Arkansas recently became the third state to receive approval from the U.S. Department of Health and Human Services (HHS) to implement a work requirement for Medicaid adults. The hand-delivered approval follows the department’s endorsement of work requirements submitted by Kentucky and Indiana and comes ahead of action on similar requests from a host of other states, including Arizona, Maine, New Hampshire, Utah, and Wisconsin. Arkansas’s request was among several proposed amendments to the state’s Section 1115 demonstration waiver for its Arkansas Works program, including a proposed income eligibility cap at 100 percent of the federal poverty level (FPL) for the expansion population, which HHS did not approve at this time.
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In 1981, Congress created the home and community-based (HCBS) waiver program. These waivers allow states, if they choose, to extend home- and community-based Medicaid services to individuals who would otherwise qualify for care in a nursing home or institution. Essentially, these waivers allow truly needy individuals on Medicaid to receive additional care they need without being institutionalized.
The waiver programs are comprised of individuals with severe intellectual disabilities, traumatic brain injuries, spinal cord injuries, and mental illnesses, among other debilitating conditions.
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Arkansas on Monday became the third U.S. state to require that Medicaid recipients work or participate in employment activities as a condition of receiving health insurance as the Trump administration continues to approve state requests that fundamentally change the 50-year-old program.
Arkansas’s waiver would require beneficiaries to work or participate in job training or job search activities for at least 80 hours per month as a condition of receiving Medicaid, the government health insurance program for the poor and disabled. Those who fail to meet the requirements for three months of a plan year will not be able to re-enroll until the following plan year.
Proposed changes to Arkansas’ Medicaid expansion program would reduce its cost by more than $356 million in the fiscal year that starts July 1, according to state Department of Human Services estimates.
The estimates include $307 million in federal and state funds saved by restricting eligibility to people with incomes of up to the poverty level, instead of 138 percent of the poverty level.
Imposing a work requirement on many of those remaining on the program would save an additional $49.4 million, the department calculated.
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Over a 6-month period, the OIG found in California:
For our sample of 150 beneficiaries, California made Medicaid payments on behalf of 112 eligible beneficiaries. However, for the remaining 38 beneficiaries, California made payments on behalf of ineligible beneficiaries (e.g., a woman who did not meet eligibility requirements for the newly eligible group because she was pregnant) and potentially ineligible beneficiaries (e.g., a beneficiary who may not have met the residency requirement). On the basis of our sample results, we estimated that California made Medicaid payments of $738.2 million ($628.8 million Federal share) on behalf of 366,078 ineligible beneficiaries and $416.5 million ($402.4 million Federal share) on behalf of 79,055 potentially ineligible beneficiaries. (These estimates represent Medicaid payments for fee-for service, managed-care, the drug treatment program, and mental health services.) These deficiencies occurred because California’s eligibility determination systems lacked the necessary system functionality and eligibility caseworkers made errors. We also identified a weakness in California’s procedures related to determining eligibility of individuals who may not have intended to apply for Medicaid.
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Kentucky Gov. Matt Bevin (R) is countersuing to stop a lawsuit filed by critics of the state’s plan to institute Medicaid work requirements.
The administration filed a lawsuit in federal district court in Kentucky on Monday seeking a ruling that the state’s Medicaid waiver fully complies with federal law.
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Ohio will soon ask the federal government to waive an Obamacare requirement that nearly everyone in the state get health insurance coverage.
It will also ask permission to make some Medicaid recipients work 20 hours a week, go to school or take on similar activities. The state announced both these actions today, anticipating it will submit separate applications to Washington in about a month, after holding public hearings.
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Galen Institute Senior Fellow Doug Badger has written a paper, published by the Taxpayers’ Budget Office of the National Taxpayers Union Foundation, in which he analyzes CBO’s expectation that the Center for Medicare and Medicaid Innovation (CMMI) would reduce Medicare spending by $45 billion over ten years. The forecast is flawed, Badger concludes, as CBO “ascribes unobserved and unobservable savings to projects that CMMI has not yet undertaken (and may never undertake).” He says the CBO’s judgements “are in some cases questionable, in others mistaken and in still others rendered obsolete.”
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Gov. Holcomb (R-IN) joined U.S. Health and Human Services Secretary Alex Azar at Eskenazi Hospital on Friday to announce Indiana gained federal approval to continue its Healthy Indiana Plan (HIP).
The plan, which the state calls a successful alternative to traditional Medicaid, has been approved through Dec. 2020.
This will allow the state to continue health coverage for more than 400,000 low-income adult Hoosiers.
The Healthy Indiana Plan was created in 2007 under Gov. Mitch Daniels. The program was expanded in 2015 by then Gov. Mike Pence with a federal waiver to implement HIP as an alternative to traditional Medicaid expansion.
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Americans are among the most generous people in the world. While this nation was founded on the pursuit of a shared dream, the moral pledge of the American people has been to never leave behind our most vulnerable fellow citizens.
When we created Medicaid in 1965 as part of President Lyndon B. Johnson’s War on Poverty, we formalized that commitment and wove a fabric of care that has provided health services for seniors in need, pregnant mothers, low-income children and parents, and people with disabilities. Johnson affirmed the nation’s safety net, saying, “Our aim is not only to relieve the symptoms of poverty, but to cure it and, above all, to prevent it.”
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