Waivers
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Medicaid Wars: The Unwinding (and Litigation) Continues (Episode IV)
It’s been seven months and change since the Biden Administration took office. What it found waiting for it on January 20 was not just a crisis of democracy and a global pandemic and a surge of unaccompanied children at the border, but also a large pile of policy intended to undercut the Administration’s ability to…
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Federal Government Accepting Public Comments on Tennessee Medicaid Block Grant Waiver Restricting Access to Prescription Drugs
The Centers for Medicare and Medicaid Services (CMS) have reopened a 30-day public comment period for Tennessee’s controversial section 1115 waiver, which the Trump Administration approved in January 2021. While the waiver’s radical centerpiece converting the state’s federal Medicaid funding into a block grant has rightfully received the most attention, the waiver would also allow…
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Biden Administration Takes Further Action to End Barriers to Medicaid Coverage
Nearly six months ago, the Biden Administration initiated efforts to withdraw work reporting requirements in the eleven states with approved section 1115 Medicaid waivers. Now, the resolution many have been waiting for is almost entirely complete. On August 10, Ohio, South Carolina, and Utah all received letters from CMS formally withdrawing their work requirement waivers.…
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More States Moving to Extend Medicaid Postpartum Coverage Option Under ARP, Why Are Georgia and Missouri Limiting Its Reach?
Extending postpartum coverage continues to be a hot topic in state legislatures, in Congress, and in the Biden Administration. As my colleagues shared in a blog last week, CMS recently approved Section 1115 demonstration waivers in Georgia and Missouri that extend postpartum benefits to at least some pregnant people. While a step forward, the approvals…
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Georgia and Missouri Postpartum Medicaid Waiver Approvals Promote Limited Coverage
As Say Ahh readers know, there have been bursts of Section 1115 demonstration activity since the start of the year. April was no different, bringing another flurry of actions from CMS. This time, however, there were some new demonstration approvals that promote coverage, albeit in a more limited way than we would have liked to…
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Medicaid Wars: Litigation Risk (Episode III)
It turns out that unwinding illegal Medicaid policies is complicated. There’s this thing called “litigation risk”. Executive Branch agencies have to make reasoned decisions and stay within their statutory guardrails; if they don’t the federal courts may rein them in. As it happens, litigation risk goes both ways. The Unwinding began with the issuance of…
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Advancing Postpartum Coverage in Medicaid: Waiver or SPA?
The recently enacted American Rescue Plan Act has many new opportunities and important provisions that we are still absorbing and unpacking. One key change, as readers of SayAhh! know, is the new state option to provide 12 months of postpartum Medicaid and CHIP coverage to women after the end of their pregnancy, well beyond the…
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Some States’ Letters to CMS on Medicaid Work Requirements Double Down
Last month, CMS began taking steps to get rid of Medicaid section 1115 work requirement waivers as my colleague Joan Alker has written about. The Biden Administration sent letters to states with approved work requirements that “preliminarily” disapproved the policy on the basis of the COVID-19 pandemic and uncertainty of its aftermath on health and…
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Medicaid Wars: Rescind and Withdraw (Episode II)
The Biden Administration has a long list of bad Medicaid policies to unwind. As chronicled in Episode I, the groundwork for the unwinding was laid in a Presidential Executive Order, “Strengthening Medicaid and the Affordable Care Act,” issued on January 28. Among other things, the E.O. directs the Secretary of HHS to review section 1115 demonstrations and…
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Trump’s Farewell Gift to Florida’s Medicaid Program
A few days before departing, former CMS Administrator and Trump appointee Seema Verma handed out ten-year Medicaid demonstration waiver extensions for political allies, with Texas and Florida,[1] approvals being granted late Friday, January 15th. The Friday before (Jan. 8th) CMS had approved the infamous and dangerous Tennessee waiver, which my colleagues explained beautifully here. Ten…
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Groups Call on HHS to Cut Red-Tape and Remove Barriers to Medicaid Coverage
A total of 116 organizations led by Georgetown University CCF and the Center on Budget and Policy Priorities sent a letter to the Acting Secretary of HHS urging immediate action to protect people who rely on Medicaid for their health insurance and who live in states with proposed or approved section 1115 work and community…
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Biden Administration Signs Health Care Executive Orders, Puts Welcome Mat Back Out
Today January 28th is Health Care theme day for the Biden Administration, which is in the midst of releasing a carefully orchestrated set of Executive Orders (EO) on a range of issues. Two Executive Orders were signed by the President today, the first to strengthen the Affordable Care Act and Medicaid, and the second to…
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The Tennessee Waiver: Block Grant, Aggregate Cap, or Windfall?
In their wondrous 1957 interpretation of a Gershwin classic, Ella Fitzgerald and Louis Armstrong sing, “You like potato and I like potahto/You like tomato and I like tomahto.” Their back-and-forth has echoes in the current debate over what to call the TennCare III demonstration, approved on January 8 by the former CMS Administrator, Seema Verma.…
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Trump Administration Tries Its Best to Knock Legs Out from Under Medicaid on the Way Out the Door
So far 2021 has been a really wild and difficult ride for me and millions of others in the U.S. with COVID-19 ravaging the nation, an armed insurrection here in DC, and an ongoing economic crisis leaving so many families in need. My mind has been struggling to absorb all that is happening so quickly.…
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Limited Postpartum Medicaid Coverage Extensions are a Missed Opportunity
States are continuing to push for extending Medicaid coverage for postpartum women beyond the current federal cutoff of 60 days after the end of their pregnancy. Just in the last month, three more states submitted waiver applications to CMS: Indiana, Georgia, and Texas. Before the end of the year, we submitted comments on Indiana’s limited…
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What Can We Expect from Biden Administration on Work Reporting Requirement Waivers?
As I was waiting to watch Vice President-elect Kamala Harris start her speech on Saturday night, I tweeted the following: Goodbye and good riddance to Medicaid work requirement waivers. — Joan Alker (@JoanAlker1) November 8, 2020 It proved to be a popular sentiment – at least on my twitter feed. As we have blogged about…
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Georgia’s Medicaid Waiver is Fiscally Foolish and Anti-Family
On October 15th, the Centers for Medicare and Medicaid Services Administrator Seema Verma traveled to Atlanta to announce the approval of Georgia’s “Pathways to Coverage” Section 1115 Medicaid demonstration. The approval is the latest in CMS Administrator Verma’s ideological crusade to “reframe” Medicaid and promote her signature initiative — work requirements. The creation of a…
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More Evidence Medicaid Work Requirements Don’t Actually Work
A new study from Ben Sommers and other researchers at Harvard University finds that Medicaid work requirements fail to promote employment but do result in more people losing their health coverage and may promote other negative health outcomes. The study, published in Health Affairs, found that negative economic consequences ensued as well – with medical…
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Request for Action on Pending Section 1115 Demonstrations to Reduce Racial Disparities
The Georgetown University Center for Children and Families and 278 other organizations sent the following letter to the Secretary of Health and Human Services urging him to take action on certain pending section 1115 demonstration waivers to address racial disparities and years of systematic racism. Medicaid_Supporting Black Women Sign-On Letter
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Oklahoma Voters Approve Constitutional Amendment to Expand Medicaid
Oklahoma voters took a historic step and nudged their state forward toward becoming the 38th in the nation (including Washington, DC) to provide residents more affordable health insurance through their Medicaid program. The constitutional amendment passed by voters requires the state to open the doors to coverage no later than July 1, 2021. State leaders…
