From stories collected week of February 11th, 2019
Total this week: $91M+
Medicaid Fraud, Waste and Abuse Curator: Volume 7
Author: MM_ADMIN
Clay’s Weekly Medicaid RoundUp: Week of February 11th, 2019
Soundtrack for today’s RoundUp pessimist readers- http://bit.ly/2X0xroM
For optimist readers- http://bit.ly/2X0qqEz
NEW ONLINE TRAINING COURSE IS OUT– Want to understand the opioid crisis? Our newest online course will help. Check it out here- http://bit.ly/2WEL3G4
IDAHO DECIDES TO MEASURE IMPACT OF EXPANSION- Medicaid expansion is getting its very own budget item so it can be tracked precisely. I know about 30 states who wished they would have thought of this.
ALASKA BACKLOG OF APPLICATIONS GOING DOWN BUT STILL A PROBLEM- The Frontier State is struggling to scale its Medicaid program after expansion nearly doubled its rolls.
MEDICAID ROLLS DECREASING IN SOME STATES; LEFTIES FORGET THE “BUT MEDICAID IS COUNTERCYCLICAL TO THE ECONOMY” LINE- To admit the economy is improving would admit The Duly Elected President of the United States of America (DEPOTUS) just might be helping rescue us from the disastrous economy he inherited. Such an admission is impossible for most in our Medicaid world. Other theories: re-enrollment apps are too many pages long (TN has 47 pages to fill out to get back on the rolls) or bennies re-applying have to wait on the phone lines too long (MO). Overall, Medicaid enrollment declined about 1.5% nationally last year. Which really isn’t that much when you realize it basically doubled in an 8-year period under ACA. So, class- Medicaid grew 100% in 8 years, then it took a 1.5% step back in the last year. (At this rate it would be 2120 before we got back to pre-ACA bennie levels). Let’s all FREAK OUT!!!! ORANGE MAN BAD! I’ll leave you with this quote from a TN Medicaid official – ““Tennessee is experiencing a state economy that continues to increase at what appears to be near-historic rates.”
MICHIGAN WORK REQUIREMENTS BATTLE RAGES ON- The Good Guvn’r (the new one- Whitmer) is looking to undo the work requirements plans already approved by CMS. She has a new report with bigger numbers on how many will lose coverage if they don’t comply with the requirements. Pro tip for those wanting to undo work requirements already approved by elected (that word is put there to remind you that about 50% of voters disagree with you) officials: looks like you just need to know the right consulting firm to get the numbers you need to justify the reversal.
VOLUNTEER STATE STEPS FORWARD FOR BLOCK GRANTS- TN state reps filed 2 bills this week (1 in the house, 1 in the senate) to require the Medicaid agency to request a waiver from CMS to convert to a block grant program. 1st shots fired. For history buffs wanting to chase a rabbit trail right this moment instead of doing whatever you are supposed to be doing at work, read the wiki page about an American hero involved in the first shots fired during the American Revolution- Crispus Attucks. For all you whippersnappers drinking the green kool-aid, the American Revolution was how this unique, wonderful country got started and began the beautiful, unique, one-of-a-kind story that is America. Thank you, Crispus, for your role in making this place awesome.
FARRIS’S FANTASTIC FRAUD FOLLIES– And now for everybody’s favorite paragraph. Let’s start the ticker and see who wins this week’s award. Manuel Barit of WV plead guilty to stealing $200k. His crime? Submitting claims for treating bennies when he was actually out of the country. The scam went on for six years. Ryan Sheridan of Austintown Township (Ohio) was charged with stealing $31M with bogus substance abuse treatment claims (DBA “Braking Point Recovery Center”). He and his buds operated recovery centers all over town. Lillian Richardson and Bridgett Burrel of Minnesota got convicted this week of stealing $7.7M in Medicaid bucks using five (count em’, five!) home care agencies they set up under the names of different family members. They submitted lots of bogus claims for helping disabled Medicaid members with daily tasks. Fun Fact- Richardson was convicted on a different Medicaid fraud in 2012 but pinky-swore to not do it again. Guess pinky swears are not what they used to be in 4th grade. Mr. Sheridan – you win. $31M is a decent chunk of change, even for Medicaid fraud.
Need even more Medicaid fraud stories? – You can get your fix in the FWA Curator archives.
Want to read the articles summarized here, highlighted for your reading pleasure? Check out the News Curator archives.
That’s it for this week. As always, please send me a note with your thoughts to clay@mostlymedicaid.com or give me a buzz at 919.727.9231. Get outside (or stay inside and order seeds – its that time again) and keep running the race (you know who you are).
FULL, FREE newsletter@ mostlymedicaid.com . News that didn’t make it and sources for those that did: twitter @mostlymedicaid .
Trystero: Rama dikirim Putra ka ngahemat dunya.
Monday Morning Medicaid Must Reads: Feb 11, 2019
Helping you consider differing viewpoints. Before it’s illegal.
In this issue…
Article 1: State wrestles with sizable backlog of Medicaid applications
Clay’s summary: Expansion nearly doubled the AK Medicaid rolls. Doubled.
Key Excerpts from the Article:
As of Jan. 29, Alaska had a backlog of 15,639 cases of new applicants or renewals on the books. About two-thirds of those, or 10,200 cases, were filed in 2018. The average wait time to be approved is currently 55 days, according to Clinton Bennett, the media relations manager for the Alaska Department of Health and Social Services… That’s the average, but not everyone is waiting that long, he wrote in an email…“Cases that are tagged as emergent, involve a pregnant woman or adding a newborn to any case are being processed on average within 2 days,” he wrote.
Alaska has a fairly large Medicaid population with about 210,276 people enrolled in the Medicaid and CHIP programs as of October 2018, according to the Centers for Medicare and Medicaid Services.
That’s about 24 percent of the state’s total population, and up from 123,335 people enrolled at the end of July 2015, just before the Medicaid expansion took effect in the state.
Though it’s still a sizable backlog, it’s significantly down from the total in May 2018, when the Alaska Ombudsman’s Office published a report highlighting the difficulties in the Division of Public Assistance. At the time, the ombudsman noted a backlog of more than 20,000 cases, itself down from 30,000 in July 2017.
Read full article in packet or at links provided
Article 2: Medicare, Medicaid Enrollment Growing Faster Than Private Coverage
Clay’s summary: New analysis says Care/Caid spending growth is nothing to be concerned about. What do they think we are, idiots? Of course they do. Shut up and pay your taxes. Don’t have opinions about how they are spent.
Key Excerpts from the Article:
Over the course of 11 years, annual spending growth averaged 5.2% for Medicare and 6% for Medicaid. This eclipsed the 4.4% spending growth among private insurers.
However, spending per enrollee from 2006 to 2017 was markedly lower for public programs compared to their private counterparts. Medicare spending per enrollee amounted to 2.4% per year, Medicaid registered at even lower 1.6%, while private insurance posted 4.4% annually.
Medicaid and Medicare also achieved positive annual enrollment growth rates over the same period of time, 4.3% and 2.8% respectively, while private insurers finished with a flat enrollment growth rate.
The study’s findings conclude that while CMS projects Medicaid and Medicare spending per enrollee to grow sizably over the next decade, both programs have “successfully moderated growth.”
The Urban Institute states that the results indicate that neither program require “major restructuring” to reduce national health spending and that the more concerning spending figures lie in the private insurance market.
The study’s authors support “modest policy proposals,” such as limiting state use of provider taxes in Medicaid or modifications to Medicare cost-sharing.
Read full article in packet or at links provided
Article 3: Medicaid cost concerns are valid
Clay’s summary: An op-ed considers a litany of examples when the state was left to deal with federal funding changes that made programs cost a lot more than originally promised- AND they connect the dots to Medicaid expansion and the “free federal money.” How dare they use logic and past experience???!!? Evil Republicans!
Key Excerpts from the Article:
Even if the state’s portion of Medicaid expansion costs doesn’t rise, the $150 million price tag is still significant. That $150 million is more than twice the amount required to provide a proposed $1,200 pay raise for every teacher this year. It’s more money than what would be saved if roughly 12,400 inmates were released from state prisons, according to one estimate. It’s more than four times the amount required to eliminate a backlog of local government reimbursements for emergency responses.
Every dollar spent on Medicaid expansion is a dollar that doesn’t go to other needs like schools, roads or public safety. And voter rejection of a 2016 sales tax increase shows limited public appetite for the kind of broad-based tax increases required to avoid such tradeoffs.
The real debate is not simply whether one supports Medicaid expansion, but whether one believes Medicaid expansion should be a higher priority than school funding increases or other causes. And, beyond fiscal considerations, debate should also focus on this question: Does Medicaid expansion improve health outcomes? Much research has found little real improvement.
Read full article in packet or at links provided
Medicaid Job Hunter: 2/11/2019
We scour the internets for Medicaid jobs listings to save you time.
In this packet…
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Community Health Worker – Seattle / King County | Community Health Plan of Washington
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Senior Contract Manager | BMC HealthNet Plan/Well Sense Health Plan
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Behavioral Health Care Manager (Part Time 10 hours) – Robbinsville | Amerihealth Inc
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Claims Analyst IMedicaid – Bend | PacificSource Health Plans
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Service Coordinator Associate LTSS, East (Philadelphia) | UPMC Health Plan
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Manager, Claims & Contract Support Services | Home State Health Plan, Inc.
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Entry Level Opportunity – Healthcare Credentialing | AmeriHealth Caritas
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Aetna Inc NC MCD VP, Medicaid Hlth Plan Job in Cary, NC
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Personal Care Clinical Manager / Medicaid Home
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Health Care Policy & Financing | State of Colorado |
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WellCare Health Plans Inc Market VP – Medicaid LOB Job in Houston, TX, United States
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Medicaid Director – Healthplan
Monday Morning Medicaid Must Reads: Jan 21st, 2019
Helping you consider differing viewpoints. Before it’s illegal.
In this issue…
Article 1: Feds OK Medicaid Work Requirements in Arizona, Health Leaders Media
Clay’s summary: This is only the 8th one approved. Must be a fluke.
Key Excerpts from the Article:
Arizona has permission from the federal government to begin imposing work requirements next year on certain Medicaid beneficiaries in the state, but most Native Americans will be exempt, the Centers for Medicare & Medicaid Services announced Friday. Arizona’s waiver is the eighth of its kind, signaling that the Trump administration intends to continue pushing forward with Medicaid work requirements despite pending legal challenges in other states. This is the first waiver to exempt members of federally recognized tribes, resolving a major sticking point with Arizona’s application. State officials had asked CMS to exempt all Native Americans from the new requirement, but Trump administration lawyers said doing so would constitute illegal preferential treatment on the basis of race. The tribes contended, however, that the administration’s position contradicted longstanding legal principles and Supreme Court precedent, as Politico reported.
“There were a lot of complex legal issues here,” CMS Administrator Seema Verma told Politico’s Rachana Pradhan. “I think that we were able to find a middle ground.”…
Read full article in packet or at links provided
Article 2: Strategies for an Affordable Medicaid Buy-In Option in Colorado, Manatt
Clay’s summary: We will sell Medicaid on the exchange, and offer subsidized premiums (so nobody really pays for it, except taxpayers). And oh yeah – we’ll pay providers at Medicare rates. What could possibly go wrong?
Full study
Key Excerpts from the Article:
In Colorado, where average Affordable Care Act (ACA) benchmark premiums have increased 71% since 2014, advocates and stakeholders initiated an analysis to evaluate the feasibility and potential impact of a Medicaid buy-in offered outside the individual ACA market, with access to Advanced Premium Tax Credit funding under an ACA Section 1332 State Innovation Waiver. The product would be offered statewide, leverage the current Medicaid infrastructure, provide the same benefits and range of cost sharing as coverage on the state Marketplace (Connect for Health Colorado), and reimburse providers at Medicare rates. The analysis evaluates expected premiums for the buy-in product, the impact of its introduction on existing individual market premiums and the potential for state savings under this program design. The effort was led by a coalition of Colorado health policy advocates, represented by the Colorado Center on Law and Policy, the Colorado Consumer Health Initiative, and the Bell Policy Center. Manatt Health provided the policy and technical support, and Wakely Consulting Group, LLC, conducted the analytical modeling of the proposed program design and scenario alternatives….
Read full article in packet or at links provided
Article 3: Ohio mental health agency closes, blames changes in Medicaid claims, Columbus Dispatch
Clay’s summary: I’ve seen this movie before.
Key Excerpts from the Article:
Tener said her problems began in July, when the Ohio Department of Medicaid, which had been reimbursing providers for mental-health services provided to Medicaid clients, transferred that responsibility to managed-care insurance plans. Tener said she’s owed $40,000 from the plans, which have been criticized for failing to pay claims in a timely manner or rejecting them for unclear reasons..The Ohio Department of Medicaid has been reviewing the plans continuously and the providers since July 1, said Thomas Betti, the department’s press secretary.
“We understand the significant learning curve with the new system; however, data suggests that month over month, significant improvement is being made in the area of claims payment,” Betti said. “Issues have been minimal and quickly resolved.”Betti said the state sought to assist providers through the transition by disbursing about $146 million, via the managed-care plans, in advance payments from July through October. Those payments are similar to loans; providers are required to repay the money, and the state has instructed managed-care plans to delay repayment schedules, which had been set to begin in November….
Read full article in packet or at links provided
Medicaid Job Hunter: 1/21/2019
We scour the internets for Medicaid jobs listings to save you time.
In this packet…
- Senior Finance Director, Medicaid Health Plan | ValueOptim
- Provider Relations Rep- NJ Medicaid Health Plan
- Health Care Business Analyst(MEDICARE & MEDICAID) | Computer Consultants Llc
- Director Medicaid Plan Marketing | ValueOptim
- Pharmacy Program Manager – Medicaid – SHCN
- Medicaid Eligibility Trainer in St Louis MO USA – HCA Health Care
- Contract and Network Development Specialist | Independent Care Health Plan
- Director, State Behavioral Health – Medicaid LOB with WellCare | Mid West Apply
- Clinical Care Manager (RN) – Transition Coordinator – UPMC McKeesport | UPMC Health Plan
- AVP, Health Plan Operations Job in Jackson, MS at Molina Healthcare
- Manager of Clinical Care Coordination (PA Medicaid) Job in Pittsburgh, PA at Highmark Health
- Pres Medicd Health Plan – CA Job in Woodland Hills, CA at Anthem, Inc
Clay’s Weekly Medicaid RoundUp: Week of January 14th, 2019
Soundtrack for today’s RoundUp pessimist readers- http://bit.ly/2VYimnr
For optimist readers- http://bit.ly/2W235C3
ABOUT THAT WHOLE MEDICAID TRANSFORMATION IN NY THING. YEAH, LET’S STOP DOING THAT- After years of major overhaul efforts to transform its Medicaid program, Cuomo just pressed pause on the key device real driving change. For 8 years, NY has capped Medicaid spending to be within a 10-year rolling average of medical inflation. In this next budget, the Good Guvn’r decided to give Big Med (primarly hospitals) a pass and allow Medicaid spending to exceed the cap (3.1% is the cap; Cuomo is authorizing 3.6%). Why, you ask? As a pre-emptive strike (in his view) to shore up against federal changes coming to Medicaid. What federal changes? Reductions in DSH that were started when ACA passed (in 2010), but Big Med has been able to get delayed year after year. Lefties, rejoice (and don’t forget to vote for him when he runs for Pres in 2020). Righties, observe yet another tax and spend Dem refusing to reform their ways (cuz, you know, they’re the good guys and your’e evil if you doubt that). Total Medicaid budget now that NY Medicaid is on a cheat-day? $19.6B (which is roughly the GDP of Botswana, and more than the GDP of 118 countries. For freakin’ Medicaid in NY, people).
HOW WAS YOUR EXPERIENCE? MA TO POLL PATIENTS- Medicaid members in The Old Colony State will be asked to rate providers and plans for the first time. Results will be made public in 2020. From what I can tell this is basically a CAHPs-type survey. Results will also likely be used for value-based care payments.
SHAKEUP IN ARKANSAS NEMT- For readers keeping tabs on the Medicaid transportation scene: Southeastrans is picking up more regions as MTM will exit. Handover starts Feb 1.
JUST WHY ARE HOSPITALS IN VIRIGINIA SO EAGER TO BE TAXED? Why do hospitals exist? To help people AND to make money. When asked why they exist, what is the answer? “To help people.” They conveniently leave out that second part. When you put it back in, it makes a little more sense why VA hospitals are eagerly paying a “tax” to help fund the recent explosion (expansion) in Medicaid spending. State reps are getting their first taste of the “surprise” cost over-runs in the expansion they approved last year. This week new adjustments to expansion costs show at least $85M more than what they were told when they voted “yes”. Hospitals, those noble creatures they are, are running full press coverage highlighting how they are so, so happy to pay a tax to help fund expansion. Long time readers remember that Medicaid provider taxes are often a total sham described thusly: we pass the hat to hospitals, who all chip in money. We then beam up the hat to planet CMS, who puts in 6x more money (or 7x or whatever your fmap is), and then sends it back down. The state gets more cash, and so do the hospitals.
PALMETTO STATE JOINS RANKS OF WORK REQUIREMENTS REFORMERS- Looks like another 1115 app will be hitting the halls of 7500 Security Blvd in Balto soon (where planet CMS is). South Carolina is doing town halls on a work requirement proposal as of this week.
IMPLEMENTING BALLOTED (IS THAT A WORD?) EXPANSION PROVING TO BE HARDER THAN CHECKING A BOX ON VOTER CARD- Utah lawmakers are trying to figure out how to pay for the expansion approved by voters in November. There are 2 issues in play: 1) how to keep the limited expansion already in place going while applying for CMS to approve full / “standard” expansion we’ve all come to know and love; and 2) how to come up with numbers during the current budget cycle that at least try to pretend there’s a way the state can pay for it. A sales tax increase is projected to come up about $45M short in the next few years.
HOSPITALS AFRAID SETTING LIMITS ON MEDICAID SPENDING COULD HURT THEIR REVENUES- See earlier entry above about why hospitals exist. As CMS suggests states may find approvals for block grant waiver apps if they only ask, hospitals are going nuts in the press. Sky is falling, cutting spending will kill everyone- you know the dril by now. There are increasingly insightful quotes coming from Verma on this. Here’s a good lil’ nugget: “We also believe that only when states are held accountable to a defined budget can the federal government finally end our practice of micromanaging every administrative process.“ Hear, here!
IN A RELATED NOTE, GA WANTS MORE FREEDOM FROM FEDERALI MICROMANAGING FOR ITS CITIZENS’ HEALTHCARE NEEDS- The Good Guvn’r Kemp (who recently barely beat romance novelist Stacy Abrams) announced a $1M project to explore a waiver with CMS that would give the state more flexibility with its use of federal Medicaid dollars. No other details than that. You get to fill in the blanks (most fill them in with block grants based on early analysis). In a somewhat related news item, GA teachers will be getting a $3k raise this year.
PASSPORT STRUGGLING WITH NEW NORMAL IN KY- For those of you watching this MCO market, Passport has been unscuccessful in getting the state to budge on recent cap rate cuts that hit Passport particularly hard. Short version – state changed up regions and rates in a way that Passport got hammered. And Passport’s whole business is Medicaid. More to come.
CANARY IN COAL MINE IN AR? We all like to think we are special and unique. Medicaid programs are no different (see what I did there?). Arkansas cooked up yet another version of the “here’s how we’ll transition legacy behavioral health providers to a capitated rate” idea a few years back. (It’s an acronym that spells PASSE; did no one look that up in French?) Like most of these inititaives, year 1 starts out all nice and you get basically extra cash to play along and maybe do a little more case management than before. In year 2 you are expected to manage medical services, pay claims, etc (depending on the state). Well, ForeverCare sees the writing on the wall (or is chickening out if you listen to state officials) and is dropping out. They say they will come back in if the Phase II implementation date is moved to July 1. It has already slid from Jan 1 to March 1.
READY FOR MEDICAID INNOVATIONS 2019- I will be there again this year (my 9th time), chairing one of the very best Medicaid events you can go to. Also, its sunny Florida in February (I’m looking at you, Michigan). If you decide to go, let me know and we can meet up. Check it out here – https://www.medicaidinnovations.com/
FARRIS’S FANTASTIC FRAUD FOLLIES– And now for everybody’s favorite paragraph. Let’s start the ticker and see who wins this week’s award- not so fast fraud junkies. No where near enough space this week. You can get your fix in the FWA Curator archives though.
Want all the highlighted news items from this week? Check it out here-Medicaid News Curator Volume 5
That’s it for this week. As always, please send me a note with your thoughts to clay@mostlymedicaid.com or give me a buzz at 919.727.9231. Get outside (buy or chop some firewood) and keep running the race (you know who you are).
FULL, FREE newsletter@ mostlymedicaid.com . News that didn’t make it and sources for those that did: twitter @mostlymedicaid .
Trystero: Baba alimtuma Mwana kuokoa ulimwengu.
Medicaid Job Hunter: 1/14/2019
We scour the internets for Medicaid jobs listings to save you time.
In this packet…
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Medicaid Director – Healthplan Job in Columbus, OH at Konexus Group
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Aetna Life Insurance Company Provider Relations Representative- NJ Medicaid Health Plan Job in Princeton, NJ
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Senior Finance Director, Medicaid Health Plan – Miami, FL – Magellan Health Services | Ladders
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Pharmacy Program Manager – Medicaid
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FCHP – Careers
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The State of Florida MEDICAL/HEALTH CARE PROG ANALYST Job in Tallahassee, FL
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Medicaid ACO Program Specialist – Needham
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Director of Business Development & Marketing – NY Medicaid Health Plan (52257BR) at Aetna
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Director, Medicaid Challenges, Provider Solutions
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Informatics Lead Analyst – NJ Medicaid Health Plan (56036BR)
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Dir Medicaid Plan Marketing
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StartWire
Monday Morning Medicaid Must Reads: Jan 14th, 2019
Helping you consider differing viewpoints. Before it’s illegal.
In this issue…
Article 1: Why 700,000 Ohioans were removed from Medicaid coverage, Columbus Dispatch, Jan 12
Clay’s summary: Could be: a) improving economy, b) glitch in enrollment system, c) evil Republicans working with Putin to hack Ohio’s democracy. You decide.
Key Excerpts from the Article:
More than 700,000 Ohioans were removed from the state’s Medicaid program in just the first 10 months of 2018. Franklin County had the most disenrollments, with nearly 90,000 losing the health-care coverage from January through October, the most recent data available show.
But no one quite knows why such a huge shift took place in the state-federal program for low-income Ohioans.
Read full article in packet or at links provided
Article 2: Trump admin’s Medicaid block grant waiver idea invites legal and political firestorm, Axios, Jan 14
Clay’s summary: They’re baaack (read in Poltergeist voice).
Key Excerpts from the Article:
The Trump administration is considering giving states the ability to receive Medicaid block grants, Politico reported on Friday, a move that has experts unsure of its legality and the political world bracing for its volatility.
Read full article in packet or at links provided
Article 3: Public Option And Medicaid Buy-Ins Emerge From 2020 Democratic Presidential Hopefuls, Forbes, Jan 13
Clay’s summary: Dems see writing on wall re unravelling ACA, start to work on workarounds at state level.
Key Excerpts from the Article:
Several Democratic governors – including one likely to run for President – are working on legislation to expand coverage to the poor in their states with legislation that would allow residents to “buy into” government subsidized Medicaid or other state coverage.
In all, “at least 10 states” are looking at Medicaid “buy ins,” Stateline reported last week. These proposals are akin to earlier proposals by some Democratic Senators mentioned as Presidential candidates to expand Medicare to Americans as young as 50 years old.
Such public options are seen by some as an alternative to more progressive single-payer “Medicare for All” proposals that would have the government control health insurance and require more taxpayer dollars. Most public option proposals emerging would continue the role of private insurers in helping administer the health benefit expansions.
Read full article in packet or at links provided
Monday Morning Medicaid Must Reads: Jan 7th, 2019
Helping you consider differing viewpoints. Before it’s illegal.
In this issue…
Article 1: Healthy and Working: Benefits of Work Requirements for Medicaid Recipients, Buckeye Institute, December 2018
Clay’s summary: Beware the red pill.
Key Excerpts from the Article:
Extending Medicaid benefits to individuals who are able to work may reduce their lifetime earnings over the long-term and adversely affect their consumption patterns in the short-term. Although households may benefit in the short-term from Medicaid coverage through little- or no-cost health care, the ACA’s Medicaid expansion does not promote individual long-term earnings growth or wealth accumulation. Workers have less incentive to invest in their human capital than if they were required to work in order to receive benefits.
To address this concern, states that have participated in the ACA’s Medicaid expansion are now considering—or have already begun to impose—work requirements for some new Medicaid enrollees. Work and “community engagement” requirements, such as education and job training, tend to keep benefits recipients participating in the work force, helping them to gain valuable work experience and generate higher earnings and income over the long-term.
Using publicly available economic data, this report reveals the potential impact of imposing work requirements on healthy, single individuals with no children. We study how eligibility work requirements may affect the lifetime earnings of some Medicaid enrollees and find that Medicaid work requirements could:
* • Increase lifetime earnings by $212,694 for women and $323,539 for men—even assuming that the individual remains on Medicaid for their entire working life; and
* • Raise the hours worked per week by 22 hours for women (from 12 hours to 34 hours per week), and by 25 hours for men (from 13 hours to 38 hours per week), bringing Medicaid recipients well above the typical 20 hours per week requirement.
We also find that the financial prospects look even brighter for individuals who transition off of Medicaid; they may earn close to $1 million more over the course of their working years.
Requiring labor force participation for benefits eligibility creates an incentive for individuals to increase human capital investment through the labor market. We show that there is a significant potential economic benefit for those able-bodied adults who would change their work effort in response to a work requirement for Medicaid eligibility.
Read full article in packet or at links provided
Article 2: State Trends and Analysis, Pew Trusts, November 2018
Clay’s summary: Turns out you do have to choose between healthcare and education. Until we find where the unicorns are hiding the magic wands, that is.
Key Excerpts from the Article:
Medicaid’s claim on each revenue dollar affects the share of state resources available for other priorities, such as education, transportation, and public safety. Because Medicaid is an entitlement program, states must provide certain federally required benefits for any eligible enrollee, even during times of sluggish revenue growth. So policymakers have less control over growth in states’ Medicaid costs than they do with many other programs.
Read full article in packet or at links provided
Article 3: Estimated Impacts of the Proposed Public Charge Rule on Immigrants and Medicaid, KFF, October 2018
Clay’s summary: The potential safety net costs for newly arriving Americans may be getting more attention if the rule is passed.
Key Excerpts from the Article:
On October 10, 2018, the Trump administration released a proposed rule to change “public charge” policies that govern how the use of public benefits may affect individuals’ ability to obtain legal permanent resident (LPR) status. The proposed rule would expand the programs that the federal government would consider in public charge determinations to include previously excluded health, nutrition, and housing programs, including Medicaid. It also identifies characteristics DHS could consider as negative factors that would increase the likelihood of someone becoming a public charge, including having income below 125% of the federal poverty level (FPL) ($25,975 for a family of three as of 2018). This analysis provides new estimates of the rule’s potential impacts. Using 2014 Survey of Income and Program Participation data, it examines the (1) share of noncitizens who originally entered the U.S. without LPR status who have characteristics that DHS could potentially weigh negatively in a public charge determination and (2) number of individuals who would disenroll from Medicaid under different scenarios:
Nearly all (94%) noncitizens who originally entered the U.S. without LPR status have at least one characteristic that DHS could potentially weigh negatively in a public charge determination. Over four in ten (42%) have characteristics that DHS could consider a heavily weighted negative factor and over one-third (34%) have income below the new 125% FPL threshold.
Read full article in packet or at links provided