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.
Utah’s Bad Medicaid Bet: Governor and Utah Legislators Relied on Trump Administration Promises that Didn’t Pan Out
What a mess. After repealing the ballot initiative passed by a majority of Utah voters that offered more affordable health coverage through a simple Medicaid expansion, Utah’s Governor and legislature substituted a law that creates a very complex Medicaid plan aimed at only people with incomes under about $12,000 a year. As it turns out, […]
New Mexico: Some Good Waiver News for a Change
Those of us who follow Medicaid waiver activity around the country can feel that we’re being constantly assaulted by bad news. So here’s some good news to brighten your day: instead of proposing burdensome requirements that limit access to Medicaid enrollment and services, New Mexico is planning to improve its section 1115 waiver – known […]
Medicaid Work Requirements: Another Win for Beneficiaries, Another Loss for CMS
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 […]
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 […]
Pending CMS Guidance on Medicaid Block Grants: Executive Overreach Strikes Again
It has been reported that CMS is developing guidance to encourage states to pursue a new “block grant” or “per capita” cap on federal Medicaid funding through Section 1115 waiver requests. And sure enough, this “Dear State Medicaid Director” letter has appeared on the Office of Management and Budget’s website signaling that it is under […]
New Study Finds Arkansas Medicaid Work Requirement Isn’t Working
As readers of SayAhhh! know, we have been closely following the developments in Arkansas – which was the first state to implement a Medicaid work requirement in the second half of 2018 before a federal judge stepped in and put a hold on the state’s Section 1115 waiver. However, prior to the court’s intervention, more […]