Waivers
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Arbitrary and Capricious: Kentucky Can’t Require Medicaid Beneficiaries to Document Work in Order to Have Coverage
Seema Verma, the CMS Administrator, has been relentless in her efforts to rewrite the Medicaid statute by encouraging states to require “able bodied” adults to document work in order to qualify for Medicaid. The resulting blizzard of red tape would predictably lead to large coverage losses and redefine Medicaid as a welfare rather than a…
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Doctors, Patients and Many Others Voice Strong Objections to Florida’s Plan to End Retroactive Medicaid Coverage
Florida recently submitted a Section 1115 Medicaid waiver request to eliminate 90-day retroactive coverage for everyone in Florida’s Medicaid program, except children and pregnant women. As we wrote in our joint comments, this is a bad idea that will expose families to medical debt and providers to higher uncompensated care costs. There is absolutely no…
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The Limits to Trump’s Medicaid Freedom for States
Governing By: Mattie Quinn Ever since being elected, President Donald Trump has vowed to give states more flexibility to enact their own health care policies. … Last month, CMS rejected a waiver from Kansas that would have set a three-year time limit for people to use Medicaid. “I was pleasantly surprised by that,” says Joan Alker,…
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What South Dakota’s Medicaid Waiver Application Doesn’t Tell You
South Dakota is in the process of applying for a Section 1115 waiver that will allow it to impose a work requirement on very poor parents in two counties, Minnehaha and Pennington, for five years, with the option to expand to other counties. The state Medicaid agency posted the application for public comment on May…
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South Carolina’s Medicaid Proposal Will Harm Children and Families
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…
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Why Virginia Expanded Medicaid: Five Key Reasons
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…
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Kansas Legislators Reject a New Barrier to Medicaid Coverage for Very Poor Parents and CMS Just Might Agree
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…
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President Trump’s Executive Order Focuses on Reducing Poverty but Many Administration Policies Run Counter to that Goal
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…
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Mississippi’s Proposed Medicaid Work Rule Would Disproportionately Harm Mothers Living in Small Towns and Rural Areas of State
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…
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Proposed Medicaid Work Requirement: Impact on Mississippi’s Low-Income Families
(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…
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Alabama Mothers and Children Will Bear the Brunt of Proposed Medicaid Restrictions
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,…
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The Impact of Alabama’s Proposed Medicaid Work Requirement on Low-Income Families with Children
(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.…
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State Medicaid Work Rules Ignore the Reality of Working Life for Americans in Low Wage Jobs
Work hour requirements to get and keep Medicaid coverage are proposed or are now required in multiple states under the encouragement of the Trump Administration. Arkansas, Kentucky, and Indiana all have received approval for Medicaid waivers containing work requirements. Even states that haven’t expanded Medicaid, where covered adults are largely either elderly, disabled, or parents…
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Gutting Medicaid Transitional Medical Assistance: Watch What We Waive, Not What We Say
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…
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Medicaid Remains Popular Despite Efforts to Stigmatize the Program
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…
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Leading Children’s Health, Medical and Advocacy Organizations Object to Work Requirements and Other Barriers to Medicaid Coverage
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…
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New GAO Report on Medicaid Waiver Evaluations Identifies Many Shortcomings
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…
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Mississippi Medicaid Waiver Could Lead to Coverage Losses for Very Poor Families
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 and a handful of other non-Medicaid expansion states have suggested they may follow suit (including Alabama, South…
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Indiana’s Waiver Approval Adds More Barriers to Medicaid Coverage
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…
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Weaponizing Medicaid Paperwork
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.…
