Waivers
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Where Does the Trump Administration’s Medicaid Waiver Policy Go Next?
Last week was a busy week with a federal court vacating both Arkansas and Kentucky’s Medicaid Section 1115 waivers on Wednesday and the Trump Administration approving Utah’s partial expansion waiver with a work requirement and an enrollment cap on Friday—but without the full expansion match. (Read more on Utah past and present). Given the immediate…
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Judge Blocks Arkansas and Kentucky Medicaid Work Requirement Waivers: What Does This Decision Mean for Other States?
Under the Administrative Procedures Act (APA), federal agencies may not take actions that are “arbitrary or capricious.” If they do, federal courts are instructed to hold the action unlawful and set it aside. Late yesterday afternoon, that’s exactly what Judge James E. Boasberg of the U.S. District Court in the District of Columbia did with…
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Florida House Committee Approves Bill to Impose Harsh Medicaid Rules on Low-Income Parents
A Florida House Committee recently (3/13) approved HB 955, on a party line vote, a bill that would authorize the Governor to seek a Section 1115 Medicaid waiver to impose likely the most punitive work reporting requirements in the nation on very poor parents receiving their health coverage through Medicaid. Because Florida has not expanded…
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How Would Utah’s Medicaid Partial Expansion Waiver Break New Ground if Approved
Utah’s legislature recently passed a bill which rolled back the Medicaid expansion passed by the voters in November and substituted a much weaker replacement. With the Governor planning to start enrollment on April 1st into the more limited version, we expect some action by CMS on Utah’s pending Medicaid Section 1115 proposal in the next…
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Evaluating the Administration’s Narrative on Medicaid Work Reporting Requirements
It turns out that last week was Never Mind Week. Who would have guessed? On Monday the Administration released its “Budget for a Better America,” proposing to cut federal Medicaid spending by nearly $1.5 trillion (with a “t”) over the next ten years. These cuts included a mandate that state Medicaid programs require that “able-bodied,…
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Child Health Providers and Advocates Ask HHS Secretary to Reject Work Requirements for Low-Income Parents
Today Georgetown University’s Center for Children and Families joined over 50 other national health care provider, research and consumer groups focused on children and families to send a letter to HHS Secretary Alex Azar raising concerns about the harm of work requirements for children and families, particularly in states that have not expanded Medicaid. The…
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First Round of Arkansas 2019 Medicaid Data Shows More Coverage Losses Are on the Way
Last week, the state of Arkansas released its latest round of data on implementation of its Medicaid work reporting requirement – the first in the country to be implemented. As readers of SayAhhh! know, over 18,000 lost coverage in 2018 as a result of not complying with the new reporting rules. And the policy is…
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CMS Administrator Ignores Congressional Advisory Committee Recommendation
In 2009, Congress created the Medicaid and CHIP Payment and Access Commission (MACPAC) to advise it on coverage for low-income Americans through Medicaid and CHIP. One of MACPAC’s statutory responsibilities is to “review and assess…Medicaid and CHIP eligibility policies, including a determination of the degree to which federal and state policies provide health care coverage…
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CMS Weighing Decision that Would Lead to Loss of Health Coverage for Thousands of Tennessee Families Living in Poverty
Tennessee, a state that has not accepted the option to expand Medicaid to more low-income adults, has become the fifth state to ask CMS to impose a work or community service reporting requirement on parents with incomes at or below 98% of the federal poverty level. South Carolina is next in the queue. If the…
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Work Reporting Requirement for Tennessee Parents Would Harm Low-Income Families with Children
Introduction Tennessee is seeking federal permission to impose a work reporting requirement on low-income parents and caregivers receiving health coverage through Medicaid. Under the proposal, these beneficiaries ages 19 to 64 would have to document that they are working at least 20 hours a week or participating in job-training, education, or volunteer activities in order…
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Arkansas’ Medicaid Work Reporting Rules Lead to Staggering Health Coverage Losses
Earlier this week, the state of Arkansas released its final round of data for 2018 for its controversial work reporting requirement policy. The data shows that an additional 1,232 adults lost their Medicaid coverage at the end of December, bringing the total Medicaid coverage loss since August to 18,164. The news motivated me to take…
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Oklahoma’s Medicaid Waiver Proposal Will Harm Its Most Vulnerable Families
Unfortunately, our series of reports looking at harmful state Medicaid work requirement rules targeting very poor parents is getting longer. Today we are releasing an updated look at Oklahoma’s proposal, which is currently up for public comment at the federal level. Six states now have active proposals – Mississippi, Alabama, and South Dakota have proposals…
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New Report Finds South Carolina’s Medicaid Waiver Would Leave Thousands of Poor Parents Uninsured
[Editor’s Note: On March 4, 2019 South Carolina posted a revised application for state public comment.] Just before the holidays, South Carolina posted its application for new work-related reporting rules for very low-income parents and caretaker relatives with incomes below 67 percent of the poverty line who are insured through Medicaid. Today we partnered with South Carolina…
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More Arkansans Lose Medicaid Health Coverage Just Before the Holidays
Earlier this week, Arkansas released the latest round of data showing that their misguided policy requiring adults to prove they are working in order to retain Medicaid coverage is continuing to fail. In December, 4,655 people lost health insurance, bringing the total coverage losses to nearly 17,000 so far, though thousands more will lose coverage…
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Surprise! CMS Approves Kentucky Work Requirement Waiver Again
Yesterday, CMS reapproved the Kentucky work requirement waiver. The reapproval comes less than two weeks after Congress’s Medicaid and CHIP Payment and Access Commission (MACPAC) wrote a letter to the Secretary of HHS asking for a pause in disenrollments resulting from the Arkansas work requirement waiver, less than a week after Arkansas announced that over…
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Arkansas Data are Clear – Trump’s Medicaid Policy is a Dangerous Failure
The primary focus of the Trump Administration’s approach to Medicaid has been to encourage states to impose work and “community engagement” requirements on adults in Medicaid through Section 1115 Medicaid waivers. As regular readers of SayAhhh! know, Arkansas is the first state in the nation to impose these new rules on its Medicaid expansion policy.…
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Medicaid at the Ballot Box: More Coverage or More Barriers? (Part 2)
I blogged earlier about which of the 17 non-expansion states might see a change in their status on the horizon post election. Today I take a look at states that already have expanded (yes, I count Maine as an expansion state despite Governor LePage’s best efforts to thwart the will of the people), where we…
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Medicaid at the 2018 Ballot Box: What to Look For (Part 1)
Next Tuesday (as usual) I will be staying up late to see what happens in the midterm elections. But for the first time in more than twenty years of working on Medicaid there will be so much to watch out for that will directly affect Medicaid! Today I will start with the 17 states that…
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Medicaid Work Requirement Waivers: Time for CMS to Hit the Pause Button
Yesterday members of the Medicaid and CHIP Payment and Access Commission (MACPAC – a Congressional agency) received a briefing from staff on the implementation of the Arkansas work requirement waiver. Staff reviewed the latest data from the state as well as the findings from their own inquiries to various stakeholders. The presentation confirmed my reading…
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Arkansas Numbers Tell the Story: Trump’s Medicaid Work Requirement Policy Promotes Coverage Losses not Work
Like many folks who work on Medicaid policy, we’ve been paying close attention to what is happening in Arkansas – the first state in the country to implement a work activities reporting requirement in Medicaid.[1] Earlier this week, the second round of data was released by the state documenting that another 4,109 Medicaid beneficiaries lost…
