Tag: Medicaid Reform

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[MM Curator Summary]: CMS is working to tie the new Medicaid / prison funding options to providing SUD services to the majority of inmates who have an addiction- while they are on the inside.

Clipped from: http://www.portlavacawave.com/lifestyles/health/u-s-to-allow-medicaid-to-pay-for-drug-treatment-in-prisons/article_fa289ed3-f031-5922-b23a-7219152435e3.html

WEDNESDAY, Feb. 22, 2023 (HealthDay News) — Soon, the federal government will allow states to use Medicaid funds to treat prisoners for drug addiction and mental health services.

In an announcement made during a visit to the Camden County Jail in New Jersey on Tuesday, Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy, said states are being encouraged to submit proposals for how they would like to use that money, the Associated Press reported. But the government will require that mental health and drug treatment be offered as part of allowing Medicaid funds in jails and prisons.

Gupta said the U.S. Centers for Medicare & Medicaid Services will release full guidance on the funds this spring, the AP reported. By summer, all federal prisons will offer medications to treat substance use disorder, he added.

Allowing drug treatment in prisons and jails could help keep people alive, advocates say. “We’re really hopeful that this coverage will help people improve their health outcomes and avoid additional involvement in the criminal justice system,” Gabrielle de la Gueronniere, vice president for health and justice policy at the Legal Action Center, told the AP.

A majority of incarcerated people are addicted to drugs. Former inmates are also more likely to die in the first few weeks after release than the average nonincarcerated person, because their tolerance to drugs decreases while incarcerated, the AP reported.

The significance of the change depends on the state. In New Jersey, where Gupta toured, 20 of the state’s 21 counties already have medication-assisted treatment in jails, said State Human Services Commissioner Sarah Adelman. About one-fourth of inmates in the Camden County Jail receive medication treatment, the AP reported. There, the change will be in funding, which could also make a difference. An opioid addiction treatment called Sublocade has cost the Camden County Jail more than $528,000 since 2019 for 170 people. The shot is administered every four weeks. Alternatively, a similar drug offered as a pill cost about $664,000 for 3,100 people.

Associated Press Article

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[MM Curator Summary]: Spoiler- Lasure says the plan is to not make any cuts. So keep spending. But somehow magical thinking on pharmacy financing will let us kick the can a little longer.

Clipped from: https://www.npr.org/2023/02/10/1155927034/are-medicare-and-medicaid-too-bloated-to-survive-without-changes

NPR’s A Martinez speaks with Chiquita Brooks-LaSure, the administrator for the Centers for Medicare and Medicaid Services, about the future of both programs.

A MARTÍNEZ, HOST:

All right. Next, we talk about one of the moments of this week’s State of the Union address, where President Biden claims some Republicans want to sunset Social Security and Medicare. Medicare is a federal health program for people ages 65 and older, as well as younger people with long-term disabilities. The program accounts for 10% of the federal budget. Some members of the GOP have openly called for funding cuts or changes, which they cannot do without Democratic support. But the political debate raises questions about the future of the government-funded programs, such as Medicare. I’m joined now by Chiquita Brooks-LaSure, administrator of the federal office that runs the program. That’s the Centers for Medicare and Medicaid Services. All right. Now, more than 60 million Americans are enrolled in Medicare. If there were any changes, Chiquita, to the program, who among them would be affected the most?

CHIQUITA BROOKS-LASURE: Well, the president is committed to making sure that we support Medicare and the health care programs. There are over 65 million people who are covered by Medicare. And these are our parents, our grandparents, our loved ones, and they’re young people, people who have had a disability in their life that have caused them to be dependent on the Medicare program. And the president has really worked hard over the last year, working with Congress to pass legislation to make Medicare program stronger than ever. And as you can hear, he wants to continue to make sure that there is support for the program and that we continue to make it sustainable for future generations.

MARTÍNEZ: So on that sustainability because Medicare spending is expected to more than double from the $829 billion it was in 2021 to $1.8 trillion in 2031, so given what – that definitely seems and looks like a massive cost increase. How would you describe the program’s long-term viability?

BROOKS-LASURE: I would say that this is something, Medicare spending, that we always have to look at. Every couple of years, it’s important for Congress to continue to make adjustments. And we made, as I mentioned, some real down payments on improving the program last year. The most important of that would be the Inflation Reduction Act or, as I like to call it, the new prescription drug law because it had really important protections not only for the people who depend on the program but also for the program’s sustainability itself – so changes to make sure that we hold companies responsible if they increase their prices above inflation on prescription drugs, which helps the Medicare program. And we saw some changes at the end of the year to the program that really help make sure it’s sustainable, like including mental health services. And the president will continue to put out more information as he releases his president’s budget.

MARTÍNEZ: But, Chiquita, let me ask you this really quick in the time we have left. Is it possible to streamline the spending without streamlining the services?

BROOKS-LASURE: There are changes that are important and necessary, so – that don’t lead to decrease in services. So we are absolutely looking at ways to make sure that we are paying appropriately. We’ve put out a number of administrative proposals to make sure that people are getting the care that they need. And that’s been a real priority, of making sure that the dollars are spent wisely. But we do need to continue to make changes that don’t cut benefits. But there are changes that will cut benefits, and that’s why the president was so emphatic about saying we have to protect the program and not put in arbitrary rules about how Medicare spending will operate so that it doesn’t end up hurting the people that depend on it every day.

MARTÍNEZ: I want to try and squeeze in Medicaid because enrollment spiked in the pandemic. And the Biden administration is ending the COVID-19 public health emergency May 11. A lot of low-income people could lose their coverage. What is your agency doing about that?

BROOKS-LASURE: We have been so thrilled to see the enrollment in Medicaid, CHIP and Affordable Care Act – or the Obamacare – rise to record levels. And we are working very hard with states as people transition, and maybe if their incomes have increased, that we make sure that they get coverage through either the Affordable Care Act coverage or get to employer-sponsored insurance. One of the key roles is making sure that states can find people and – if they’ve moved or things have changed. So one of the things we encourage everybody who is on Medicaid is to make sure they’re looking at the information that their states are sending to them…

MARTÍNEZ: OK.

BROOKS-LASURE: …About updating their information. And that’s one of our top priorities this year.

MARTÍNEZ: Chiquita Brooks-LaSure is the administrator for the Centers for Medicare and Medicaid Services. Thanks a lot for your time.

BROOKS-LASURE: Thank you.

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[MM Curator Summary]: Chucky says talk to the hand.

Clipped from: https://news.yahoo.com/chuck-schumer-vows-no-cuts-000342140.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAALMMY3tMR3RhrBoLTCC4IVoMnJqTkqJLK9JvU3K6_47OwWsDqX-MvLdIM-nGFWO39Gv-jR5JqFS5UF0j6GZh55r-5lDL3rrJUfch3b7NXpM7nSCrrZePaXTlrzUbV_EF3nWn5iftRoHCVIcvk4mdCEoLkf12knLVhqBSHzgeCuGg

President Joe Biden Faces Off Against Republicans

The president called out certain Republicans who have threatened to get rid of social security and some members of the GOP were not happy.

Senate Majority Leader Chuck Schumer (D-N.Y.) made clear that Democrats won’t accept cuts to Medicaid, the government health insurance program for low-income Americans, amid the ongoing standoff with Republicans over the nation’s borrowing limit.

“It’s a very popular program and we will defend it. We don’t think any cuts on Medicaid, just like cuts on Medicare and Social Security, should be attached to debt ceiling brinksmanship,” Schumer told HuffPost at a Wednesday press conference on Capitol Hill.

Medicaid, whose enrollment is now above 80 million, hasn’t been in the spotlight as much lately as other critical safety net programs like Social Security and Medicare.

Republican leaders have promised that Social Security and Medicare benefits for current recipients are not on the table for cuts as it relates to talks over raising the debt limit this year, but they haven’t made a similar explicit commitment for Medicaid benefits.

Medicaid spending has been a top GOP target over the years as the party has sought to address the nation’s deficits and debt. Former House Speaker Newt Gingrich (R-Ga.) tried to extract Medicaid cuts from President Bill Clinton, leading to the federal government shutdown of 1995 and 1996. Former Speaker Paul Ryan (R-Wis.) also targeted Medicaid spending in his budget proposals a decade ago.

Medicaid spending grew substantially after the passage of the Affordable Care Act in 2010, which allowed states to expand the program to all people in households with incomes below or just above the poverty line.

Republican lawmakers are being careful not to spell out which specific programs they want to cut this year, speaking only in general terms about the need to get the nation’s fiscal house in order.

“I just don’t think it’s really productive in the debt ceiling talks to establish what is a sacred cow and what should be on the chopping block specifically,” Sen. Cynthia Lummis (R-Wyo.) told HuffPost when asked about Medicaid. “It’s really too delicate a conversation to say that a certain aspect of our problem is totally off the table. If we do that, we are just hamstringing our own ability to come up with a creative solution.”

The nonpartisan Congressional Budget Office on Wednesday released a projection saying that the federal government won’t be able to pay its obligations beginning sometime between July and September. Congress must raise the debt limit before then or risk an unprecedented default that could rattle financial markets and harm the economy.

Biden and congressional Democrats have held firm in their position so far that the debt limit, which Republicans raised easily three times under President Donald Trump, shouldn’t be held hostage. If Republicans want to negotiate over spending, Democrats add, they should do so separately during the regular congressional budget process.

But Republicans, led by House Speaker Kevin McCarthy (R-Calif.), have continued to call on Biden to negotiate over spending cuts and the debt limit. They’ve yet to release a plan for their desired spending restrictions and the clock is ticking.

“Very soon the MAGA brigade will see that the Speaker made a bunch of promises that he won’t be able to keep. And I worry greatly that the dangers of slipping into default will only increase as the toxic dynamic within the House GOP gets worse day by day,” Schumer said Wednesday.

MM Curator summary

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[MM Curator Summary]: With the explosive growth in Medicaid enrollment the past few years, and it now paying for everything- good luck prying it from the hands of bennies.

Clipped from: https://www.politico.com/newsletters/politico-nightly/2023/02/14/how-vulnerable-is-medicaid-in-the-debt-ceiling-battle-00082903

About The Author : Joanne Kenen

BIRTHS, DEATHS AND OPIOIDS — Medicare and Social Security look like they are off Washington’s proverbial budget-cutting table in this spring’s debt ceiling showdown after President Joe Biden’s impromptu sparring with the GOP during the State of the Union.

That could mean Medicaid — the combined federal-state health program that currently covers about 90 million low-income Americans, including lots of kids and elderly people — will have a great big spot of its own on that spending cut table.

Nobody knows how intense the brinkmanship over raising the national debt ceiling will be, or how deep the partisan acrimony may run a few months from now when we hit the “X date” when the federal government won’t be able to pay its bills. Either way, Medicaid is politically better positioned to weather the storm than ever.

The House Republican “Commitment to America” released before the fall elections was vague on trimming spending, and even more vague on health policy. The conservative Republican Study Group’s budget blueprint for the current fiscal year would have restructured Medicaid entirely and cut $3.6 trillion over a decade compared to the current spending trajectory — but there’s no way that Democrats (or even some more establishment Republicans) would accept that.

Medicaid, once the overlooked stepchild to the big two entitlements, Medicare and Social Security, has become a bigger part of the U.S. safety net. And it’s got a much stronger constituency. Republicans included a bid to turn Medicaid into a block grant program — an idea that dates back to the Reagan years — as part of its decade-long effort to repeal the Affordable Care Act. But that assault on Medicaid was one reason repeal failed.

“Medicaid is way more politically resilient than people think,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. He noted it’s the largest payer of nursing home care in the U.S, and it’s a lifeline for disabled kids and their families, both very politically sympathetic populations.

The program has expanded a lot over the years, including covering more low income people under Obamacare, although 11 states are still refusing to take part. Many more people got Medicaid coverage during Covid, although some will lose Medicaid as the public health emergency declaration winds down.

More than half of US kids are covered by Medicaid and its sister program the Children’s Health Insurance Program or CHIP. In some states, more than half of births are covered, and it provides postpartum care, including to minority populations that have disproportionately high rates of maternal death. And it covers long-term care for the poor elderly — or people who became poor after spending most of their savings on long-term care.

“Medicaid now is touching the majority of families in the country. It’s part of people’s lives at critical junctures. Birth and death,” said Joan Alker, executive director of the Center for Children and Families at Georgetown University. Meaning renewed Republican efforts to target it will likely receive pretty intense pushback.

It’s also a huge payer for mental health and for addiction treatment for opioids, including for kids.

“If you are cutting Medicaid, you are chopping at mental health in a bad way,” said Ezra Golberstein, a University of Minnesota health economist who studies behavioral health.

And — as if all that wasn’t enough — Medicaid keeps safety net hospitals afloat. And those hospitals, which treat a large share of poor people in both rural and urban settings, are in an even more precarious financial position than usual after the pandemic.

“They are fragile in the best of times,” said Bruce Siegel, president and CEO of America’s Essential Hospitals, which represents those hospitals. Now, he said, “they are losing money,” partly because of high labor costs and temporary staff brought in to fill pandemic-related shortages. Even without a big GOP attempt to overhaul Medicaid, these hospitals face a scheduled cut in special payments they get — although Congress has reversed similar planned cuts to health providers in the past.

“Cutting Medicaid,” Siegel said, ” would lead to some hospitals, major systems in this country, closing access — and potentially closing hospitals.”

Medicaid is a great big pot of money — more than $700 billion in fiscal 2021 (though it may decline as the pandemic wanes). So if budget cutting is the name of the game this spring, Republicans will likely take another run at it. Even if they don’t go down the block grant path, there are a host of other conservative ideas — charging premiums, enacting work requirements, limiting eligibility — that they could turn to.

Which doesn’t mean they will succeed.

Tom Miller, a health expert at the center-right American Enterprise Institute who has written extensively on what he sees as more realistic conservative approaches to improving Medicaid, including broader use of federally-approved waivers for states, expects conservative Republicans to try again this year — and again overreach and fail.

“There’s healthcare blustering,” he said. “And the blustering stage may be at another magnitude.”

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[MM Curator Summary]: The Good Guvnr is taking another run at it, and instead of kicking able-bodied members off if they don’t work, they get moved into crappy fee for service. Who stands to lose in this? It rhymes with banaged flare schmorganizations.

Clipped from: https://www.arkansasonline.com/news/2023/feb/16/sanders-announces-proposed-work-requirement-for/

The state Department of Human Services is seeking federal approval to require participants in Arkansas’ Medicaid expansion program to work, volunteer or enroll in training or classes, Gov. Sarah Huckabee Sanders announced Wednesday.

The new requirement would apply to recipients of the Arkansas Health and Opportunity for Me program, or ARHOME, an expansion that uses Medicaid dollars to buy private health insurance for participants, Sanders said during a news conference.

Unlike the state’s previous Medicaid work requirement, ARHOME recipients would not lose Medicaid coverage if they failed to meet the requirement outlined in Sanders’ proposal. Instead, their coverage would revert to traditional Medicaid fee-for-service coverage.

“Arkansas is still too far behind in making sure able-bodied citizens are working,” the Republican governor said. “We need a clear path for Arkansans to move from government dependency to financial independence.”

More than 300,000 adults are enrolled in the ARHOME program. The Medicaid expansion offers coverage to Arkansans with incomes below 138% of the federal poverty level, which corresponds to an annual income of $18,000 for a one-person family, said Kristi Putnam, secretary of the Department of Human Services.

The Department of Human Services plans to publish a draft Medicaid waiver amendment April 23 that would remain open for a 30-day public comment period. On June 1, the state expects to submit the waiver amendment to the federal Centers for Medicare and Medicaid Services. State officials are proposing Jan. 1, 2024, as the effective date for the new requirement, Putnam said.

Arkansas became the first state to implement work requirements for a Medicaid expansion in June 2018. More than 18,000 people lost their health coverage while the requirement was in place over nine months. A federal judge blocked the requirement in a 2019 ruling. At the time, the state’s Medicaid expansion program was known as Arkansas Works.

Under former President Donald Trump, 13 states received approved work requirements for Medicaid programs. Arkansas was the only state that enacted its requirement and took action against recipients who failed to comply. Other states began instituting requirements but did not cut Medicaid coverage for recipients due the coronavirus pandemic and litigation.

The Centers for Medicare and Medicaid Services under President Joe Biden has finalized the withdraw of waivers from all states that approved work requirements under the previous administration, according to the nonprofit Kaiser Family Foundation.

Sanders said she expects federal officials to approve the state’s request. She said the measure was “fully compliant with previous court rulings” and reiterated that it differed from previous work requirements in that it would not lead to Arkansans losing Medicaid coverage.

While several states have instituted various forms of work requirements tied to Medicaid, Department of Human Services spokesman Gavin Lesnick said none has taken the same approach that Sanders has outlined.

When asked about what would incentivize ARHOME participants to fulfill the work requirement, Putnam said the state expansion provides enhanced benefits compared to traditional Medicaid coverage, including additional health and social supports.

Since there is currently no work requirement in effect, state officials are not tracking the number of ARHOME recipients who aren’t working, volunteering or taking classes, said Lesnick.

State law wouldn’t have to change for officials to institute the work requirement. Statutes allow the department to use qualified health plan enrollment “as an incentive to foster economic independence,” said Putnam.

Rep. Lee Johnson, who chairs the House Committee on Public Health, Welfare and Labor, voiced support for the work requirement, saying that boosting the state’s labor force was a top priority for officials.

“Anything we can do to address the workforce shortage we’re having right now in Arkansas is important. I think it’s arguably the most important economic thing we can do,” said Johnson, a Republican from Greenwood. “A strategy like this seems to be something that can help alleviate some of those concerns.”

Jodiane Tritt, executive vice president of the Arkansas Hospital Association, said her organization was happy to see Arkansans wouldn’t lose Medicaid coverage under the proposed work requirement.

“We most definitely approve of the fee-for-service safety net,” she said during an interview Wednesday. “We feel that having coverage in this requirement is much better than the previous work requirement.”

Tritt noted that most hospital types see lower reimbursement rates for patients with traditional fee-for-service Medicaid than for patients with qualified health plans like those offered by the ARHOME program. The impact of patients shifting to fee-for-service coverage would vary between hospitals according to their patient mix, Tritt said.

Will Watson, director of strategy for the Democratic Party of Arkansas, called the work requirement “a mean-spirited tactic already rejected by a federal judge” in a statement Wednesday.

Senate minority leader Greg Leding, D-Fayetteville, said that while work requirements for Medicaid programs may be politically popular, he doesn’t believe they are effective. A better approach to growing the workforce, he said, would be for state officials to focus on providing Arkansans access to better transportation, stable housing and social support networks.

“People aren’t just choosing not to work,” Leding said Wednesday.

Harvard researchers in a 2020 analysis found that Arkansas’ previous work requirement did not increase employment among 30-to-49 year-olds — the demographic targeted by the policy — when compared to states without work requirements.

When asked about studies that showed work requirements were ineffective, Sanders said “the goal always has to be to encourage people to get into the workforce and not be fully dependent on the government.

“Any time we can offer pathways and incentives we’re going to look for that.”

The number of hours an ARHOME participant would have to work, volunteer or take classes per month under the requirement has yet to be determined. State officials will address specifics of the program as they develop the draft amendment for public comment, Lesnick said in an email Wednesday.

Continuous coverage requirements for states’ Medicaid programs are set to phase out starting April 1 under the federal public health emergency. Recipients who are no longer eligible or do not respond to renewals may start losing coverage then even if the federal emergency is continued.

“We estimate between 15 and 30 percent of Medicaid recipients who have had their coverage extended because of the Public Health Emergency (PHE) and who are in categories outside of the Long Term Services and Supports (LTSS) populations may be disenrolled,” Lesnick said.

The department, however, won’t know precisely how many Arkansans will be impacted until it completes the unwinding process and redetermines eligibility for the affected recipients. This process will be completed within six months of April 1.

The total enrollment in Medicaid at the end of 2022 was 1,143,219, Lesnick said.

 Gov. Sarah Huckabee Sanders listens Wednesday at the state Capitol as Kristi Putnam, secretary of the state Department of Human Services, discusses plans for ARHOME recipients. Putnam said statutes allow the department to use qualified health plan enrollment “as an incentive to foster economic independence.” (Arkansas Democrat-Gazette/Thomas Metthe)
  

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[MM Curator Summary]: The fight to trim the SNAP/Medicaid spending in Iowa now has a Senate bill version.

Clipped from: https://iowacapitaldispatch.com/2023/02/15/bill-could-make-iowans-with-cars-savings-ineligible-for-snap-medicaid/

The Salvation Army of Ames stocks shelves with food donations from community members as well as corporate contributions. (Photo by Kate Kealey for Iowa Capital Dispatch)

Having a car or modest savings could disqualify families for some public assistance under a bill lawmakers are considering in the Iowa Senate.

Senate Study Bill 1105 would require an asset test for Iowans applying for SNAP and Medicaid assistance. The Senate bill does not include changes proposed in the House legislation that restrict the use of SNAP to purchase certain foods, including soda and candy.

A subcommittee on Wednesday recommended moving the bill forward with amendment to the Senate Health and Human Services Committee.

The asset limit would match the federal asset test guidelines, which would mean families could have a maximum of between $2,750 and $4,250 in assets, depending on the disability status of household members, to remain eligible for the public assistance programs. The test would apply to both savings and property like cars and land.

Speakers and legislators questioned Wednesday whether the bill’s asset limit tests would kick off kids from program benefits if their parents were found ineligible when factoring in their assets’ value.

Following the pandemic and supply chain problems, even used cars skyrocketed in value, lobbyists speaking against the bill said. That would automatically disqualify many legitimately needy Iowans from accessing assistance. It also could mean if a household with children exceeds these value limitations, the kids’ coverage in these program could be affected.

Sen. Jeff Edler, R-State Center, said he would check with Iowa HHS staff on children’s qualifications, but still stood in support of some form of asset test. He said families with snowmobiles or $5 million worth of land in Nebraska should not be receiving taxpayer money in Iowa.

“I think we need to work together to try and figure out how do we truly get help to these folks,” he said, and asked for suggestions of what asset level would be appropriate.

Representatives of Iowa food banks and hunger assistance programs said many Iowa residents who face food insecurity already do not qualify for the Supplemental Nutrition Assistance Program, SNAP, under state law. Even though SNAP use is at a 14-year low, Iowans are coming at record-high numbers to get assistance from food banks, Luke Elzinga with the Des Moines Area Religious Council Food Pantry Network and the Iowa Hunger Coalition said.

It’s unrealistic to expect rural Iowans to live without cars, Elzinga said, and not being able to save money could keep those people from exiting poverty long term.

“This tells me that the state should be looking at ways to expand access to the program,” Elzinga said.  “Investing in things like Double Up Food Bucks, looking at raising the income eligibility for SNAP. This really feels like a step in the wrong direction for our state.”

Other changes include a requirement for single parents to work with the state on child support payment enforcement to stay eligible, and for new documentation requirements.

These new stipulations will make it harder for people in need to access food or health care, Laura Hessburg with Iowa Coalition Against Domestic Violence said. Victims leaving an abusive home often do not have time to grab the IDs or documents they would need under the legislation to prove their eligibility. Additionally, it would be dangerous to force domestic abuse survivors to contact their abuser about child support to qualify for benefits, she said.

Additionally, speakers opposed to this bill repeatedly brought up Pennsylvania, where the state’s asset test was reversed within three years of implementation because a study showed its high cost to the state.

But lobbyists with conservative groups like Americans for Prosperity and the Opportunity Solutions Project spoke in support of the legislation, saying lawmakers have an obligation to serve as responsible stewards of taxpayer funds. Asset tests are not meant to keep people in need off of assistance programs, but instead make sure the money isn’t going to people who shouldn’t receive it.

Scott Centorino with the Opportunity Solutions Project said it’s important to remember Pennsylvania is not the only state that has  implemented asset tests. He said other states have “gotten ahead” of Iowa on welfare accountability measures.

“For every Pennsylvania, there’s a Missouri or a South Dakota or a Kansas,” Centorino said. “Those states have not turned back.”

The legislation will next be discussed by the full Senate Health and Human Services Committee.

MM Curator summary

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[MM Curator Summary]: More on the push to convert CMS into USDA.

Clipped from: https://www.usatoday.com/story/money/personalfinance/2023/02/15/food-medicaid-programs-explained/11258161002/

“Food as medicine” may be coming to a health plan near you.

More states are testing Medicaid programs that’ll provide more people with healthy foods and, potentially, lower healthcare costs. 

Medicaid typically only covers medical expenses, but Arkansas, Oregon and Massachusetts received approval from the Centers for Medicare & Medicaid Services (CMS) last year to use a portion of their Medicaid funds to pay for food programs, including medically tailored meals, groceries and produce prescriptions (fruit and vegetable prescriptions or vouchers provided by medical professionals for people with diet-related diseases or food insecurity). California already was running a food program under a different CMS approval. The aim is to see whether providing people with nutritious foods can effectively prevent, manage, and treat diet-related diseases.  

“A lot of what ails our health care system is overutilization because we’ve never changed the lifestyles that take us into the health care system in the first place, and that starts with your diet,” said Indiana Senator Mike Braun at a hearing in December. 

Eradicating hunger:New push to cut hunger, improve Americans’ diets touted at White House conference

Though different processes will be tested, Massachusetts and California allow medical professionals to refer struggling patients to a local food assistance organization to determine their needs. That could result in grocery store gift cards, kitchen supplies, cooking classes, nutrition counseling or a service that will deliver “medically tailored meals” to patients. In Massachusetts, patients are checked on every three months. 

In November, the U.S. Department of Agriculture (USDA) invested $59.4 million partly to support so-called “produce prescriptions” from a health care provider for fresh fruits and vegetables. 

Does food as medicine work? 

“The relationship between what we eat and how it affects our health and mortality is clear,” said Dan Glickman, co-chair of the Task Force on Hunger, Nutrition, and Health, at a hearing in December. 

A study published last fall estimated that if all patients in the U.S. with mobility challenges and diet-related diseases received medically tailored meals, 1.6 million hospitalizations would be avoided, with a net savings of $13.6 billion annually. 

Another study in 2019 found that over the course of about a year, the meals resulted in 49% fewer inpatient admissions and a 16% cut in health care costs compared with a control group of patients who did not receive the meals. 

Priorities:Biden has lofty plan to ‘end hunger.’ But president must address Americans’ urgent needs.

Fighting diabetes:Diabetes care gets major update: More aggressive approach to weight loss, cholesterol, disparities recommended

This spring, the American Heart Association and Rockefeller Foundation will launch a $250 million “Food is Medicine” Research Initiative to determine if such programs can be developed cost-efficiently enough to merit benefit coverage and reimbursement for patients, said Kevin Volpp, director at the University of Pennsylvania’s Center for Health Incentives and Behavioral Economics and leader of the initiative. 

CMS requires such programs to be neutral to the federal budget and capped at 3% of the state’s total Medicaid spend, according to Madeline Guth, senior policy analyst with KFF’s Program on Medicaid and the Uninsured.

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Medora Lee is a money, markets, and personal finance reporter at USA TODAY. You can reach her at mjlee@usatoday.com and subscribe to our free Daily Money newsletter for personal finance tips and business news every Monday through Friday morning.