit managers (PBMs) on behalf of Medicaid managed care plans and Medicare Part D plans. This is a highly welcome move. As we have explained since…
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House Committee Advances Bill to Sustain Medicaid Programs in the Territories and Avoid Deep, Harmful Cuts
On July 11, by voice vote, the Health Subcommittee of the House Energy and Commerce Committee reported out essential legislation (H.R. 3631) to avert large federal Medicaid funding shortfalls the territories will face starting in 2020. Without additional federal funding the bill would provide, the territories would have no choice but to institute damaging cuts…
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Proposed HUD Rule Adds to Climate of Fear for Immigrant Families, Puts America’s Children at Greater Risk of Homelessness
Yesterday was the deadline for comments on yet another anti-immigrant proposed rule, this one targeting over 55,000 citizen children in mixed status families that rely on prorated housing assistance under current program rules. We joined other child health groups in submitting comments, underscoring the serious negative impacts of homelessness and housing insecurity for child well-being…
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Real Protections for Kids and Families in the Newest Texas Medicaid Managed Care Laws
In June 2018, the Dallas Morning News began publishing a series of in-depth investigative reports on Texans harmed through Medicaid managed care, potential conflicts of interest, and weaknesses in oversight and enforcement of Medicaid managed care contracts. The articles resulted in public hearings in the Texas House of Representatives that further explored the issues and allowed the public to comment. In…
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CMS Awards $48 Million in Outreach Funds for Children’s Coverage
Earlier this week, CMS announced that it was awarding $48 million in cooperative agreements to 39 organizations in 25 states to enroll eligible children in health coverage. Since 2009, CMS has awarded $210 million in funds to connect kids to coverage through various federal appropriation bills. Unfortunately, this latest round of grants was delayed as…
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State Medicaid Programs Already Have Considerable Flexibility to Adopt Innovative Payment Models for New High-Cost Prescription Drugs
As I have previously warned, the ongoing prescription drug pricing debate could intentionally or unintentionally lead to significant harm to the Medicaid program and its effective Drug Rebate Program. That, in turn, could result in higher federal and state Medicaid drug costs and reduced beneficiary access to needed medications. One key element of the Medicaid…
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How a Small Provision of ACA Made a Big Difference for One Pennsylvania Family
Years after its passage, I am still finding new ways that the ACA helps my family. For over two and a half years, my family has been involved in the fight to save the Affordable Care Act and prevent cuts to Medicaid. We travel around Pennsylvania and Capitol Hill educating others about the importance of…
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Is There Really A Question? Intervenor States Have Clear Interest in Defending the Affordable Care Act
The Fifth Circuit Court of Appeals has asked the parties in Texas v. United States to file supplemental briefings on the issue of whether the defendant states attorneys generals and the U.S. House of Representatives have standing to appeal. Standing is a legal term that means a party has a right to bring a lawsuit,…
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Sound House Bill Would Establish Pathway for a Sustainable, Improved Medicaid Program in Puerto Rico
As we wrote last year, Congress should consider making permanent changes to Puerto Rico’s federal Medicaid financing structure to ensure the long-term viability of its Medicaid program. This includes eliminating Puerto Rico’s federal funding cap over time, raising the federal matching rate and requiring fuller compliance with the same federal Medicaid requirements that now apply…
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New Texas Report Details Opportunities to Keep Moms Healthy During the Fourth Trimester
“If we want kids, moms, and communities to thrive in Texas, then we need to help local moms stay healthy.” — Adriana Kohler, Senior Health Policy Associate, Texans Care for Children A new report, Healthy Moms Raising Healthy Babies: Central Texas and Statewide Challenges and Opportunities to Support Maternal…
