Tag: Finance

Posted on by

Florida not expanding Medicaid but extending postpartum coverage from two to 12 months

 
 

MM Curator summary

 
 

Florida says no to expansion, but yes to more funds to improve maternal health.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Florida state Sen. Annette Taddeo, D-Miami

Steve Cannon / AP

(The Center Square) – Florida’s Republican-led Legislature has no plans – not an inkling – to expand Medicaid to 800,000 low-income residents but under a new proposal, a year of subsidized healthcare could be provided to nearly 100,000 new mothers and their infants.

House Speaker Rep. Chris Sprowls, R-Palm Harbor, announced Tuesday that a yet-to-be-filed bill will propose extending postpartum Medicaid coverage from two months, as currently permitted in Florida, up to 12 months.

“Today, the Florida House is making a meaningful commitment to address the disparities in health outcomes for our children and for their moms,” he said. “We believe that providing the access to postnatal coverage for up to one year after the birth can significantly boost health outcomes for moms and their babies, and we know that healthy moms are better positioned to raise healthy and thriving children.”

Sprowls said the impetus for the bill is House Bill 645 filed by Rep. Kamia Brown, D-Ocee, who flanked the speaker at the Capitol news conference.

“This extension is critical for mothers, going leaps and bounds beyond what is offered in the past,” Brown said, noting of 36 Florida women who died from pregnancy-related complications in 2019, half were Black. “This problem impacts minority communities disproportionately.”

The announcement follows a Biden administration initiative within the $1.9 trillion ‘American Rescue Plan’ adopted by Congress earlier this month to extend Medicaid coverage for a full year to low-income women after they deliver their babies. Under the proposal, it is optional for states to provide extended postpartum Medicaid health coverage.

Florida’s Medicaid program offers coverage to pregnant women who earn up to 196 percent of the federal poverty level, a higher standard than federal law which requires states to cover pregnant women with incomes up to 138 percent of the poverty line.

About 97,600 women would be eligible under the extension, according to the state’s Agency for Health Care Administration (AHCA), which manages Florida’s $30 billion Medicaid program.

“If we’re going to be truly committed to mothers and the health of their children in the long term, it needs to be signaled in both word and deed that this is a long-term commitment, and that’s what we’re going to do,” Sprowls said.

With Missouri and Oklahoma voters in 2020 ordering their Republican-controlled legislatures to expand Medicaid under the Affordable Care Act (ACA) in 2021, Florida remains one of 12 states that have not expanded Medicaid.

Advocacy groups and Democrats, while praising the proposed postpartum coverage extension, said the measure doesn’t go far enough and that now is the time to expand Medicaid.

In a Tuesday Zoom conference, U.S. Health & Human Services Secretary Xavier Becerra joined U.S. Rep. Ted Deutch, D-Boca Raton, and state Sen. Annette Taddeo, D-Miami, in calling for Florida to expand Medicaid under the ACA in which the federal government pays 90 percent of the costs.

A provision in the ‘American Rescue Plan’ provides another 5 percent of funding, meaning the state would only need to cover 5 percent of expansion costs.

“The American Rescue Plan lowers health insurance premiums for millions of American families,” Deutch said. “A family of four making $90,000 could see their monthly premiums come down by $200 a month.”

Taddeo has introduced unheard bills to expand Medicaid under the ACA for several years, including 2021’s SJR 276, assigned four committee hearings – a kiss of death – and unheard before any.

“The time is totally now to do this,” Taddeo said. “We don’t need to have 800,000 Floridians without health care. Deep-red, conservative states such as Idaho, Missouri, Nebraska, Oklahoma and Utah expanded Medicaid. Have any of them said, ‘Oh, we made a mistake. Let’s go back?'”

 
 

Clipped from: https://www.henryherald.com/news/florida-not-expanding-medicaid-but-extending-postpartum-coverage-from-two-to-12-months/article_3e5d0a01-5f2c-5031-9ff3-b2972d3d7971.html

Posted on by

Medicaid incentive so far not enough to sway holdout states

MM Curator summary

Most non-expansion states say they will not take the increased incentives in the COVID relief bill.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

South Carolina Gov. Henry McMaster talks about vaccine distribution and abortion during a news conference on Wednesday, Jan. 27, 2021, in Columbia, S.C. Congress just sweetened the incentives for states to extend Medicaid insurance coverage to more low-income adults, but the dozen Republican-controlled states that have spent years resisting expanding the programs have no plans to change course now. “Gov. McMaster isn’t for sale, regardless of whatever ill-conceived ‘incentives’ congressional democrats may come up with,” spokesman Brian Symmes said in a statement. “What the federal spending plan does is attempt to offer a short term solution for a long term problem.” (AP Photo/Jeffrey Collins, file) (Jeffrey Collins)

COLUMBIA, S.C. — (AP) — Democrats’ nearly $2 trillion coronavirus relief package includes a big financial incentive for the states that have opted against expanding Medicaid to provide health coverage for more low-income Americans. It’s proving to be a tough sell.

The Associated Press surveyed top Republican elected officials in the dozen states that have resisted expanding coverage under a key provision of former President Barack Obama’s heath care law. Some have softened their opposition, but the key gatekeepers— governors or legislative leaders — indicated they have no plans to change course.

South Carolina Gov. Henry McMaster remains firmly opposed to the Medicaid expansion.

“Gov. McMaster isn’t for sale, regardless of whatever ill-conceived ‘incentives’ congressional Democrats may come up with,” spokesman Brian Symmes said in a statement. “What the federal spending plan does is attempt to offer a short term solution for a long term problem.”

The federal government already pays 90% of the costs of expanding Medicaid coverage to more low-income adults. Thirty-six states have signed on to the expansion. Two more — Missouri and Oklahoma — are scheduled to begin their expansions in July.

Under the enticement included in the coronavirus relief bill adopted by Congress and signed by President Joe Biden, the federal government would boost its share of costs in the regular Medicaid program, which offers coverage for the poorest Americans. The bump in federal funding would last two years for the states that join the Medicaid expansion.

An analysis by the Kaiser Family Foundation found the additional federal money would cover 150% to 400% of the cost for the holdout states to expand Medicaid, which is jointly funded with federal and state dollars.

In Texas, the incentives would send the state about $5 billion over two years, and the state’s share of expanding coverage would be about $3.1 billion. More than 1.4 million people in the state could become eligible for coverage. For Georgia, the estimate says it would add a net $710 million to state coffers and in Tennessee, $900 million.

“It’s the literal offer you can’t refuse, but let’s see if anyone refuses it, anyway,” said Katherine Hempstead, a senior policy adviser at the nonpartisan Robert Wood Johnson Foundation.

Through interviews and public statements, AP found little change in the 12 states that have held out against the Medicaid expansion: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming.

In Mississippi, one of the nation’s poorest states, advocates say up to 300,000 people — about one-tenth of the state’s population — could become eligible for health coverage if the state adopted the expansion.

Gov. Tate Reeves, a Republican, said he’s not going for it, noting that his stance was a major issue in his 2019 campaign. His GOP primary opponents supported a plan to expand, with the state’s share being paid for by hospitals and a fee of up to $20 a month for people who signed up. He opposed it, even as the Mississippi Hospital Association said it could bring up to 19,000 jobs to the state.

“My position has not changed,” he said last week. “I am opposed to expanding Medicaid in Mississippi. I am opposed to Obamacare expansion.”

In three of the states — Kansas, North Carolina and Wisconsin — the Democratic governor favors expansion but can’t convince a Republican-controlled legislature.

Kansas Gov. Laura Kelley this year called for legalizing medical use of marijuana and using the tax revenue to pay for expanding Medicaid. But the Republicans who control the Legislature blocked hearings on the proposal.

Those lawmakers say they worry the federal government would eventually cut its share of expansion funding.

“It’s not a big enough bribe,” said Richard Hilderbrand, the chair of the state Senate health committee.

Many Republicans remain concerned about the long-term costs of the program and are ideologically opposed to expanding government health care to working-age adults.

“I acknowledge that there are some gaps in coverage that need to be addressed, but I think they can be addressed in ways that do not require us to create a whole new level of entitlement in the state of North Carolina,” North Carolina Senate Leader Phil Berger, a Republican, told The Associated Press.

It’s a similar story in Wisconsin, where the GOP-dominated Legislature and Democratic Gov. Tony Evers are at odds over the expansion. The Democrats’ coronavirus aid package doesn’t change that, Assembly Speaker Robin Vos said earlier this month.

“It’s a nonstarter, and we will continue to oppose the liberal wish list item of Medicaid expansion,” he said.

Hempstead, of the Robert Wood Johnson Foundation, said Medicaid expansion is a way to address one of the biggest shortcomings in the national healthcare landscape: How to get coverage for a group of adults whose incomes put them below the poverty line — $12,880 for a person living alone.

In states that haven’t expanded Medicaid, there are about 2.2 million such people, the Kaiser study found. They usually don’t qualify for traditional Medicaid programs. They also do not make enough to be eligible to buy subsidized private coverage on the health insurance marketplaces established under Obama’s overhaul.

Another 1.8 million people in those states who make slightly more — up to about $17,774 for an individual — qualify for subsidized coverage but often can’t afford it. They also could be covered through an expansion of Medicaid.

Studies have found that adding coverage for these lower-income people reduces charity care in hospitals, allows some people to be healthy enough to work and creates additional health care industry jobs. The financial benefits partially or totally offset the states’ share of the costs over time.

Even in the holdout states, those arguments catch the attention of some Republicans. In Texas, a Republican lawmaker has introduced a longshot bill calling for expansion, though the legislation has no other GOP co-sponsor and there is no indication that Republicans there have lessened their opposition. A similar measure has advanced through a legislative committee in Wyoming, though its prospects appear slim for passing the full Legislature.

In Alabama, Gov. Kay Ivey left open the possibility of expanding Medicaid at some point in the future, but there are no plans to do so.

“The problem has always been how to pay for it,” Ivey spokeswoman Gina Maiola said. “She is open to the discussion, but right now, we simply do not have all the facts.”

___

Mulvihill reported from Cherry Hill, New Jersey. Follow him at http://www.twitter.com/geoffmulvihill and Collins at http://www.twitter.com/JSCollinsAP

___

Associated Press writers Scott Bauer in Madison, Wisconsin; Kimberly Chandler in Montgomery, Alabama; Brendan Farrington in Tallahassee, Florida; Stephen Groves in Sioux Falls, South Dakota; John Hanna in Topeka, Kansas; Gary Robertson in Raleigh, North Carolina; and Emily Wagster Pettus in Jackson, Mississippi, contributed to this report.

 
 

Clipped from: https://www.wokv.com/news/medicaid-incentive/WYDNBDNO32IDVMVIU3CIIQDF2E/

Posted on by

Florida unlikely to expand Medicaid for 800,000 residents, despite offer of more federal money

MM Curator summary

Florida is not being swayed by the new expansion funding being offered.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

TALLAHASSEE — Gov. Ron DeSantis and Florida legislative leaders still aren’t interested in expanding Medicaid under the Affordable Care Act, despite the federal government’s offer to defray the cost to the state for two years as part of the $1.9 trillion COVID-19 relief package signed by President Biden last week.

Democrats and advocates who’ve pushed for expansion say there’s no excuse not to offer coverage to 800,000 more Floridians now that the cost to the state would be less.

Sen. Annette Taddeo, D-Miami, for example, noted that DeSantis doesn’t plan on giving back to the federal government any of the $10 billion in direct aid Florida is getting, as U.S. Sen. Rick Scott requested, so traditional GOP arguments in favor of fiscal restraint seem to have evaporated in Tallahassee, she said.

“Even Gov. DeSantis said to former governor and senator Rick Scott, ‘that’s crazy to turn back money,'” Taddeo said Wednesday. “Well, I feel exactly the same way — that’s crazy to turn back money for Medicaid expansion in the middle of a global pandemic, to say to people, ‘you still can’t have insurance.'”

Medicaid expansion would provide coverage under the program, which is run jointly by the state and federal government and covers poor families, children and pregnant women, to people who earn up to 138% of the federal poverty line, which stands at $18,000 per year for a person and $37,000 for a family of four.

The federal government would cover the entire cost of expansion at first before their share reduces to 90%, with the state paying the remaining 10%. The usual cost share of the current Medicaid program varies by year but can reach as high as 60% paid by the federal government and 40% paid by Florida.

Under the relief package, for two years the federal government would pay an extra 5% of its share of the main Medicaid program, which is expected to serve nearly 4.6 million Floridians next fiscal year before enrollment drops in future years due to a rebounding economy.

Florida’s Medicaid program is projected to cost $31.6 billion this year, or about one-third of the state’s $92.2 billion budget. State economists estimate the state’s share this year to be $11 billion and it is expected to rise to $13 billion next year.

Florida Policy Institute, a liberal think tank based in Orlando, estimates expanding Medicaid now would save the state $3.5 billion.

That would free up money for other things, such as education and the environment, and advocates argue the savings would be even greater, because the cost of uncompensated care at hospitals would go down, eventually reducing health care premiums across the entire system.

“There is no excuse fiscally for any lawmaker to say it would be fiscally undoable,” said Holly Bullard, FPI chief strategy and development officer. “The fiscal argument isn’t there, it’s really reversed.”

But GOP leaders still have an eye on the 10% cost to the state in future years.

“The president has concerns about the long-term, recurring costs associated with Medicaid expansion,” Katie Betta, spokeswoman for Senate President Wilton Simpson, R-Trilby, stated in an email explaining his opposition.

DeSantis office didn’t return a request for comment Wednesday, but his spokeswoman told the Washington Post this week he “remains opposed to the expansion of Medicaid in Florida.”

House Speaker Chris Sprowls, R-Palm Harbor, is more concerned about allowing more residents coverage, an echo of the criticism from past GOP House leaders that “able-bodied adults” would be eligible for Medicaid under expansion.

“The Speaker will not pursue a Medicaid expansion,” Sprowls spokeswoman Jenna Sarkissian stated in an email. “He believes Medicaid should be reserved for our most vulnerable residents, such as low-income senior citizens, people with disabilities, children and pregnant women.”

Sarkissian added that Sprowls “has expressed a strong desire to address disparities in maternal health care for low-income women and invest in areas like career and higher education help to generate better outcomes for Floridians and put them on a path to employment, financial resilience and prosperity.”

After years of intense debate over Medicaid expansion, the fight over the issue in the Legislature has cooled.

In 2013, Florida House Democrats demanded all bills be read in full, slowing down the chamber to protest the lack of action on the issue, but a Senate plan to allow newly eligible enrollees to receive private health plans paid by the federal government was rebuffed by House Republicans.

At the time, then-Gov. Rick Scott had come out in favor of expansion, as long as the federal government was covering the costs. After he was reelected in 2014, he reversed course and didn’t speak in favor of a plan pushed by Senate Republicans in 2015 to expand Medicaid while imposing work requirements and attaching other strings. House Republicans again rejected the plan, but only after a standoff between the chambers that delayed the budget.

Faced with the stalemate in the Legislature, those in favor of expansion have turned to a potential ballot measure that would put the issue before voters. Those efforts, however, have been stymied so far, too.

The Florida Decides Healthcare political committee halted its petition gathering push in 2019, saying it would be unable to gather enough petitions in time to be placed on the 2020 ballot. The group will try again for the 2022 ballot, but the Legislature last year passed a law placing greater requirements on petition gatherers and increased the amount of petitions needed for a Florida Supreme Court review.

Taddeo wants the Legislature to eliminate the need for that process by putting the measure on the ballot itself. She’s filed SJR 276 to put Medicaid expansion on the 2020 ballot, but that avenue is unlikely, too, because it requires 60% support in both chambers.

“After this icing on the cake is handed to us from the federal government … and we still don’t do it – it’s so sad because we’re playing with people’s lives,” Taddeo said.

grohrer@orlandosentinel.com

 
 

Clipped from: https://www.orlandosentinel.com/politics/os-ne-florida-medicaid-expansion-20210317-uxyqvh3trjgvthw4qxoba52syy-story.html

 
 

 
 

 
 

Posted on by

Feds will cover 100 percent of Medicaid vaccinations

MM Curator summary

Medicare will pay 2x for COVID vaccines under the new bill, and CMS will cover them through Medicaid at the same rate.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

This screen grab from the website shows the main web page for the HealthCare.gov. HealthCare.gov’s market for subsidized health plans reopens Monday, Feb. 15, 2021, for a special three-month sign-up window, as the Democratic-led Congress weighs legislation that could cut premiums by double digits for many. (Centers for Medicare and Medicaid Services via AP, File)

BOSTON (SHNS) – The federal government on Monday announced another part of its strategy to speed vaccinations — paying vaccinators more money and ensuring that vaccinations will continue to be free to those who receive them.

The Medicare reimbursement rate for administering vaccines will nearly double from $23 to $40 per shot. In addition, under the $1.9 trillion spending bill signed by President Biden last week, the federal government will now cover 100 percent of the cost for Medicaid and children’s health insurance beneficiaries to get vaccinated.

“This protects states from bearing any costs associated with the increased Medicare reimbursement rates,” Acting Centers for Medicare and Medicaid Services Administrator Andy Slavitt said. “And the Biden administration stands ready to work with states who are interested in increasing their Medicaid reimbursement rates for vaccinations so that we can make sure that we have most effectively reached vulnerable communities. This is an important health equity step, as working and lower-income Americans have faced the brunt of this crisis and must receive the resources needed to protect them.”

MassHealth, the state’s Medicaid program, already reimburses providers $45 a shot for COVID-19 vaccinate, or $90 for two doses of the Moderna and Pfizer vaccines.

The two moves show the federal government is “doing more than saying thank you to all the people we call heroes,” Slavitt said.

 
 

Clipped from: https://www.wwlp.com/news/state-politics/feds-will-cover-100-percent-of-medicaid-vaccinations/

 
 

 
 

 
 

Posted on by

Georgia budget: House endorses behavioral health & developmental disability spend, not Medicaid

MM Curator summary

 
 

GA legislators have approved increased funding for MH/BH.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

 
 

The state’s top House Republican says his chamber’s version of the $27.3 billion state budget makes a new, significant investment in Georgians’ mental and behavioral health needs. But Democrats say Georgians need much more health spending in general.

For House Speaker David Ralston, R-Blue Ridge, one of the highlights of the state House budget is $58 million in new or restored state spending on the needs of folks who have behavioral health challenges or developmental disabilities. Earlier this year, he had announced those services would be a House priority this year in spending and legislation, after a 2020 study commission.

The House’s total budget is just about same amount as that of Republican Gov. Brian Kemp.  But the House “found” some money for its priorities by trimming a couple of places like economic development and accounting for the feds’ willingness to pay a greater percent of Medicaid costs during COVID-19.

So the House’s proposed $58 million will pay for things like services for 2,100 more people who have addictive diseases and mental health services for some 5,200 more Georgians. Pending approval from the federal government, the House budget would also increase the rates the state pays to intellectual and developmental disability providers.  And it includes $7 million in annual funding for a behavioral health crisis center for people who have intellectual and developmental disabilities.

“Part of our work is to remove the stigma from seeking help for behavioral health or developmental disability services. It is nothing to be ashamed of and it is nothing to hide from if you need help,” Ralston said at a press conference Friday, just after his chamber passed the budget, 136-31.

Georgia’s spending has long been conservative, too conservative for Democrats. Hence the ‘no’ votes. It took years for state spending per Georgian to recover to what it was before the 2008 Great Recession, for example.

And many cuts made last year in preparation for a recession this year are still in the budget — even though state tax revenue has been healthy. K-12 education is set for an appropriation of about $10.2 billion.  Two years ago, it was $10.6 billion.

Even some Republicans think state has been a little too tight and that it needs to do things like increase state staff salaries to try and keep folks from quitting.

All year, Democrats have been urging the majority Republicans to draw down the state’s $2.5 billion-plus rainy day fund for the things pandemic-ravaged Georgians need today and in the near future.

Ralston said the state needs to be “cautious” about drawing from the rainy day fund and that he appreciates the “measured” approach to the rainy day fund in Kemp’s version of the draft budget. Memories are probably still there of the Great Recession, when the rainy day fund went down to a frightening $103 million.

However, Democratic state Rep. Jasmine Clark of Lilburn said that at this point, Georgia is socking money in a bank instead of filling its empty fridge.

She doubled down on a policy Democrats have sought for years: expansion of Medicaid to more low-income Georgians. The state would pay for a share of that and the feds would pay a share.

Expansion would “provide billions in matching funds and give hundreds of thousands of Georgians access to health care and save rural hospitals from shuttering their doors,” Clark said on the House floor Friday.

To make that point, House Democrats tried an almost unheard of parliamentary maneuver: adding Medicaid expansion to the budget bill via House floor amendment. Not surprisingly, that move failed, 68-98. Republicans have for years said an expansion would be too costly.

Gov. Kemp’s draft budget for the year that will begin in July is fairly similar in proportion to the House version.

So, overall, the House’s budget proposal and that of the governor are very similar to recent years: the most money for education and health. In fact, if the whole budget were $1, more than 50 cents would go to those two areas.

The state Senate will come up with their own draft budget in the coming weeks. Then the House, Senate and governor must come to some consensus budget by March 31.

Documents:

House budget documents

Gov. Brian Kemp’s budget documents

 
 

Clipped from: https://saportareport.com/georgia-budget-house-endorses-behavioral-health-developmental-disability-spend-not-medicaid/columnists/maggie-lee/maggie/

 
 

 
 

Posted on by

How the $1.9T COVID-19 Relief Package Impacts Medicaid, CHIP

MM Curator summary

 
 

The latest version of the COVID relief bill includes an additional 5% federal matching for states to expand.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

The relief bill included many elements that could benefit Medicaid and CHIP beneficiaries and state programs, particularly by increasing the federal medical assistance percentage.

 
 

Source: Getty Images

 
 

By Kelsey Waddill

March 09, 2021 – Congress passed a $1.9 trillion relief package to support the nation’s coronavirus pandemic response efforts and the law could have particular significance for Medicaid and CHIP programs.

The bill passed in the Senate by a vote of 50 to 49. While it still resembled the American Rescue Plan put forth by the Biden administration to expand COBRA and Affordable Care Act marketplace subsidies, the bill sustained several changes in the Senate, American Hospital Association reported in a special bulletin on the policy.

As it stands with the Senate’s alterations, the law would offer an increased Federal Medical Assistance Percentage (FMAP) to incentivize states to expand their Medicaid programs. This newest boost to the FMAP would add five percentage points to the state’s base program for two years.

States that adopt Medicaid expansion during the public health emergency would receive the 6.2 percentage point FMAP boost—which CMS enacted in March 2020 due to the pandemic—as well as the five percentage-point increase described in the new law.

The main requirement would be that participating states offer continuity of coverage, including COVID-19 vaccine and treatment coverage.

“The increased match does not apply to the already-enhanced matching rate for expansion populations, to federal matching rates for Medicaid Disproportionate Share Hospital (DSH) payments or CHIP,” the AHA special bulletin clarified.

Medicaid and CHIP beneficiaries would continue to receive the vaccine for free. The federal government would cover vaccine and vaccine administration up to 100 percent of the FMAP until a full year after the end of the public health emergency.

The federal government would also match 100 percent of the FMAP in order to cover vaccination and treatment for the uninsured population.

From the fourth quarter 2020 earnings calls, it was clear that payers such as Centene anticipated an increase in the FMAP. The higher FMAP could increase their revenues for 2021, which have already received a boost from lower utilization of care.

The FMAP would not be restricted to COVID-19 vaccinations and treatment, however. Funds towards home-and-community-based services would also be higher for a year. The Urban Indian Organizations and Native Hawaiian Health Care Systems would likewise receive more FMAP support.

Apart from directly coronavirus-related funding, the legislation also sought to improve continuity of coverage for pregnant beneficiaries and new mothers on Medicaid.

The bill would allow states to extend full Medicaid benefits and Children’s Health Insurance Program (CHIP) coverage to pregnant beneficiaries for up to a year after giving birth. This flexibility would be available to states for five years.

Studies have demonstrated that longer postpartum Medicaid coverage can improve patient outcomes for mothers and infants. These results have been particularly evident for Medicaid expansion states.

Additionally, studies have linked Medicaid funding cuts to poor health outcomes for child beneficiaries. The positive health effects of Medicaid coverage can follow a child through to young adulthood and may lower the incidence of childhood mortality and chronic disease.

The law would set aside $10 billion for coronavirus vaccine and testing activities under the Defense Production Act, $70 billion for coronavirus vaccine, testing, and workforce, $6 billion for the researching, manufacturing, and purchasing of coronavirus vaccines, and $1 billion to “strengthen vaccine confidence,” the bill outlined.

Another $47.8 billion would go towards implementing the national coronavirus testing strategy and $1.75 billion would be used for genomic sequencing and surveillance.

Although the Senate’s bill was very much like the one that passed in the House of Representatives two weeks prior, there were several key changes to elements related to rural hospital funding, the Medicare wage index, coronavirus-related funding, and support for families and small businesses.

The House has to ratify the changes that the Senate made to the law before the bill goes to the president’s desk.

Clipped from: https://healthpayerintelligence.com/news/how-the-1.9t-covid-19-relief-package-impacts-medicaid-chip

 
 

 
 

Posted on by

New York lawmakers, advocates dismayed by Cuomo administration’s proposal to cut Medicaid reimbursements

 
 

 
 

MM Curator summary

 
 

NY lawmakers are considering a 1% cut to Medicaid funding.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

A patient wears a protective face mask as she is loaded into an ambulance March 18, 2020, at The Brooklyn Hospital Center emergency room in New York. Anticipating a spike in coronavirus patients, New York City-area hospitals are clearing out beds, setting up new spaces to triage patients and urging people with mild symptoms to consult health professionals by phone or video chat instead of flooding emergency rooms that could be overrun.

John Minchillo / AP photo

(The Center Square) — While the COVID-19 nursing home scandal that has plagued the Cuomo administration drew a lot of attention at Thursday’s legislative budget hearing, New York state lawmakers still had time to pepper administration officials on what’s being proposed for the year ahead. And a proposed 1 percent cut in the Medicaid budget certainly caught the eye of some legislators as well as other advocates.

The Healthcare Association of New York State called on the Legislature to reject the cut, noting that the public insurance program currently only reimburses providers at a rate of 67 cents for every $1 of care given.

“While it is never a good time to cut state support for healthcare, this year it would be devastating. … Further deterioration of that support – especially as we work to end and recover from the pandemic – would worsen an already fragile safety net system and put patients at risk,” Healthcare Association President Bea Grause said in written testimony.

The proposed cut in Medicaid funding comes as the state faces a multibillion dollar deficit it needs to fill. While Gov. Andrew Cuomo has been hopeful the federal government will provide the state with $15 billion in direct funding to make the state whole, he’s noted that program would face cuts without help from Congress.

Lawmakers raised their own concerns, saying the cuts would be particularly hurtful to hospitals that primarily serve lower-income patients.

“If you cut 1 percent of Mount Sinai’s Medicaid allotment and 1 percent of, say, Elmhurst’s Medicaid allotment, that might sound fair to somebody who doesn’t know anything about our hospitals, but it obviously is not,” said state Assemblyman Richard Gottfried, D-Manhattan.

Health Commissioner Dr. Howard Zucker said the administration recognized that hospitals considered part of the state’s safety net were facing challenges even before the pandemic. Once COVID-19 hit and elective surgeries were curtailed, it only became worse.

Deputy Health Commissioner Donna Frescatore told the committee that the 2022 budget contains an additional $900 million for “financially distressed” hospitals.

Still, other lawmakers noted that the pandemic has caused more people to enroll in Medicaid. Senate Finance Committee Chairwoman Liz Krueger, D-Manhattan, pointed out that when the state implemented a cap on Medicaid spending a decade ago there was about 4 million New Yorkers on the program.

She then recalled that Frescatore said earlier in the hearing that number has since grown to 7 million.

“It doesn’t matter how many times we go back and look at the numbers and ask you for the data, you just can’t provide health insurance for 7 million people on a lowered cost from that which you started off on for 4 million people, and you shouldn’t be trying,” the chairwoman said.

Not only were lawmakers upset at the budget cut, but they were also upset that they received information detailing the cuts just the night before the hearing. State Sen. Tom O’Mara, R-Big Flats, said lawmakers had no time to review the plan.

For O’Mara, the ranking Finance Committee member who unsuccessfully tried to get Krueger to swear in Zucker at the beginning of his five-hour testimony, that maneuver is proof that the administration still is not being transparent with lawmakers even in the wake of the nursing home controversy.

“I find virtually everything you’ve said here today to be totally without credibility,” O’Mara told Zucker.

 
 

Clipped from: https://www.ontownmedia.com/coronavirus_pandemic/new-york-lawmakers-advocates-dismayed-by-cuomo-administrations-proposal-to-cut-medicaid-reimbursements/article_437c0b1d-1c6a-50c2-81d3-f023c840172e.html

 
 

 
 

Posted on by

House Lawmakers Include 7.35% Medicaid Boost for Home- and Community-Based Services in Stimulus Proposal

 
 

MM Curator summary

 
 

One of the Medicaid components of the $2T pandemic bill would be a 7% for HCBS services.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

The House Energy and Commerce Committee has proposed some major Medicaid provisions to the $1.9 trillion relief package making its way through Congress. If enacted, the measures would benefit home-based care providers across the U.S., at least in the short term.
 

Specifically, the draft legislation includes a two-year, 5% Federal Medical Assistance Percentage (FMAP) boost for states that recently expanded their Medicaid programs. It also features a 7.35% rate bump for states to specifically enhance home- and community-based services (HCBS) during the public health emergency.
 

“The legislation provides for flexibility on how state Medicaid programs participate and where to use the additional funding,” Dave Totaro, chairman of the Partnership for Medicaid Home-Based Care (PMHC), said in a statement shared with Home Health Care News. “PMHC strongly encourages states to work with HCBS stakeholders, including providers, to identify the areas of greatest need for these important resources.”
 

Advertisement

The Washington, D.C.-based PMHC is an industry advocacy group that represents home- and community-based care providers operating in the Medicaid space.
 

The bump in Medicaid rates would be crucial for home-based care providers for a few reasons.
 

For one, cash-strapped providers are dealing with an ongoing pandemic and all the added expenses that come with it, such as costly personal protective equipment (PPE) and hazard pay for courageous workers manning the front lines.. Additionally, many states are dealing with budget deficits forcing them, in some cases, to uniformly decrease funding for a variety of programs, including Medicaid.
 

Advertisement

Yet even though the 7.35% bump would be very positive news for all home- and community-based services providers, it’s not a final or complete solution to every problem they face.
 

“It certainly is helpful, in that it probably reduces the issues that providers and state Medicaid budgets are going to have in the upcoming budget year,” PMHC Vice Chairman Darby Anderson told HHCN. “But it’s probably, in and of itself, not enough to make them all go away.”
 

In other words, a 7.355 bump wouldn’t be a panacea to all state budget problems. With that in mind, PMHC is still advocating for more direct aid to states and localities, Anderson noted.
 

Any boost to state Medicaid programs is meant to supplement — not supplant — existing funding, the draft legislation clarifies. Examples of HCBS groups it calls out include home health providers, personal care services agencies, case management entities, PACE organizations and others.
 

Examples of what the additional funding can be used for include generally increased rates for HCBS providers. The potential boost can also specifically be used to purchase PPE, enable hazard pay, recruit new workers or support appropriate time off for front-line workers.
 

The added Medicaid money could additionally help states shift more individuals out of facility-based settings back into their homes and communities.
 

Despite all of those benefits, the increase’s temporary nature also raises some concern.
 

As the debate continues in regards to a permanent $15 minimum wage, home-based care insiders are concerned that reimbursement won’t match a mandated wage increase in the future.
 

The groundwork for a $15 minimum wage increase was included in the proposed relief package.

“As Congress debates increasing the federal minimum wage, PMHC is advocating to incorporate a requirement for state Medicaid programs to, at minimum, match the federal minimum wage increase through commensurate increases in reimbursement rates for Medicaid HCBS,” Totaro said. “The additional, temporary FMAP payment for HCBS cannot be considered a full solution to address the minimum wage issue.”
 

While PMHC is pleased with the temporary funding increase for home- and community- based services during the pandemic, it’s calling for more specific and permanent resources to be put into place if the federal minimum wage does increase.
 

If there is a failure to require and support states in increasing reimbursement rates to match, PMHC believes it will further limit both access to care delivery and limit HCBS providers’ ability to recruit workers.
 

“Matter of factly, in a lot of states, these are minimum wage positions. And we don’t believe they should be, but they’re largely affected by it,” Anderson said. “And so it’s a significant thing. But I don’t want our concern over a minimum wage to diminish the enthusiasm around this proposal, because I think it’s very positive. But minimum wage is a significant threat.”
 

Beyond the HCBS items, the House Energy and Commerce Committee proposal also would institute Medicaid drug rebate caps and dole out $14.2 billion for vaccine-related activities.
 

Clipped from: https://homehealthcarenews.com/2021/02/house-lawmakers-include-7-35-medicaid-boost-for-home-and-community-based-services-in-stimulus-proposal/

 
 

 
 

Posted on by

Feds woo Georgia, other Medicaid expansion holdouts with billions

MM Curator summary

 
 

Biden dangles $20B+ in front of non-expansion states.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

In October, Georgia Gov. Brian Kemp signed an agreement with the Trump administration to create a $218 million-per year plan that limits the new Medicaid coverage pool to about 50,000 uninsured Georgia adults. The Biden administration aims to sweeten Georgia’s reason to expand Medicaid to more than 350,000 other low-income Georgians. Ross Williams/Georgia Recorder

WASHINGTON—U.S. House Democrats are trying again to entice Georgia and other holdout states to expand Medicaid coverage with the prospect of billions of dollars in federal cash.

The new offer, included in a massive $1.9 trillion COVID-19 relief package that House Democrats are pushing through committees this week, could help provide health coverage to more than 2 million Americans – more than 400,000 in Georgia. They are falling between the cracks in government programs in the midst of the pandemic and economic downturn.

Most are childless adults who earn some money but still fall below the federal poverty income level, or about $12,880 per year.

In the vast majority of states, people in that situation could qualify for Medicaid, a public program that provides health insurance to low-income people and people with disabilities.

But in Georgia and 13 other states that have not yet expanded Medicaid, they are still ineligible for that program. Meanwhile, they are still too poor to get subsidized private coverage through insurance exchanges.

Edwin Park, a research professor with the Center for Children and Families at Georgetown University, said the House proposal could “move the dial” in some states.

“For others, unfortunately, I think they may walk away from this very good deal,” he said.

Holdout states in addition to Georgia include Florida, North Carolina, Kansas, Tennessee and Wisconsin.

Georgia’s GOP leaders have resisted fully expanding Medicaid’s income eligibility to include people who make 138% of the poverty rate since the state became eligible to do that eight years ago under the Affordable Care Act.

In October, Georgia Gov. Brian Kemp signed an agreement with the Trump administration to create a $218 million-per year plan that aims to expand Medicaid coverage to about 50,000 uninsured Georgia adults who could be covered – if they satisfy a work or activity requirement of 80 hours a month. It is set to begin in July with the final piece taking effect in January 2023.

The U.S. Supreme Court announced in December that it would hear a case to determine whether Georgia and other states can impose work requirements on Medicaid recipients.

Kemp said at the October signing that expanding Medicaid outright would be too expensive, costing the state $550 million a year.

If Georgia fully expanded Medicaid with the federal government absorbing 95% of the tab, the state could cover an additional 350,000 uninsured people, said Laura Colbert, executive director of Georgians for a Healthy future. She said an estimate by the governor’s own Office of Planning and Budget a couple of years ago calculated that once savings from programs or services that would instead be covered by Medicaid are factored in, the cost of full expansion is effectively a wash with Kemp’s Patients First program.

“It’s heartbreaking, frankly, to see our state continue to pass up what we think is the most cost-effective, moral and common sense investment in our people and in our health care system,” Colbert said. “And that heartbreak grows when it’s in the midst of a pandemic.”

Supreme Court ruling

The gap that many low-income people fall into was created when the U.S. Supreme Court struck down part of the health care law, also known as Obamacare. The court said Congress could not make states expand their Medicaid programs.

But states have gradually signed on over the last decade, because Congress provided them such big financial incentives to do so. At first, the federal government picked up the entire cost of adding childless adults and others to the Medicaid rolls. These days, it still covers 90 percent of the cost. The federal government last covered 95% in 2017.

Throughout much of the South, along with places like Kansas, South Dakota, Wyoming and Wisconsin, though, state officials have resisted calls to expand their Medicaid programs. Republicans in particular have balked at what they see as an overreach by the federal government.

The latest measure, though, would add a new twist. It would give holdout states more money for the patients they are already covering if they agree to expand Medicaid.

“Even though states still pay 10 percent [for the new patients], they would still come out ahead,” said Robin Rudowitz, the co-director of the Kaiser Family Foundation’s Program on Medicaid and the Uninsured. “I think that changes the math.”

An analysis by the left-leaning Center on Budget and Policy Priorities shows that states would gain substantially under the Democratic proposal:

  • Florida could receive $3.5 billion.
  • North Carolina would be in line for $2.4 billion.
  • Georgia could bring in $1.9 billion.
  • Tennessee could collect $1.7 billion.
  • Wisconsin could gain $1.3 billion.
  • Missouri could receive $1.7 billion.
  • Kansas could bring in $330 million.

Texas stands to gain the most, with a potential of bringing in nearly $6 billion. The extra money would end after two years.

How Medicaid works

Medicaid is run jointly by states and the federal government. The federal government reimburses states a set amount of the money they spend on the program, and that rate varies by state.

States whose residents have lower average incomes get higher reimbursement rates. In March, Congress increased the reimbursement rate for all states for as long as the COVID-19 emergency remains. The Biden administration has said it will extend that emergency until at least the end of 2021.

The House proposal would further increase the reimbursement rates for new expansion states by 5 percentage points.

The new incentives would be part of a larger congressional effort to address the fallout of the COVID-19 pandemic. Democrats’ relief bill covers everything from distributing vaccines to supporting transportation networks to doling out stimulus checks.

That health emergency has also changed how state officials view an expansion of health insurance eligibility, Rudowitz said.

“The pandemic has certainly highlighted the issues around the need for health coverage, and you have more people [in states that haven’t expanded Medicaid] becoming uninsured as related to the economy,” Rudowitz said.

Even before the pandemic, Georgia’s uninsured rate consistently ranked among the highest in the country.

States may resist

Park said that the federal government picks up the costs of the expansion, and people who get health coverage demand fewer state services.

“The fiscal impact of [Medicaid] expansion has always been positive… But some states may resist for ideological reasons rather than looking at the numbers.”

The House Energy and Commerce Committee is set to hold a hearing on the proposed changes Thursday morning.

Among the other changes that the lawmakers are considering are measures to ensure that women retain their Medicaid coverage for up to a year after giving birth; fully covering the cost of COVID-19 vaccines under Medicaid; and allowing prison inmates to qualify for Medicaid 30 days before they are released.

Georgia Recorder Editor John McCosh contributed to this report.

Clipped from: https://georgiarecorder.com/2021/02/11/feds-woo-georgia-other-medicaid-expansion-holdouts-with-billions/

 
 

 
 

Posted on by

Timing fluke could garner Missouri $1.7 billion in additional federal Medicaid funds

 
 

MM Curator summary

 
 

As MO took some time to figure out how to pay for expansion, it may get a lot more federal funding under the Democrats new plan to sweeten the deal for expansion hold outs.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Republican state Sen. Dan Hegeman, of Missouri, discusses voter approval of a ballot measure he sponsored during an interview on Thursday, Nov. 5, 2020, in his state Capitol office in Jefferson City, Mo. 

AP Photo/David A. Lieb

(The Center Square) – The Missouri Senate Appropriations Committee will engage in a “perfection debate” Monday afternoon on a proposed bill implementing Medicaid expansion approved by state voters when they adopted Amendment 2 in August. 

According to estimates compiled by State Auditor Nicole Galloway, expanding Medicaid under the Affordable Care Act (ACA) could cost the state more than $200 million or save it as much as $1 billion annually by 2026.

But Congress could change the calculus – and potentially provide Missouri with a windfall $1.7 billion over two years in Medicaid funding attributable to timing.

While expansion was approved by 53% of voters in Missouri, it won’t be in effect at least until the start of the new fiscal year, July 1. Oklahoma voters also approved Medicaid expansion last summer that goes into effect in July. 

But Missouri and Oklahoma are still among the 14 states that U.S. House Democrats are trying to induce into expanding Medicaid under the ACA.

Billions in additional federal funding for Medicaid expansion for states that have not done so is included in a $1.9 trillion COVID-19 relief package proponents say would provide health coverage to more than 2 million Americans “falling between the cracks in government programs in the midst of the pandemic and economic downturn.”

Under House Democrats’ plan, Missouri could receive up to $1.7 billion by expanding Medicaid. Texas would receive $6 billion, Florida $3.5 billion, North Carolina $2.4 billion, Georgia $1.9 billion, Tennessee $1.7 billion, Wisconsin $1.3 billion and Kansas $330 million by expanding Medicaid under the ACA.

Amendment 2 expands Medicaid for residents between the ages of 19 and 64 with an income level at or below 133 percent of the federal poverty level. Supporters say the measure will provide healthcare to more than 200,000 Missourians who earn less than $18,000 annually.

 
 

 
 

 
 

Republican Gov. Mike Parson and the Legislature’s GOP leaders vigorously opposed the measure. In his State of the State address last month, however, Parson told lawmakers he expected them to execute the will of the people in implementing the expansion.

How the potential $1.7 billion boost influences Monday’s Senate Appropriations Committee’s “perfection debate” on Senate Bill 1 is uncertain.

The bill, filed by committee chair Sen. Dan Hegeman, R-Cosby, would extend the state’s federal match program — the Federal Reimbursement Allowance (FRA) — for Medicaid payments. Nearly 85 percent of all payments to Missouri hospitals through MO HealthNet are covered by the FRA.

The state’s FRA program was established as voluntary before being enacted into law as a provider tax in 1992. Hospitals contribute to the FRA and Missouri’s Medicaid program — MO HealthNet — uses the funds to earn higher returns in federal matching dollars.

SB 1 would continue maximizing federal matching dollars through Medicaid expansion to the burden on state general revenues, Hegeman told the panel when it preliminarily advanced the measure in an 11-1 vote on Jan. 26.

Among extensions is continuing to allow the Missouri Department of Health (DOH) to collect approximately $1.28 billion in Hospital Tax in Fiscal Year 2022 and in FY23. Hospital tax revenues will, in turn, draw approximately $2.391 billion in federal funds each year to the state.

Missouri Hospital Association (MHA) Executive Director Rob Monsees told the panel that adding 200,000 people to the state’s Medicaid program will generate “a substantial amount of new FRA dollars. Some of those dollars can help provide an offset to the cost of expansion.”

Sen. Bill Eigel, R-Weldon Spring, the lone dissenter, said the FRA is growing too big and needs reform. “We have thrown money at a broken program with no meaningful reform whatsoever,” he said.

 
 

Clipped from: https://www.thegriffonnews.com/news/state/timing-fluke-could-garner-missouri-1-7-billion-in-additional-federal-medicaid-funds/article_72201da5-fce7-5e0b-8c5f-c9015f1ff34d.html