Waivers
Section 1115 of the Social Security Act establishes authority for the Secretary of Health and Human Services (HHS) to waive certain provisions of the Medicaid and CHIP statutes for a state to establish an “experimental, pilot or demonstration” project that promotes the objectives of the program. Such demonstrations are intended to test and learn about new approaches to program design and administration. States have obtained Section 1115 waivers that make broad changes in Medicaid eligibility, benefits, cost sharing, and delivery and payment of care.
After Two Months Under New Work Requirements, Thousands of Arkansans May Lose Medicaid Without Even Realizing the Rules Changed
Arkansas’s Department of Human Services released numbers on its work requirement late Tuesday and they continue to suggest that the rollout of the new work requirements policy is extremely flawed and that thousands could lose coverage by September 1. Since this is now the second month of the work requirement rollout, a large group of […]
Lawsuit Challenges Arkansas’s Medicaid Work Requirement
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 […]
Oklahoma’s Proposed Work Rule Would Harm Mothers and Children
Oklahoma has one of the highest uninsured rates for children in the nation, and the state will likely make matters worse if it gets a green light from CMS to go through with a plan to impose more red tape requirements on poor parents. Oklahoma is seeking approval to amend its Section 1115 demonstration waiver […]
New Waiver Proposal for Oklahoma Medicaid Beneficiaries Would Harm Low-Income Families With Children
Introduction Oklahoma is planning to ask federal permission to impose a work requirement on very low-income parents and caregivers receiving health coverage through Medicaid. Under the proposal, these beneficiaries would have to document that they are working at least 20 hours a week or participating in job-training or volunteer activities in order to maintain their […]
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 […]
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 […]