Say Ahhh!
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Coverage That (Doesn’t) Count: How the Short-Term, Limited Duration Rule Could Lead to Underinsurance
Any day now, the Trump administration is expected to publish new rules that will expand access to short-term, limited duration insurance (STLDI). The proposed rule would allow STLDI plans to extend up to almost a full year, along with other changes that enable consumers to purchase STLDI as an alternative to comprehensive insurance products currently sold on the individual…
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Medicaid Waiver Wars: CMS Strikes Back
Late last month, a federal District Court ruled that the approval of the Kentucky Medicaid work requirements waiver by the Secretary of Health and Human Services was “arbitrary and capricious” because, among other things, even though the record showed that 95,000 people would lose Medicaid coverage, “the Secretary paid no attention to that deprivation.” The…
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Medicaid and Work: Fact and Fiction in Government Reports
Last week saw the release of two reports on Medicaid and work. One, from the nonpartisan Medicaid and CHIP Payment and Access Commission (MACPAC), an arm of the Congress, is fact. The other, from the White House Council of Economic Advisors (CEA), is fiction. The difference matters, because it goes to the basic identity of…
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Perry County to Tuscaloosa: A 70-Minute Drive for Rural Women Seeking Obstetrics Care
I have driven the 57 miles from Perry County, Alabama to Tuscaloosa many times, with long stretches of bumpy road that is marred by stop lights as you get closer to the city. All in all it’s about a 70-minute drive, a 70-minute drive residents of Perry County have to make if they need to…
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One Month into Medicaid Work Requirement in Arkansas, Warning Lights are Already Flashing
Arkansas’s Department of Human Services released numbers on its work requirement to a select group of reporters and officials late last Friday, and we just saw them earlier this week. The numbers confirm reports of widespread confusion over the work requirement’s rollout and exacerbate our fears that red tape will eventually lead to significant coverage…
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Public Comments Reflect Strong Opposition to Proposed CMS Medicaid Access Rule
Public comments matter – the recent federal court decision on the Kentucky HEALTH waiver proved that. And they matter not just on Section 1115 waivers; they matter on regulations as well. Under the Administrative Procedures Act, federal agencies have to provide the public with an opportunity to comment on a proposed regulation, and it has…
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School Readiness as an “Essential Quality Metric” for Children: A Hook for Medicaid in Cross-System Work
The importance of a child’s first months and years can’t be overstated. It’s a time of rapid brain development and learning, where relationships and environments set the course for a child’s lifelong trajectory—even shaping the architecture of the brain. In 2016, Medicaid and CHIP served close to half of all children under 6, and more…
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New Study Finds Evidence of a “Chilling Effect” in 2016 Marketplace Enrollment
There have been reports in the news of immigrant families decreasing their use of health care services and safety net programs because they fear that their information may be used to identify undocumented family members. A new study in the National Bureau of Economic Research explores this topic. Researchers examine the effects of Secure Communities,…
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Medicaid’s Vital Role for Schools and Students
It feels like summer just arrived, but back-to-school time is near! Before the back-to-school bell rings, we wanted to take stock of health coverage for school-age children. As SayAhhh! readers are well aware, Medicaid and CHIP, the primary public health coverage sources for children, have worked together in recent decades to bring the rate…
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A Disturbing Trend of Hiding the Coverage Losses is Emerging in Medicaid Waivers
For those of us closely watching the action on new Section 1115 Medicaid research and demonstration waivers that the Trump Administration has been inviting and approving this year, the recent court decision putting a hold on Kentucky’s plans was welcome news. The court ruled that the Secretary’s decision in granting the Medicaid waiver was “arbitrary…
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Trump Administration Encourages States to Seek Waivers to Opt Out of Medicaid Drug Rebate Program
On June 27, the Centers for Medicare and Medicaid Services partially approved Massachusetts’ Medicaid waiver proposal, but among other provisions, rejected a proposal to impose a “closed formulary” for prescription drugs under which the state could entirely exclude coverage of certain drugs in ways not permitted under current law. Instead, CMS expressed openness to approving…
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Trump Administration Strikes Another Blow to the ACA by Cutting Navigator Funding
In what seems an endless stream of administrative actions to undermine the Affordable Care Act, the Trump administration has cut navigator funding from the 2016 level of $63 million to $37 million in 2017 to a meager $10 million for the upcoming fall (2018) open enrollment period. It also looks like the administration is trying…
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Video: These Parents of Medically Complex Kids Explain Why Medicaid Matters to Their Families
If you want to know about kids, listen to parents. Sometimes in the health policy and political worlds, it’s easy to forget this simple piece of advice – and sometimes politicians and policymakers are too focused on the latest bill or political win to remember it. Over the last year, we’ve spent a lot of…
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House Committee to Consider Expanding Health Savings Account Tax Breaks for High Income
Today, July 11, the full House Ways and Means Committee will begin consideration of multiple health-related tax bills, many of which would expand tax breaks for Health Savings Accounts (HSAs). These HSA bills would primarily benefit those with high incomes, rather than make health coverage more affordable for low- and moderate-income children and families. Health…
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Administration Stops Risk Adjustment Payments to Insurers: Another Act of Sabotage?
On July 7, the Centers for Medicare and Medicaid Services announced that it would indefinitely delay making “risk adjustment” payments owed to insurers participating in the individual and small group markets. In the short-run, this would result in many insurers not receiving payments they are expecting this year as scheduled. That would adversely affect these…
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Research Update: Evidence Continues to Build on Medicaid’s Role Promoting Economic Security
I previously wrote about the primary role of health insurance, which is to protect against economic insecurity, medical debt, and bankruptcy. Recently, I have been reading new studies that continues to build on this body of work. NBER’s Medicaid and Financial Health Using consumer credit data, the authors examine the financial distress of non-elderly adults…
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Want to Help Young Children? Expand Medicaid.
We are asked a lot about the ways states can do more for young children in Medicaid—and we have a lot to say! Young children’s healthy development is influenced by their interactions and relationships with parents and other adults. So naturally, for the 17 states holding out, we start by raising Medicaid expansion. While we…
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Research Update: How Has Medicaid Expansion Impacted Workers?
This week, I am reading research showing that there may be links between the Medicaid expansion and trends in employer-sponsored insurance, labor force participation and employment. Health Affairs’ Employer-Sponsored Insurance Stable For Low-Income Workers In Medicaid Expansion States Urban Institute researchers used data from the Health Reform Monitoring Survey between July 2013 and March 2017…
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Positive Economic Effects from Louisiana’s Medicaid Expansion Provides Example for Southern States
A new report produced by Louisiana State University shows Louisiana’s decision to expand Medicaid to non-elderly adults below 138%of Federal Poverty Level (FPL) has resulted in millions in net revenue for the state. Using an economic impact analysis from the Kaiser Family Foundation, the study finds the Medicaid expansion created 19,195 jobs and $177.8 million…
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The Kentucky Medicaid Waiver Approval: How Do You Spell “Arbitrary and Capricious”?
Late last Friday, a federal District Court overturned the approval of the Kentucky HEALTH waiver by the Secretary of HHS and sent it back to the agency. As a result, Kentucky could not implement work requirements or other harmful changes – premiums, lockouts, elimination of retroactive coverage, etc. – on July 1, as it had…
