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Say Ahhh!

  • Arkansas Data are Clear – Trump’s Medicaid Policy is a Dangerous Failure

    The primary focus of the Trump Administration’s approach to Medicaid has been to encourage states to impose work and “community engagement” requirements on adults in Medicaid through Section 1115 Medicaid waivers. As regular readers of SayAhhh! know, Arkansas is the first state in the nation to impose these new rules on its Medicaid expansion policy.…

  • Medicaid Transformation in NC: Three Priorities to Watch

    By Ciara Zachary Seventy percent of the people enrolled in Medicaid and NC Health Choice in North Carolina are children. So as the state’s Medicaid transformation process continues to meet major milestones, NC Child is closely monitoring this complex undertaking for its impacts on children. Here’s a brief update on where we are in the…

  • New Policy Brief asks: “Why are Tennessee moms and babies dying at such a high rate?”

    Tennessee Justice Center’s recent policy brief focuses on rising rates of infant and maternal mortality in Tennessee. When I saw the state’s dismal outcomes in the 2018 America’s Health Rankings Health of Women and Children report, I immediately wanted to learn why moms and babies were dying at higher and higher rates in Tennessee. According…

  • Actual State Budget Impacts in Five States that Expanded Medicaid

    Michigan, Montana, Louisiana, Colorado and Virginia have all expanded Medicaid.  In each of these states, local analysis has shown expanding Medicaid has either been a positive for the state’s general fund revenues or has not resulted in any additional cost to the state.  The reason is a combination of substantial state savings from Medicaid now…

  • Medicaid at the 2018 Ballot Box: What to Look For (Part 1)

    Next Tuesday (as usual) I will be staying up late to see what happens in the midterm elections. But for the first time in more than twenty years of working on Medicaid there will be so much to watch out for that will directly affect Medicaid! Today I will start with the 17 states that…

  • New Guidance Reinterprets Section 1332 Waivers

    On October 22, the Trump Administration issued new guidance related to section 1332 state waivers of certain provisions of the Affordable Care Act.  The guidance eviscerates the existing statutory requirements for affordability, comprehensiveness and coverage that section 1332 waivers must satisfy to receive federal approval.  As a result, as other analysts have pointed out (here…

  • Trump Administration Hands States Another Tool for Dismantling Preexisting Condition Protections

    Last week, the Trump administration issued long-anticipated guidance regarding the Affordable Care Act’s Section 1332 “innovation waiver” program. The release rebrands and creatively reimagines the ACA program (they’re now “State Relief and Empowerment” waivers), breaking dramatically with past policy and, arguably, with the statute it purports to interpret. In the administration’s view, the ACA permits states to…

  • Advocates Have a Key Role to Play Encouraging Early Childhood Sector to Leverage Medicaid to Meet Children’s Developmental Needs

    Medicaid and early childhood care providers, including Head Start, child care centers, and home visiting programs, serve many of the same low-income children, yet the two systems rarely collaborate to improve overall population health. Reaching vulnerable children in their early years of physical, social and emotional development is essential to setting them on a path…

  • More Rural Hospitals Closing in States Refusing Medicaid Coverage Expansion

    The University of North Carolina’s Rural Health Research Program tracks closures of rural hospitals across the country. From 2010 to the present there are six states with five or more rural hospital closures. Texas leads with a stunning 15 rural hospitals closed, followed closely by Tennessee (9 rural hospitals closed) and Georgia (7 rural hospitals…

  • States Lean In as the Federal Government Cuts Back: Navigator and Advertising Funding for the ACA’s Sixth Open Enrollment

    On November 1, the Affordable Care Act’s (ACA) insurance marketplaces will launch their sixth enrollment season. This year, the challenges they face may be greater than laster year, with the loss of the individual mandate penalty as an enrollment incentive and the emergence of a parallel, unregulated market that could siphon away healthy enrollees. Yet the Trump administration has…

  • Medicaid Work Requirement Waivers: Time for CMS to Hit the Pause Button

    Yesterday members of the Medicaid and CHIP Payment and Access Commission (MACPAC – a Congressional agency) received a briefing from staff on the implementation of the Arkansas work requirement waiver. Staff reviewed the latest data from the state as well as the findings from their own inquiries to various stakeholders.  The presentation confirmed my reading…

  • Are you Ready for Open Enrollment? Updated Navigator Resource Guide will Help You Understand Policy Changes

    On November 1, the sixth open enrollment period begins for marketplace coverage under the Affordable Care Act (ACA). We at the Georgetown University Center on Health Insurance Reforms will soon re-launch our updated Navigator Resource Guide, made possible by the support of the Robert Wood Johnson Foundation. The Guide provides information on recent policy changes, a list of enrollment…

  • The MOM Model: New CMS Initiative Aims to Improve Systems of Care for Pregnant and Postpartum Women with Opioid Use Disorder

    The CMS Innovation Center announced a new tool to help address the devastating impact our nation’s growing opioid crisis is having on pregnant and postpartum women and their infants. The Maternal Opioid Misuse (MOM) model is the latest approach in CMS’s strategy to tackle the opioid crisis in a key population group, expectant and new…

  • How Would Medicaid Provisions of New Law to Address Opioid Epidemic  Impact Children?

    Today President Trump signed the “SUPPORT for Patients and Communities Act” into law. SUPPORT is an acronym for “Substance Use—Disorder Prevention that Promotes Opioid Recovery and Treatment.” The bill, which passed with overwhelming bipartisan support in both the House (396-14) and the Senate (98-1), is 250 pages long. It affects a broad array of federal…

  • What Medicaid Can Do for Our Nation’s Youngest Children

    The science is clear: We have a critical opportunity to reach young children during a period of rapid development, with the brain forming one million new neural connections every second. These earliest years are full of possibilities equally as powerful as the vulnerabilities that greatly influence children’s lifelong trajectories. Anyone who’s had the pleasure of chatting…

  • Arkansas Numbers Tell the Story: Trump’s Medicaid Work Requirement Policy Promotes Coverage Losses not Work

    Like many folks who work on Medicaid policy, we’ve been paying close attention to what is happening in Arkansas – the first state in the country to implement a work activities reporting requirement in Medicaid.[1] Earlier this week, the second round of data was released by the state documenting that another 4,109 Medicaid beneficiaries lost…

  • Proposed “Public Charge” Rule Risks Immigrants’ Access to Private Coverage, Too

    On October 10, the Trump administration published a proposed rule that significantly harms immigrant families, in part by dramatically reducing their access to health coverage and care. As our Center for Children & Families (CCF) colleague Kelly Whitener has documented on our sister blog (CCF’s Say Ahhh!), the so-called “Public Charge” rule would make it far more difficult…

  • The Trump Administration’s Association Health Plans Emerge: What Early Announcements Tell Us About this New Market

    This past summer, the Department of Labor (DOL) finalized a regulation calling for the expansion of association health plans (AHPs) for small businesses and self-employed individuals. AHPs are insurance policies offered through an association, often to members within a specific trade, industry, or profession. Among other changes, DOL’s rule loosened the requirements under which a group of employers…

  • Administration Moves Forward with Proposed Public Charge Regulation; Comments Due in December

    As we have long suspected, the Administration is moving forward with a proposed regulation to dramatically change our immigration system and significantly harm immigrant families. The Department of Homeland Security posted a draft version of the rule about two weeks ago, and just this morning the rule was finally posted for inspection in the Federal…