Category: Implementation

A federal judge on Friday blocked Kentucky’s closely watched plan to require many Medicaid recipients to work, volunteer or train for a job as a condition of coverage.

The state had been poised to start carrying out the new rules next week and to phase them in fully by the end of this year.

Judge James E. Boasberg of Federal District Court for the District of Columbia, an Obama appointee, ruled that the Trump administration’s approval of the plan had been “arbitrary and capricious” because it had not adequately considered whether the plan would “help the state furnish medical assistance to its citizens, a central objective of Medicaid.”

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The CMS is ratcheting up scrutiny of state Medicaid programs.

The agency announced Tuesday that it is boosting audits to confirm that Medicaid beneficiaries are correctly identified as expansion or pre-expansion enrollees. States receive higher federal match rates of around 90% for expansion enrollees, while the match rate can be as low as 50% for pre-expansion enrollees.

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The federal government doesn’t have to pay insurers billions of dollars under an Affordable Care Act program aimed at enticing them into the markets by helping cover their financial risks, a divided federal appeals court ruled Thursday.

In a case brought by Moda Health Plan Inc., the ruling is a blow to insurers hoping to recoup money they say they were owed under the 2010 health law.

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Growth in state spending on the Medicaid program is expected to fall significantly in the short term, according to a new report by state budget officers.

The findings, published Thursday in a report from the National Association of State Budget Officers, or NASBO, show that state Medicaid spending is expected to carry a median growth rate of 4.5 percent in fiscal 2018, and then growth is projected to slow significantly in fiscal 2019, to a median growth rate of 1.5 percent. The organization uses governors’ budgets in making its assessments.

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Senate Majority Leader Mitch McConnell said “everybody” in the Senate wants to preserve consumer protections for people with pre-existing conditions, an Obamacare provision that the Trump administration last week said is unconstitutional and should be struck down in court.

“Everybody I know in the Senate — everybody — is in favor of maintaining coverage for pre-existing conditions,” McConnell told reporters in the Capitol. “There is no difference in opinion about that whatsoever.”

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Health and Human Services Secretary Alex Azar told lawmakers Tuesday that he wants to preserve access to affordable insurance for Americans with preexisting medical conditions, but he declined to disclose his view of an administration move that could undercut such consumer protections.

Calling it “a constitutional position . . . not a policy position,” Azar sidestepped grilling on whether he agreed with a legal brief filed last week by Justice Department attorneys stating they would not defend the Affordable Care Act in a federal lawsuit by Texas and 19 other Republican-led states.

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Federal officials will not block insurance companies from again using a workaround to cushion a steep rise in health premiums caused by President Donald Trump’s cancellation of a program established under the Affordable Care Act, Health and Human Services Secretary Alex Azar announced Wednesday.

The technique — called “silver loading” because it pushed price increases onto the silver-level plans in the ACA marketplaces — was used by many states for 2018 policies. But federal officials had hinted they might bar the practice next year.

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The Republican-led Michigan Legislature on Thursday gave final approval to a bill requiring able-bodied adults in the state’s Medicaid expansion program to meet work or job-related requirements, sending it to Gov. Rick Snyder for his expected signature.

Starting in 2020, adults age 18 to 62 would have to show workforce engagement averaging 80 hours a month — through work, school, job or vocational training, an internship, substance abuse treatment or community service. Michigan would first seek a federal waiver to implement such requirements that have been embraced by President Trump’s administration.

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Gov. Ralph Northam (D-VA) signed a bill into law Thursday that will allow more people to sign up for health care coverage paid for by the Medicaid program. This is projected to move 400,000 low-income residents onto the program. Lawmakers arrived at a compromise on Medicaid and on other parts of spending in part by setting a tax on hospitals. Under Obamacare, the federal government paid for all of the cost of Medicaid expansion in states beginning in 2014, but this support will fall to 90 percent of costs by 2020. In some states, that will mean billions of dollars in additional spending.

Senate Majority Leader Mitch McConnell’s move to scrap most of the chamber’s August recess promises to rob politically imperiled Democratic incumbents of campaigning time, but Minority Leader Chuck Schumer is embracing the change with a pitch for how to spend it: health care.

Schumer (D-N.Y.) plans to send McConnell (R-Ky.) a letter on Wednesday asking him to set aside August time for votes on five Democratic-backed proposals aimed at expanding and lowering the cost of health care, which he previewed Tuesday after the Kentucky Republican announced plans to ax three of the Senate’s four planned recess weeks during that month.

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