Section 1115 Medicaid demonstration waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. While there is great diversity in how states have used waivers over time, waivers generally reflect priorities identified by states and the Centers for Medicare and Medicaid Services (CMS). On March 14, 2017, the CMS sent a letter to state governors that signaled a willingness to use Section 1115 authority to support work requirements and the alignment of Medicaid programs with private insurance policies.

. . .

Mississippi has received the first-ever 10-year extension of a Medicaid Section 1115 demonstration waiver, allowing the state to continue providing family planning services for people with income of up to 194% of the federal poverty level.

The CMS said the 10-year extension is part of the agency’s effort to give states greater flexibility in running their Medicaid programs, without having to ask the government for frequent approvals. Up to now, the agency typically granted Section 1115 waivers, which are supposed to be budget-neutral for the federal government, for five-year periods.

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Whether it was bracing for a possible repeal of Obamacare or pondering an ambitious single-payer program that would overhaul how California provided medical care to its residents, the issue of healthcare kept politicians and policy wonks busy in 2017.

That’s not likely to let up in 2018.

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Seemingly lost in the news of last week’s big tax-cut victory for the GOP was the repeal of the individual mandate — the Obamacare provision that required Americans to have health coverage or else pay a penalty. This is, to borrow a phrase from Vice President Joe Biden, a “big f***ing deal.” It is a big victory for conservatives, who disdained the mandate as government coerciveness. But from a broader perspective, the rise and fall of the mandate is yet another example of how Congress struggles to regulate the national economy.
. . .

Congressional Republicans’ move to scrap the Affordable Care Act’s individual mandate is likely to drive up sales of cheap, short-term health plans that do not have Obamacare’s consumer protections or benefits, health insurance experts say — a development that could further destabilize the Obamacare exchanges.

The GOP’s final tax legislation, which is now awaiting President Donald Trump’s signature, eliminates in 2019 the ACA’s mandate requiring most people to have health insurance or pay a penalty. For 2018, the penalty is set at $695 or 2.5 percent of household income, whichever is greater.

. . .

Republicans are under renewed pressure to shore up the fragile US healthcare system after they knocked out a pillar of Obamacare in landmark tax legislation, but did not attempt to stabilise it. Party leaders differ over whether to make healthcare a signature issue, stung by their failure to repeal Barack Obama’s reforms entirely in the summer. But the tax bill has made it harder for Congress to do nothing in the coming election year, say experts.

. . .

As President Donald Trump completes his first year in office, Americans are increasingly concerned about health care, and their faith that government can fix it has fallen.

A new poll by The Associated Press-NORC Center for Public Affairs Research finds that 48 percent named health care as a top problem for the government to focus on in the next year, up 17 points in the last two years.

The poll allows Americans to name up to five priorities and found a wide range of top concerns, including taxes, immigration and the environment. But aside from health care, no single issue was named by more than 31 percent.

. . .

Senate Majority Leader Mitch McConnell (R-Ky.) on Friday encouraged two key senators to continue working on legislation to repeal and replace ObamaCare.

McConnell encouraged Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) to keep working to cobble together enough votes to pass their ObamaCare repeal legislation.

“I wish them well,” McConnell said and added that if the senators can get the votes next year, he’d encourage the Senate to vote on the bill.

. . .

Washington continues to debate health policy as if the number of people covered by government insurance programs is the key measurement of success. This week brought more evidence that the ObamaCare experiment of signing up millions more people for subsidized coverage has not made Americans healthier.

“Life expectancy in the United States fell for the second year in a row in 2016,” NBC News reports this week. The network quotes the government’s National Center for Health Statistics:

“This was the first time life expectancy in the U.S. has declined two years in a row since declines in 1962 and 1963,” the NCHS, part of the Centers for Disease Control and Prevention, said in a statement.

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California’s “Medi-Cal” program is one of the worst offenders when it comes to controlling costs.  It’s getting worse not better.  In fact, Medi-Cal is such a big spender it begs the question what is driving out of control spending in the Golden State – waste, fraud, abuse, incompetence, or all of the above?  Every taxpayer in America should be asking these questions, as we are all footing the majority of the bill.

Over the past ten years, Medicaid spending in California has almost tripled, growing from $37 billion per year to a whopping $103 billion per year—including both state and federal funding. And things have only accelerated since the state expanded Medicaid to a new group of able-bodied adults.

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