Republicans and Democrats are engaging in warfare over a traditionally bipartisan program to insure children.

The House Energy and Commerce Committee is marking up legislation to extend the Children’s Health Insurance Program by five years. However, Democrats have objected to the legislation because of measures to pay for the program.

“Here we are with a partisan bill that asks us to pay for coverage of children on the backs of seniors and the most vulnerable among us,” said Rep. Diana DeGette, D-Colo.

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Congress should enact waiver legislation that clarifies the availability of federal subsidies for the purposes of evaluating waivers’ deficit neutrality, including all potential federal spending that could be offset by a waiver, and evaluates its impact over a long (8-10 year) time period after an initial pilot period. Federal “guardrails” to prevent unintended consequences on patient outcomes and the deficit should focus on collecting data on costs and impact on vulnerable populations, while expanding consumer choices around affordable, high quality plan options.
Congress should also instruct HHS to create a set of standardized, expedited waivers that could be quickly approved, to enhance confidence in the process. Congress should also allow states to form multi-state compacts to share costs and develop the necessary implementation infrastructure.
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Only in government does modestly slowing spending growth mean severe “cuts.” Opponents of the Graham-Cassidy-Heller-Johnson (GCHJ) proposal to change ObamaCare falsely claim that it will result in massive spending cuts, especially in Medicaid. That simply is not true.

The bill does not spend fewer dollars. In fact, under this bill, taxpayers will spend more over the next 10 years than they are spending right now. The “severe” change being referenced in almost every news story is a reduction in the rate of growth. Some ObamaCare supporters have even claimed that Congress will be unable to afford the GCHJ block grants.
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Conspicuously absent from most commentary arguing that Kansas should expand Medicaid under the Affordable Care Act is any discussion about the program actually improving the health of recipients. Instead, we are left with terribly materialistic arguments about forgone federal money. Why is it that on the biggest policy questions facing Kansas, such as Medicaid or education, we hear lots about money spent and little about health outcomes or student achievement?
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The Centers for Medicare and Medicaid Services has a powerful tool for improving quality and reducing costs: the Center for Medicare and Medicaid Innovation. Congress created the Innovation Center in 2010 to test new approaches or “models” to pay for and deliver health care. The complexity of many of the current models might have encouraged consolidation within the health care system, leading to fewer choices for patients. The Trump administration is analyzing all Innovation Center models to determine what is working and should continue, and what isn’t and shouldn’t. Strengthening Medicare and Medicaid will require health care providers to compete for patients in a free and dynamic market, creating incentives to increase quality and reduce costs.

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Ohio Gov. John Kasich on Friday said that some of the essential health benefits that had been set up under Obamacare were too limiting to customers, proposing that someone have the option to buy a plan that excludes maternity coverage while explaining his decision to mandate autism coverage in his state.

Kasich, a Republican, was appearing in a panel in Washington alongside Colorado Gov. John Hickenlooper, a Democrat with whom he has been working on an Obamacare stabilization plan to lower the costs of premiums and give customers more choices for health insurance plans.

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The Kaiser Family Foundation’s Larry Levitt says, “States actually have a lot flexibility in theory under current waivers, but the guardrails are very hard to meet, which limits the amount of flexibility in practice.” During the repeal-and-replace effort, Republicans wanted to remove some of those “guardrails”—allowing states to chip away more substantively at some of the law’s benefit mandates and coverage guarantees. Sen. Lamar Alexander, though, is trying to keep his proposal more tailored. He’s focusing more on changes to the process of seeking a waiver than on the substance of what can be waived.

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Donald Trump’s gleeful deal with the Democrats—ratcheting up the debt ceiling, as well as the ire of the Republican establishment—puts John Cogan’s mind on 1972. Starting in February of that year, the Democratic presidential candidates engaged in a bidding war over Social Security to gain their party’s nomination. Sen. George McGovern kicked off the political auction with a call for a 20% increase in monthly payments. Sen. Edmund Muskie followed suit, as did Rep. Wilbur Mills, chairman of the Ways and Means Committee. Former Vice President Hubert Humphrey, never one to be outdone, offered a succulent 25%.

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Major bipartisan accomplishments in federal policy feel like a rarity these days. But it was just over 20 years ago that the parties came together to pass significant, positive reforms to our nation’s cash assistance program for families in poverty. The 1996 welfare-reform law, passed by a Republican Congress and signed by President Bill Clinton, significantly strengthened work requirements in a new program, now known as Temporary Assistance for Needy Families (TANF). In the years following the law’s enactment, child-poverty rates dropped significantly and employment among poor mothers increased, while teen pregnancy and abortion rates continued to fall. Policies that encouraged work succeeded in achieving the intended, positive result: fewer Americans in poverty and more Americans providing for themselves.
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A majority of voters back the idea of tying Medicaid eligibility to employment status as the Trump administration weighs whether to give more states the power to impose work requirements on the government health program.

In an Aug. 10-14 Morning Consult/POLITICO poll, 1,997 registered voters were asked whether they generally support requiring individuals to have a job in order to be eligible for the program. Fifty-one percent of voters said they support that proposal, while 37 percent said they oppose it. The survey has a margin of error of plus or minus 2 percentage points.

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