Tag: Medicaid Reform

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[MM Curator Summary]: Walmart me-toos Amazon. Not that me-too, the other me-too.

 
 

 
 

Clipped from: https://www.al.com/news/2023/07/walmart-has-major-new-discount-for-snap-social-security-medicaid-recipients.html

 
 

Walmart is offerings a discount on its Walmart+ subscription service for people receiving some types of government assistance.Walmart

Walmart is offerings a discount on its Walmart+ subscription service for people receiving some types of government assistance.

In a press release, Venessa Yates, SVP and General Manager, Walmart+, said recipients of Supplemental Nutrition Assistance, or SNAP, Supplemental Security Income, or SSI, and Medicaid will be eligible for the half-price subscription. The discounted price will be $6.47 a month, or $49 a year, compared to $98 a year. Membership benefits include free shipping on online orders, gas discounts, free grocery delivery and access to Paramount+ streaming services.

READ MORE: Walmart closing another store

“We’re making it easier and more accessible for government-assisted customers to become members and take advantage of the full suite of savings Walmart+ has to offer them,” Yates wrote.

The new program is available to all eligible new and existing members. Existing members who qualify an sign up will receive a prorated refund and the new price will start immediately.

To sign up you should visit Walmart.com/plus/assist to verify eligibility through SheerID.

In 2019, Walmart was one of the first retailers to begin taking part in the U.S. Department of Agriculture’s SNAP online purchase pilot. Walmart is now the first retailer to accept SNAP benefits online in all 50 states.

Updated July 20 at 8:13 p.m. to reflect SSI, not Social Security, is included in the program.

MM Curator summary

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.

 
 

[MM Curator Summary]: After GA won its court case, Ohio and others are inspired.

Clipped from: https://www.theregreview.org/2023/07/22/saturday-seminar-states-renew-push-for-medicaid-work-requirements/

 
 

Scholars evaluate the impact of work requirements on Medicaid beneficiaries.

About one in five Americans receive health coverage through Medicaid, making it the largest source of health coverage in the United States. Should states make eligibility for Medicaid contingent on employment?

The institution of work requirements for federal safety net programs such as Medicaid emerged as a point of debate during recent federal debt ceiling negotiations. House Republicans proposed expanding work requirements for those receiving food assistance through the Supplemental Nutrition Assistance Program (SNAP) or cash assistance through the Temporary Assistance for Needy Families (TANF) program. House Republicans also proposed new work requirements for those receiving health care through Medicaid.

In a decision that has been criticized by some congressional Democrats, President Biden agreed to expand existing SNAP and TANF work requirements in exchange for a two-year suspension of the debt ceiling. A Medicaid provision that would have required Medicaid recipients to work, volunteer, or participate in job training for at least 80 hours per month to be eligible for coverage did not survive negotiations. Moreover, exceptions built into the debt ceiling agreement will reduce the number of recipients adversely affected by the deal.

Yet beyond Capitol Hill, state officials are leading a renewed push for Medicaid work requirements.

Although the federal government provides states with Medicaid funds, states administer the program. Section 1115 of the Social Security Act grants states flexibility to tailor their programs to meet residents’ needs.

Under Section 1115, states can submit waiver requests to the U.S. Department of Health and Human Services (HHS) to amend eligibility requirements. The Health and Human Services Secretary can approve a waiver request if a state program supports Medicaid’s overarching goals of providing health coverage and improving health outcomes for low-income individuals.

Prior to the Trump Administration, no states had ever received Section 1115 waivers to tie the receipt of Medicaid support to employment. But beginning in 2017, President Trump’s top health officials encouraged states to align their Medicaid requirements with the work conditions of other safety net programs, such as TANF and SNAP, and HHS granted Section 1115 waiver requests to 12 states that sought to add work requirements.

Health care advocates and civil rights groups sued the Trump Administration, successfully challenging the approvals of Section 1115 waivers in Kansas and Arkansas. Because the courts found that work requirements contravened Medicaid program goals, the lawsuits prevented several states from implementing work requirements.

In 2021, President Biden revoked Section 1115 waiver approvals for several of the states that sought to attach work requirements to Medicaid. Only one state—Georgia—sued the Biden Administration in response. Judge Lisa G. Wood of the Southern District of Georgia sided with the state, finding that the Administration failed to consider whether rescinding Georgia’s program would result in less Medicaid coverage.

Judge Wood’s decision cleared the way for Georgia’s Pathways to Coverage Program—a limited Medicaid expansion program that covers a subset of low-income adults who meet work requirements and which began enrollment on July 1 of this year.

Currently, Georgia is the only state to condition Medicaid receipt on employment.

In discussion of work requirements, many scholars argue that the requirements impose barriers to health coverage and fail to increase employment rates among Medicaid enrollees. Indeed, the Georgia Department of Community Health revealed that nearly 100,000 low-income Georgians lost health coverage after the state reassessed their eligibility in advance of the new coverage program.

In addition, the debt ceiling negotiations revived long-standing policy disagreements over the role of safety net programs and the federal government’s responsibility toward low-income Americans. Should Medicaid be understood as a public assistance program that nevertheless encourages employment? Or is it a fundamental entitlement that provides access to necessary and affordable health care?

In this week’s Saturday Seminar, scholars evaluate the effects of work requirements on Medicaid enrollment and explore why efforts to attach work requirements to Medicaid eligibility persist.

• Work requirements have little effect on employment rates among Medicaid beneficiaries, according to a report from the Congressional Budget Office (CBO). The CBO report
  explains that work requirements tend to reduce enrollees’ benefits more than they increase their earnings. The report examines Arkansas’s Medicaid work requirement, granted through a Section 1115 waiver, finding that 23 percent of Medicaid recipients subject to work requirements lost health coverage in the months before the court struck down Arkansas’s waiver approval. CBO also finds that the work requirements roughly doubled the number of adults in the state who reported having serious difficulties affording their medical bills.
  
• In an article in the Temple Law Review, Nicholas P. Terry of the Indiana University Robert H. McKinney School of Law identifies a correlation between individuals with opioid use disorder and Medicaid eligibility. Terry argues that states that have used Section 1115 waivers to condition Medicaid benefits on employment have worse health outcomes for enrolled individuals with opioid use disorder. Terry contends that work requirements invert the relationship between work and health because the ability to work is necessarily a product of good health. According to Terry, individuals with opioid use disorder often have serious medical conditions, such as disabilities, that prevent them from being employed, and because these individuals frequently cycle through treatment, recovery, and relapse, they often cannot qualify for work requirement exemptions.
  
• A Northwestern University Law Review
  article by Andrew Hammond of Indiana University Maurer School of Law explores why Medicaid and SNAP persist despite conservatives’ repeated efforts to dismantle them. Hammond contends that the Trump Administration effectively changed substantive welfare law—that is, the rules about who receives benefits and how much— by increasing administrative burdens on public benefits applicants, such as through work requirements and drug tests. Yet Hammond maintains that the Administrative Procedure Act provides some protections against the dismantling of anti-poverty programs, and that litigation remains an effective tool to protect access to health coverage and food assistance.
  
• In a working paper issued by the National Bureau of Economic Research, Laura Dague and Benjamin D. Ukert of Texas A&M University document current minimum eligibility and enrollment requirements for Medicaid. Dague and Ukert provide an overview of research on “disenrollment policies,” which are policies that allow states to stop coverage for individuals who purportedly fail to meet eligibility requirements. For example, when Arkansas introduced its short-lived Medicaid work requirement in 2018, the state automatically disenrolled more than 17,000 people who failed to report the minimum monthly work requirement, observe Dague and Ukert. They echo past research findings that disenrollment likely amounted to an increase in the uninsured rate among low-income Arkansans.
  
• In an article published in the Journal of Health and Life Sciences Law, Sarah Somers and Jane Perkins of the National Health Law Program
  argue that Medicaid work requirements often carry racial overtones. Somers and Perkins cite as an example a Michigan bill that sought to impose work requirements on Medicaid beneficiaries in majority Black cities such as Flint and Detroit, but would have exempted residents in other counties. According to Somers and Perkins, prior studies confirm that states with higher Black populations are less likely to expand Medicaid eligibility. Yet Somers and Perkins contend that Medicaid has the potential to advance racial equity by addressing health disparities. Somers and Perkins argue that states that have expanded Medicaid coverage have reduced disparities in uninsured rates between white and Black adults, improved Black adults’ access to primary care, and lowered Black patients’ mortality rates.
  
• In an article in the Yale Journal of Health Policy, Law, and Ethics, Kristen Underhill of Cornell Law School shows how laws communicate information about societal norms and public policy. Underhill interviewed Medicaid participants in Kentucky, which, at the time, had an approved Section 1115 waiver request conditioning coverage on employment. Drawing on these interviews, she seeks to explain how Medicaid enrollees perceived work requirements as part of the state’s policy goals. Underhill finds that many interviewees who supported the work conditions believed that, although their own participation in Medicaid was a matter of circumstance, other participants were unwilling to work and took “advantage” of Medicaid. Conversely, Underhill finds that some interviewees criticized Kentucky’s Medicaid work requirements as embodying state officials’ unrealistic expectations for beneficiaries, claiming that racial animus and punitive intent provided the basis for the state’s policy choice.
  

The Saturday Seminar is a weekly feature that aims to put into written form the kind of content that would be conveyed in a live seminar involving regulatory experts. Each week, The Regulatory Review publishes a brief overview of a selected regulatory topic and then distills recent research and scholarly writing on that topic.

MM Curator summary

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[MM Curator Summary]: In which the academics try to just say give Medicaid to everybody. But with lots of words.

 
 

 
 

Clipped from: https://theconversation.com/where-the-government-draws-the-line-for-medicaid-coverage-leaves-out-many-older-americans-who-may-need-help-paying-for-medical-and-long-term-care-bills-new-research-208527

Marc Cohen, Jane Tavares, UMass Boston

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Disclosure statement

Marc Cohen receives funding from the National Council on Aging (NCOA).

Jane Tavares receives funding from the National Council on Aging

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The Research Brief is a short take about interesting academic work.

The big idea

Medicaid, which provides low-income Americans with health insurance coverage, currently excludes large numbers of adults over 65 with social, health and financial profiles similar to those of people the program does cover. Based on a study we conducted, we determined that if strict eligibility rules for Medicaid were changed to help cover such people, from 700,000 to 11.5 million people over 65 would be newly eligible for the program.

We analyzed data from the 2018 Health and Retirement Study, a large national survey of older adults conducted by the Institute for Social Research at the University of Michigan every two years, to determine how using five different financial eligibility criteria would increase the number of older adults who would qualify for Medicaid and what they would look like.

Depending on which rules were changed, we would expect to see one of the following scenarios:

• If the government switched from the official poverty measurement Medicaid uses – currently an annual income of US$14,580 for one person – to its more accurate supplemental one, which takes taxes, health care costs and certain other expenses into account, about 700,000 more older Americans would get Medicaid coverage.
  
• If the amount of assets that people can have were in line with other programs, such as the Medicare Savings Plan, an additional 1.4 million people would qualify. Medicare Savings Programs help pay Medicare costs for older adults with limited income and savings.
  
• If Medicaid stopped considering assets altogether, an additional 2 million would qualify.
  
• If the income eligibility threshold were higher, equal to 138% of the federal poverty level, it would mirror how the government determines whether adults under 65 can get Medicaid, and 4.7 million more older people could be covered by the program.
  
• A measure that’s increasingly used to evaluate the vulnerability of older adults is the Elder Index, which takes into account basic expenses like housing, health care and food. People over 65 with incomes that fall above the official poverty line but below the Elder Index are considered to be financially vulnerable. If the government used the Elder Index as a basis for Medicaid eligibility, 11.5 million additional older adults would qualify for the program.
  

Unless the government adopted the Elder Index approach, most of the additional enrollees in these scenarios would have poor health and few financial assets.

Why it matters

The extra Medicaid enrollment would be in addition to the 7.2 million older people already in the program.

All the people who would potentially qualify under these different eligibility standards are unable to shoulder even modest long-term care costs without public assistance aside from their Social Security benefits – one of the largest risks facing the over 70% of older adults who will have such needs. This risk persists in part because Medicare does not cover such needs.

Low-income adults who are excluded from Medicaid under existing criteria also face high health care costs that contribute to their financial insecurity. Researchers found that 1 in 5 Americans over 65 skipped, delayed or used less medical care or drugs because of financial constraints.

Increasing the number of low-income older people with both Medicaid and Medicare coverage would reduce their out-of-pocket health spending. That would make it easier for them to hang on to their modest savings and also enable them to expand their own caregiving options should they have high medical or long-term care expenses as they age.

What still isn’t known

Increasing the number of older people with Medicaid coverage would require more government funding, although the degree of extra spending would depend on which rules the government would change.

Based on the average cost per Medicaid user, our rough estimates suggest that the cost of expanding Medicaid coverage for older people in the first four of the five scenarios we considered would range between about $8 billion and about $51 billion per year. We could not provide an estimate for the Elder Index scenario because the profile of individuals brought into the program would be substantially different from the current Medicaid users, so the per-person costs would be harder to predict.

Accurately estimating these costs and the potential benefits for families and communities that would come from these changes would require additional research.

MM Curator summary

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[MM Curator Summary]: LOL.

 
 

 
 

Clipped from: https://www.benefitspro.com/2023/07/26/hospitals-ask-congress-to-delay-aca-medicaid-funding-cuts-for-the-14th-time/?slreturn=20230627040946

Since 2013, Congress has voted 13 times to postpone billions in Medicaid funding cuts prescribed by the Affordable Care Act, siding with hospitals over their claims that losing the money would hinder the delivery of care.

 
 

It has become as familiar a sight in Washington as the cherry blossoms in spring: lobbyists from the nation’s hospitals descending on the Capitol to ask lawmakers to postpone billions in Medicaid funding cuts prescribed by the Affordable Care Act — cuts industry leaders agreed to years ago.

It is unlikely the reductions will occur this year, if history is any indication. Since 2013, Congress has voted 13 times to delay them, siding with hospitals over their claims that losing the money would hinder the delivery of care.

Unless Congress acts by October, the federal government will cut $8 billion from this year’s budget — then make the same cut each year for the next three years — for a Medicaid program intended to help safety-net facilities that serve a large share of Medicaid and uninsured patients. The amount budgeted varies annually, though in 2021 the program’s spending totaled about $19 billion.

Known as the Medicaid Disproportionate Share Hospital (DSH) payments program, it has drawn criticism amid evidence that a substantial amount of its funding goes to hospitals that do not primarily cater to low-income patients. According to industry groups, more than 2,500 hospitals — about 40% of the total in the United States — get the payments.

The cuts are part of a deal brokered with the hospital industry 14 years ago, as the fate of the ACA dangled in the balance. At the time, hospitals agreed to accept $155 billion in Medicare and Medicaid funding cuts over 10 years, assuming the legislation’s promise to insure more patients would improve their bottom lines. A portion of those cuts were to Medicaid DSH payments.

Despite record-high hospital profits and record-low uninsured rates in recent years, the hospital industry again says this is not a good time for cuts, pointing to the COVID-19 pandemic and the millions of people losing Medicaid coverage as a result of pandemic-era protections ending.

Current Medicaid funding covers only about 81% of hospitals’ costs of caring for patients, said Jolene Calla, a vice president of The Hospital and Healthsystem Association of Pennsylvania.

Losing the Medicaid safety-net funding “would be devastating to hospitals,” she said.

A bipartisan group of 231 members of the House of Representatives — a majority — have signed a letter to House leaders asking for another delay. Legislation is moving in the chamber that would delay any cuts to the Medicaid safety-net program until 2026.

The postponements show the political muscle of the hospital industry, strengthened by virtually every lawmaker’s district having at least one hospital that provides care and jobs.

Hospitals have been among the biggest donors to members of Congress and have a large lobbying force.

According to the watchdog group OpenSecrets, the Greater New York Hospital Association, which represents more than 160 hospitals, gave more than $11.8 million to congressional campaigns in the 2022 cycle. The American Hospital Association spent about $27 million on lobbying to influence lawmakers in 2022, more than nearly any other organization.

Critics say the hospital industry — which often increases prices, sues patients for lack of payment, and pays big-dollar salaries to top executives — should hold up its side of the deal it made with Democrats, particularly the Obama administration, in 2009.

“Too many hospitals have for years been trying to have it both ways, benefitting from the ACA while trying to escape responsibilities they have under the law,” said Daniel Skinner, an associate professor of health policy at Ohio University. “They constantly deploy their political power to wiggle out of these responsibilities while trying to maintain the generally good feeling they have within communities.”

Related: Profits over patients? States scrutinize nonprofit hospitals’ charity spending

On July 8, 2009, the nation’s top hospital leaders stood with then-Vice President Joe Biden at a White House press conference to announce their deal to keep national health reform legislation on track after a century of failed attempts, dating as far back as Theodore Roosevelt’s push for national insurance.

At the time, ACA reform efforts teetered as interest groups feuded and Democrats struggled to settle on a plan. The agreement, which followed a similar deal with the drug industry, was part of a plan by the Obama administration to preemptively negotiate with corporate interests that had blocked previous reform efforts.

The savings from the $155 billion in hospital funding cuts would “cover health care cost reform,” Biden said during the press conference. “As more people are insured, hospitals will bear less of the financial burden of caring for the uninsured and the underinsured, and we will reduce payments to cover those costs in tandem with that reduction.”

President Barack Obama signed the ACA into law in March 2010. The number of uninsured, which was 48 million in 2010, fell to 28 million by 2016. By 2021, the uninsured rate fell to record lows, with about 27 million uninsured.

Hospital lobbyists argue the industry has already absorbed cuts in Medicare funding under the ACA and that the Medicaid cuts should not be implemented because uninsured rates have not dropped as low as the 5% rate predicted before the law’s passage.

Though the health law has been a “godsend,” it also has not met its anticipated goal of universal coverage, said Chip Kahn, the president and CEO of the Federation of American Hospitals, which represents for-profit hospitals.

Kahn, who was involved in the agreement with the Obama White House, said the ACA has fallen short of universal coverage largely because 10 states, including more populous ones like Florida and Texas, have yet to adopt Medicaid expansion.

As a result, hospitals in these states have provided more unpaid care than anticipated and need the additional Medicaid payments to cover costs, he said.

Kahn said the extra Medicaid payments also help offset shortfalls caused by Medicare and Medicaid underpaying hospitals.

The ACA called for the DSH program’s cuts to be phased in, with less than $1 billion being cut in each of the first few years. But after hospitals lobbied Congress to postpone them, the revised budget deals meant future cuts would be deeper and immediate — leading to the $8 billion annual cuts currently slated for the coming years.

In fiscal year 2021, the most recent year for which data is available, DSH spending nationwide totaled $18.9 billion. While those payments represent 3% of overall Medicaid spending, they account for as much as 10% of some states’ Medicaid spending.

The program, intended for safety-net hospitals, has been the subject of controversy for decades.

One reason is that the money does not always go to safety-net hospitals.

A study published in Health Affairs last year found 57% of hospitals received the DSH payments in 2015. About 94% of these payments went to hospitals with either a high percentage of uninsured patients or Medicaid enrollees or higher-than-average uncompensated care.

But 6% of recipient hospitals did not meet these criteria, the study showed.

The researchers estimated that about a third of the payments went to hospitals not focused on caring for low-income populations.

Paula Chatterjee, the lead author on the study and the director of health equity research at the Leonard Davis Institute of Health Economics at the University of Pennsylvania, said hospitals aren’t transparent about how they spend the extra money and that the states that receive the most money do not always have the highest rates of uninsured residents.

While the safety-net program is intended to help hospitals treating large numbers of Medicaid and uninsured patients, the formula determining how much money states get is based on historical Medicaid spending totals before limits were put in place in 1992, she said.

As a result, states like New York and New Jersey are among the largest recipients of the supplemental funding even though they have some of the lowest uninsured rates, she said.

Beth Feldpush, the senior vice president of policy and advocacy for America’s Essential Hospitals, which represents 300 safety-net hospitals, said these facilities’ 3% average operating margin would disappear if not for DSH money. “Members of Congress recognize there are pockets of underserved communities in most congressional districts,” she said.

Chatterjee said hospitals will likely argue there is never a good time to accept the cuts. She noted some rural and urban hospitals have closed in recent years even as other hospitals have made record profits.

“It’s always hard to take money away from hospitals because they hold such symbolic meaning, and legislators know that,” she said.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

MM Curator summary

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[MM Curator Summary]: Seems some in KY still are looking for more control over who gets Medicaid benefits.

 
 

Clipped from: https://apnews.com/article/kentucky-governor-medicaid-144cb682bdb502712239271f5ef568fb

 
 

LOUISVILLE, Ky. (AP) — Republican candidate Daniel Cameron said Wednesday that he would move quickly as Kentucky’s governor to revive a push to require some able-bodied adults to work in exchange for health care coverage through Medicaid.

If he succeeds in unseating Democratic Gov. Andy Beshear later this year, Cameron said his administration would seek federal permission to impose the Medicaid work requirement. The proposed rule would exclude able-bodied adults who are “truly vulnerable,” including those with children or who are pregnant, his campaign said in a follow-up statement. Cameron declared that connecting Medicaid coverage to work for some Kentuckians would raise workforce participation in the post-pandemic era.

“That will be one way in which we tackle the workforce issue,” Cameron said while attending a forum hosted by the Kentucky Farm Bureau, which Beshear did not attend.

The issue of imposing a Medicaid work requirement is yet another stark differences between Cameron and Beshear, who is seeking reelection to a second term in November. Beshear rescinded an attempt by the state’s previous GOP governor, Matt Bevin, to create a Medicaid work requirement that Beshear says would have stripped coverage from about 100,000 Kentuckians.

Cameron, the state’s attorney general, also used his time before the farm bureau officials to lay out his views on agriculture, taxes and spending. The Republican nominee is trying to cultivate strong support in GOP-leaning rural regions to offset Beshear’s expected strength in the metropolitan areas of Louisville and Lexington. Kentucky’s showdown for governor is one of the nation’s most closely watched campaigns this year.

Cameron said he supports policies promoting “generational farming,” enabling Kentuckians to keep farming operations within their families. He said he would “lean on” the GOP-led legislature and his running mate, state Sen. Robby Mills, on whether to pursue new tax exemptions to support agriculture.

Asked about his budget priorities, Cameron pointed to law enforcement. He recently unveiled a public safety plan that included awarding recruitment and retention bonuses to bolster police forces.

“We’re going to prioritize making sure that there is money within our budget to help our law enforcement community,” Cameron said Wednesday.

Beshear has touted his crime-fighting record by noting he pushed for large pay raises for state troopers, as well as increased training for police officers. The governor says he will seek additional funding for police training and body armor to protect law officers if he wins another term.

Cameron, answering a question about taxation, said he wants property taxes to be “as low as possible.”

“But I also recognize that our schools and a lot of local entities rely on some of those taxes,” Cameron added. “And so we’ll have to be smart and deliberative about how we approach this.”

Cameron’s pledge to seek a Medicaid work rule for some able-bodied adults would put an immediate Republican imprint on his administration if he wins in November. Cameron raised the issue during the GOP primary and vowed again Wednesday to make it “one of the first things I will do as governor.”

“If we want the plan and the coverage to exist and remain solvent for those that are means-tested and medically necessary, we need to make the program, as best as possible, transitory – something that folks will come off of if they are able-bodied individuals,” he said at the forum.

Medicaid is a joint federal and state health care program for poor and disabled people. Advocates have said work requirements would become one more hoop for low-income people to jump through, and many could be denied coverage because of technicalities and challenging new paperwork.

In Kentucky, hundreds of thousands were added to the Medicaid rolls when then-Gov. Steve Beshear, the current governor’s father, expanded the program to cover able-bodied adults. For many Kentuckians, it was their first time to have health coverage in a state plagued by high disease rates.

Bevin’s plan would have required that affected recipients either work, study, volunteer or perform other “community engagement” activities to qualify for Medicaid. A federal judge blocked the requirements before they took effect, but Bevin’s administration had appealed until Andy Beshear rescinded those efforts. At the time, Beshear referred to his action as the “moral, faith-driven thing to do.” Beshear, who calls health care a “basic human right,” narrowly defeated Bevin in the 2019 governor’s race.

Cameron’s campaign said Wednesday that his proposal would require affected adults to either work, be enrolled at least part-time in college or be involved in job training or community service to stay on Medicaid.

“We will protect the truly vulnerable but we will not allow able-bodied people to take advantage of taxpayer generosity,” Cameron said in the follow-up statement from his campaign.

MM Curator summary

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[MM Curator Summary]: In which an administrative redefinition of 2 words could add whole new permanent Medicaid eligibility category.

 
 

Clipped from: https://iowacapitaldispatch.com/2023/07/18/daca-recipients-medicaid-eligibility-slammed-by-u-s-house-republicans/

 
 

Supporters of the DACA program rally outside the U.S. Supreme Court in November 2019. (Photo by Robin Bravender/States Newsroom)

WASHINGTON — A panel on the U.S. House Oversight and Accountability Committee on Tuesday grilled a Biden administration official about the White House’s decision to allow undocumented people in the Deferred Action for Childhood Arrivals program to enroll in Medicaid or private insurance provided under the Affordable Care Act.

The chair of the subcommittee, Republican Rep. Lisa McClain of Michigan, argued that the policy decision to allow those under DACA to gain access to health care coverage is “rewarding illegal immigrants at the expense of (the) American citizen.” 

“The proposal will incentivize further illegal immigration,” she said.

The hearing comes after the Biden administration in April announced rulemaking that would change the definition of “lawful presence” to include DACA recipients in Medicaid and Affordable Care Act coverage. Medicaid is a joint federal-state program that provides health coverage to low-income Americans and people with disabilities.

Democrats on the panel argued that the hearing was an attack on DACA recipients and an opportunity for Republicans to criticize the Biden administration’s immigration policy.

“Somehow, letting people who legally live in the United States buy health care is going to create a border crisis,” the top Democrat on the committee, Rep. Katie Porter of California, said. “It’d be funny to watch this bad argument fall apart if it weren’t such a waste of time.” 

The sole witness was Ellen Montz, the deputy administrator and director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services, which is part of the U.S. Department of Health and Human Services.

Montz said the proposed rule would allow about 129,000 DACA recipients to access coverage for Health Insurance Marketplaces, the Basic Health Program and some Medicaid and Children’s Health Insurance Programs. If finalized, the rule would go into effect Nov. 1.

“The COVID–19 public health emergency further highlighted the need for this population to have access to high-quality, affordable health coverage,” she said.

Montz said about 200,000 DACA recipients were considered essential workers during the early stages of the pandemic.

“During the height of the pandemic, essential workers were disproportionately likely to contract COVID-19,” she said. “These factors emphasize how increasing access to affordable health insurance would improve the health and well-being of many DACA recipients currently without coverage.”

There are about 600,000 DACA recipients, and they are protected from deportation and deemed lawfully present in the U.S.

Applications for the DACA program have been halted since 2021 following an injunction by a Texas judge, who will also determine whether the program is legal. 

Even if applications could be accepted, immigration advocates have criticized that thousands of undocumented youth are not eligible for the program, some because they were not even born yet. To qualify, an undocumented youth needs to have continuingly resided in the U.S. since 2007.

Immigration policy

Republicans on the panel argued that because of the Texas decision, DACA is considered unlawful, and therefore health care should not be extended to those recipients.

The program has not been deemed unlawful — the Texas judge found the Obama administration memorandum that created the program illegal, so the Biden administration went through the formal rulemaking process that now is before the Texas judge. 

That decision is expected in the coming months and if DACA is deemed unlawful, the case is expected to go to the U.S. Supreme Court in 2024. 

McClain took issue with HHS rewriting immigration policy. She said immigration reform should be up to Congress.

 Montz said that the agency was not crafting immigration policy and has the authority to set definitions. 

“Do we owe a legal duty to provide health care to DACA recipients over American citizens?” McClain asked Montz.

Montz said that DACA recipients are considered lawfully present in the country and therefore the Affordable Care Act would be extended to them.

“What this rule does is extend eligibility, it does not restrict eligibility for any other category,” Montz said.

Democratic Reps. Alexandria Ocasio-Cortez of New York and Greg Casar of Texas said they found the hearing inappropriate, coming off the news of a joint investigation by the Houston Chronicle and the San Antonio Express-News that reported Republican Texas Gov. Greg Abbott directed border troopers to push migrant children into the Rio Grande and deny migrants water. Wire running along the water was also installed and it led to many migrants being injured.  

“We are having this hearing on the heels of Gov. Abbott in Texas issuing an order to Texas troopers to push children and infants into the Rio Grande River. And now we’re having a hearing today about why we should push people brought here as children off health care coverage,” Ocasio-Cortez said.

Ocasio-Cortez said that DACA recipients pay about $9 billion in taxes each year.

“I do not know a group of people that oftentimes are more patriotic to this country than DACA recipients,” she said. “They give and they give and they give to a country that does not love them back.” 

Republican Reps. Glenn Grothman of Wisconsin and Eric Burlison of Missouri said the new rule would be too costly.

“At the end of the day, health care costs a lot of money,” Burlison said. “And this nation is nearly broke.”