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Waivers

  • South Carolina’s Medicaid Proposal Will Harm Children and Families

    Joan Alker

    South Carolina is the latest state to consider imposing a work requirement on parents receiving Medicaid. While there’s no formal proposal yet, officials have outlined their plans in a concept paper that raises as many questions as it answers. In a report we released today, we outline the problems with imposing a work requirement in…

  • Why Virginia Expanded Medicaid: Five Key Reasons

    Adam Searing

    Virginia decided today to expand Medicaid, which will allow the state to start to cover approximately 400,000 people who are unable to afford health plans yet too poor to get tax credit subsidies to buy insurance. This is a significant win for Virginians and for bipartisan cooperation in an increasingly partisan age as a newly-elected…

  • Kansas Legislators Reject a New Barrier to Medicaid Coverage for Very Poor Parents and CMS Just Might Agree

    Joan Alker

    At CCF we have been doing a lot of work lately trying to educate folks about who exactly is impacted by Medicaid waivers that create new barriers to coverage in states that have not accepted the option to expand Medicaid. As our recent reports on Alabama and Mississippi show, these work requirement proposals will result…

  • President Trump’s Executive Order Focuses on Reducing Poverty but Many Administration Policies Run Counter to that Goal

    Joan Alker

    The President issued an executive order yesterday titled “Reducing Poverty in America by Promoting Opportunity and Economic Mobility”. It requires the Secretaries of Treasury, Agriculture, Commerce, Labor, HHS, HUD, Transportation and Education to review all regulations and guidance to ensure they are in compliance with the executive order and submit a list of recommended regulatory…

  • Mississippi’s Proposed Medicaid Work Rule Would Disproportionately Harm Mothers Living in Small Towns and Rural Areas of State

    Joan Alker

    Mississippi’s request for a Medicaid work requirement has emerged as the one to watch. Its section 1115 waiver is now awaiting federal action and could well be the test of whether states that have never accepted the Medicaid expansion can impose this sort of requirement on their most vulnerable parents. CCF, working with the Mississippi…

  • Proposed Medicaid Work Requirement: Impact on Mississippi’s Low-Income Families

    Joan Alker

    (Updated August 3, 2018) Introduction Mississippi has joined a handful of states seeking federal permission to require parents and caregivers who qualify for Medicaid to prove they are working at least 20 hours a week or participating in an approved work activity before receiving health coverage. Called the “Mississippi Workforce Training Initiative,” the application for…

  • Alabama Mothers and Children Will Bear the Brunt of Proposed Medicaid Restrictions

    Joan Alker

    As regular readers of SayAhhh! know, on January 11th CMS released guidance announcing its interest in approving state proposals to impose work requirements on Medicaid beneficiaries. Since then CMS has approved three waivers to do so (along with other important and harmful changes such as lockouts which we are not talking about today) – Kentucky,…

  • The Impact of Alabama’s Proposed Medicaid Work Requirement on Low-Income Families with Children

    Joan Alker

    (Updated August 23, 2018) What is Alabama proposing to do? Alabama is seeking federal permission through a Section 1115 Medicaid demonstration waiver to require parents and caregivers who rely on Medicaid to work 20 to 35 hours a week, prove they are looking or training for a job or do community service before receiving Medicaid.…

  • Gutting Medicaid Transitional Medical Assistance: Watch What We Waive, Not What We Say

    Andy Schneider

    For over 30 years, Medicaid has encouraged work by parents, persons with disabilities, and others. You sure wouldn’t know it from the CMS Administrator’s repeated calls for “community engagement” by the “able bodied.”   But there it is, in plain view: section 1925 of the Social Security Act, Transitional Medical Assistance (TMA). TMA was designed to…

  • Medicaid Remains Popular Despite Efforts to Stigmatize the Program

    Andy Schneider

    Last week, the Kaiser Family Foundation released its February tracking poll. The results? Three quarters of respondents had a “very favorable” (40%) or “somewhat favorable” (34%) opinion of Medicaid. Over half of respondents (52%) said that the Medicaid program is working well for most low-income Americans covered by the program. On Monday, someone who has…

  • Leading Children’s Health, Medical and Advocacy Organizations Object to Work Requirements and Other Barriers to Medicaid Coverage

    Cathy Hope

    A broad and diverse group of children’s health, medical and advocacy organizations are speaking up against adding work requirements and other barriers to Medicaid coverage. Forty-four organizations sent a letter to HHS Secretary Alex Azar today expressing serious concerns about the agency’s proposed changes to Medicaid’s Section 1115 waiver policy, which could lead to thousands…

  • New GAO Report on Medicaid Waiver Evaluations Identifies Many Shortcomings

    Joan Alker

    Earlier this week, the GAO released a new report that looks closely at Section 1115 Medicaid demonstration evaluations. The states examined are Arizona, Arkansas, California, Indiana, Kansas, Maryland, Massachusetts, and New York. The report was requested by Republican Members of Congress from the committees of jurisdiction. The report uncovered a number of problems including that…

  • Mississippi Medicaid Waiver Could Lead to Coverage Losses for Very Poor Families

    Joan Alker

    I recently pulled out my calculator to look into the budget neutrality assumptions underlying Mississippi’s Section 1115 Medicaid waiver, and the results were disturbing. I unpacked this waiver in a previous blog. Kansas has a similar request pending[note]It is possible that Kansas may withdraw this request due to pending action by the state legislature.[/note] and…

  • Indiana’s Waiver Approval Adds More Barriers to Medicaid Coverage

    Joan Alker

    Following the recent approval of Kentucky’s waiver, Indiana becomes the second major waiver approval by the Trump Administration which establishes more barriers to Medicaid coverage. This is an unfortunate but not surprising turn of events. It’s worth noting that Indiana’s own evaluation shows numerous barriers to coverage already existing in Indiana’s HIP 2.0 program, yet…

  • Weaponizing Medicaid Paperwork

    Andy Schneider

    It turns out that CMS has a “Patients Over Paperwork” initiative, which the agency describes as “our effort to reduce administrative burden and improve the customer experience while putting patients first.” Who knew? If you’ve been following Administrator Verma’s crusade to condition Medicaid coverage on meeting requirements to document work, you would be quite surprised.…

  • Trump Administration’s New Medicaid Work Requirement Policy Will Harm Families

    Joan Alker

    Today the Centers for Medicare and Medicaid Services (CMS) issued guidance that radically alters Medicaid by allowing states to link Medicaid eligibility with work requirements. Essentially, the Secretary of Health and Human Services will allow states, using Section 1115 Medicaid demonstration waivers, to condition Medicaid eligibility on compliance with state-determined policies that require non-disabled adults…

  • Michigan Medicaid Evaluation Has Important Lessons for States Considering Work Requirements

    Joan Alker

    On Monday, a team of researchers from the University of Michigan (who are the official evaluators of the Healthy Michigan Plan) published a study in the Journal of the American Medical Association (JAMA) on the employment status of the adult Medicaid expansion population in Michigan. In a survey of 4,090 expansion adults, researchers found that…

  • Tracking Medicaid Work Requirement Proposals

    Olivia Pham

    We here at Georgetown University CCF are closely tracking Medicaid Section 1115 demonstration waiver proposals as states attempt to create new barriers to coverage. There are many troubling proposals pending, but one of the most common is the imposition of a work or community service requirement as a condition of Medicaid coverage. As a reference,…

  • Kansas and Mississippi Medicaid Waivers Race to the Bottom: Most Vulnerable Families Targeted by Harmful Proposal

    Joan Alker

    Medicaid is a critical part of health insurance coverage in the US, covering millions of children and their parents, seniors and individuals with disabilities.  More than half of states have taken the Affordable Care Act option to expand Medicaid coverage to more low-income parents and childless adults. But some states are trying to move in…