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.
. . .
Having failed to repeal the Affordable Care Act, congressional Republicans now want to create a new corporate welfare program to save it. Here’s a better idea: Congress and the administration should give states more latitude to clean up the mess—at no additional cost to the federal government. That is a central recommendation of a new study co-authored by Doug Badger, Senior Fellow at the Galen Institute, and Rea Hederman, Vice President of Policy at The Buckeye Institute. The study examines congressional and federal proposals that surfaced throughout last year in the broader context of the “repeal and replace” debate. The most promising ideas to repair broken insurance markets emanated not from Washington, but from the states. Read the full Mercatus Center study here.
. . .
Gov. Scott Walker (Wis.), a Republican who has been one of ObamaCare’s most vocal opponents, signed a bill Tuesday that would shore up the law’s insurance markets.
The bill would authorize the state to apply for a federal waiver to offer a reinsurance program covering 80 percent of medical claims costing between $50,000 and $250,000.
The program would cost $200 million, with the federal government paying 75 percent of the costs, and is meant to lower premiums for everyone else by paying for claims filed by the sickest, most expensive patients.
. . .
Democratic and Republican states are moving in opposite directions on health policy, leaving Americans with starkly divergent options for care depending on where they live.
The Trump administration and congressional Republicans, by easing many of the Affordable Care Act’s nationwide requirements after failing last year to repeal the entire law, are effectively turning major components of health policy over to the states.
. . .
Twenty states have filed a lawsuit against the Trump administration over Obamacare’s individual mandate — again.
Wisconsin, Texas and several other red states claim in the lawsuit filed today that since Congress repealed the individual mandate’s tax penalty for not having coverage, that means the mandate itself — and the whole health care law — is invalid.
. . .
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.
. . .
Through its regime of subsidies, penalties, and federal regulations, the Affordable Care Act (ACA) made health insurance affordable to millions of people who were uninsured because they earned too little or had preexisting conditions. But it also made insurance more expensive for millions who used to be able to afford it. Between December 2013 and January 2017, average premiums more than doubled, and individual markets were in turmoil.
. . .
On February 21, 2018, the District of Columbia (D.C.) moved one step closer toward becoming the second in the nation, behind Massachusetts, to adopt an individual health insurance mandate. The Executive Board of the D.C. Health Benefit Exchange Authority (Authority) approved a resolution recommending the adoption of a District-level mandate as well as a number of other policy proposals. The resolution will have to be approved by the D.C. Council before going into effect.
D.C. would be the first to adopt its own mandate in the wake of repeal of the Affordable Care Act’s (ACA’s) individual mandate, but it joins at least eight states considering or studying their own individual mandate.
. . .
Riding a wave of enthusiasm from progressive Democrats, supporters of single-payer have effectively made it a front-and-center issue in California’s 2018 elections. It’s been discussed in virtually every forum with the candidates running for governor, emerged as a point of contention in some legislative races, and will likely be a rallying cry at the upcoming California Democratic Party convention. Advocates of the single-payer system know that it’s not going to happen now, it’s not going to happen tomorrow, but long-term, they hope to make single-payer a reality.
. . .