Waivers
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Wisconsin Provides A Reality Check about What Low-Income Families Can Afford to Pay for Medicaid
States that have not yet decided to expand Medicaid to low income adults and parents are considering their options, and some are hoping to experiment with charging monthly premiums. New data from Wisconsin provides a helpful reality check. Slightly more than two-fifths of the lowest income adults paying premiums—who did not exit BadgerCare or Transitional…
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I Support Arkansas’ Effort to Move Forward (But Am Holding My Nose)
So I just skimmed through the Arkansas Section 1115 Medicaid waiver application,which was submitted to the federal government a few days ago. This proposal is unique and uses Medicaid funding to buy coverage in the new marketplace through a premium assistance arrangement. I AM happy that Arkansas legislators and the Governor were sensible enough to…
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GAO Releases New Report on Section 1115 Waiver Budget Neutrality
The latest GAO analysis of Medicaid Section 1115 waivers finds that the federal government does not always have a consistent policy of ensuring that the waivers are “budget neutral” to the federal government. GAO took a look at 10 Medicaid waivers approved in recent years to see whether there was a consistent policy that ensured…
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CMS Issues Final Rule on New Premium Assistance Option
As my diligent colleague Tricia Brooks reported, CMS issued an important final rule on July 5th that we have been expecting for some time. While the rule did not finalize a number of issues, it did include slightly revised rules for states interested in pursuing premium assistance in the individual market – sort of a hot…
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Florida’s Medicaid Managed Care Waiver Receives Final Approval: Some Strong Consumer Protections Included, Oversight Will Be Critical
So it may seem like this already happened but today CMS issued the final documents approving Florida’s request to move almost its entire Medicaid program into managed care. The state needed demonstration waiver approval for some (e.g. children on SSI, in foster care, dual-eligibles, etc) but not all of the populations it is seeking to move into…
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Red Flags Raised on Indiana Waiver Proposal
A group of influential national organizations, including Georgetown CCF, submitted a letter today to Secretary Sebelius expressing concerns about some features of the pending Section 1115 Medicaid Demonstration request from the state of Indiana. The letter is available here. The Section 1115 waiver request focuses on using Healthy Indiana as a vehicle for the state’s…
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CMS Clarified Enrollment Caps in Medicaid Waivers Will Not be Permitted
The Centers for Medicare and Medicaid Services (CMS) issued questions and answers today which, among other things, clarified that Section 1115 waiver requests that include enrollment caps or similar policies would not be approved going forward. CMS notes that such policies do not “further the objectives of the program.” Background note here, Section 1115 Secretarial…
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On Medicaid and ACA, Arkansas Lawmakers Choose Practical Step Forward Over Ideological Objections
All eyes— again! — have been on my home state of Arkansas this week as the General Assembly late yesterday passed the “private option,” aka the “Arkansas Plan,” or using Medicaid funds to buy exchange coverage for 250,000 uninsured Arkansans starting next year. This was no small feat, given the structural and political barriers at…
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CMS Issues Guidance on Arkansas Type Premium Assistance Plans
So as Tricia Brooks blogged about yesterday while I was taking the day off, CMS issued some interesting Q and A’s last Friday on how a state might consider taking a premium assistance approach to expanding their Medicaid program. The Q and A’s, to my mind, were a helpful contribution to the ongoing discussions in…
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CMS Q&A Shines Light on “Arkansas Plan”
Just in time for the holiday weekend, CMS issued a Q&A regarding the state option to expand Medicaid by using premium assistance to buy coverage through a qualified health plan in the new insurance marketplaces. Over the past few weeks, “the Arkansas plan” worked itself into a media frenzy and had Medicaid stakeholders concerned over…
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New Resource Looks at Premium Assistance Options in Medicaid/CHIP
Yesterday my new report for the Kaiser Commission on Medicaid and the Uninsured was released called Premium Assistance in Medicaid and CHIP: An Overview of Current Options and Implications of the Affordable Care Act. The paper examines how statutory changes in the Children’s Health Insurance Program Reauthorization Act and the Affordable Care Act have changed…
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HHS Secretary Answered Several Questions About New Medicaid Coverage and Waivers
As my colleague Elisabeth Burak blogged about last month, Secretary Sebelius released a letter to Governors with answers to 39 frequently asked questions related to ACA implementation on December 10th. Most notably, the FAQ addressed whether or not CMS would allow waivers for “partial expansions” now that the Supreme Court has rendered the expansion of…
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Arizona’s Waiver Request to Limit Medicaid Extension Raises Questions
A question on the minds of waiver watchers these days is whether the Obama Administration can, will, or should allow states to do a partial expansion of Medicaid to 100% of FPL for childless adults and parents who are newly eligible under the Affordable Care Act. Remember, Section 1115 demonstration waiver authority was created to…
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What Was Medicaid Doing in a Foreign Policy Debate?
My oldest son was required to watch this week’s presidential debate and report back to his teacher on flawed logical reasoning by the candidates. I thought my husband, who is somewhat of a foreign policy wonk, would be on homework helper duty and I could just sit back and enjoy the show—after all, it was…
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Vote Now for Favorite Comments on New Mexico’s Medicaid Waiver Proposal
By Wesley Prater HHS has done a good job of inserting more transparency into the Medicaid waiver approval process and providing “waiver watchers” with an opportunity to provide our input on important health care policy decisions. One way the agency is collecting input is through the “CMS Idea Factory” website. Now is the time to…
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Stand Up for Kids By Voting For Comments on Kansas Medicaid Waiver Proposal on Idea Factory
HHS has done a good job of inserting more transparency into the Medicaid waiver approval process and providing “waiver watchers” with an opportunity to provide our input on important health care policy decisions. One way the agency is collecting input is through the “Idea Factory” website. Now is the time to take HHS up on…
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In the Aftermath of SCOTUS: Should States Get Medicaid Waivers Allowing Partial Expansions?
One of the many questions that has arisen since the Supreme Court handed down its decision on the Affordable Care Act is whether a state could do a partial expansion – say to 100% of the poverty line — rather than 133% of FPL. This number is not plucked from the air but rather reflects…
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CMS Shines Light on the Secret Lives of Medicaid Waivers
Just as Yelp has saved us from many a bad meal, the new Medicaid “Idea Factory” has the potential to protect us from bad health policy decisions. The idea behind the “Idea Factory” is to infuse more transparency into the process and elicit greater public input into important health policy decisions. In my view, nowhere…
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Wisconsin’s 1115 Waiver Approved – Bad News/Good News
By Wesley Prater Medicaid waivers have been a very hot topic lately! Just take a look at my colleague Joan Alker’s blog on recent action around waivers. You may have heard that CMS recently approved Wisconsin’s 1115 waiver for the state’s BadgerCare program. Most of the changes will affect adults with incomes over 133% of the…
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Waiver Frenzy
Interesting events have kept Medicaid waiver watchers very busy in the last week. On Friday April 27th final regulations creating new requirements for state and federal public process to allow for public input when Medicaid waivers are developed and considered went into effect. A summary I did with Samantha Artiga at Kaiser Commission on Medicaid…