Tag: State News

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Biden administration likely to cancel controversial SC Medicaid work requirements

 
 

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SC is another state that will be denied the opportunity to test their CMS-approved work requirements.

 
 

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.

 
 

File/Lauren Petracca/Staff

A program approved by the Trump administration requiring South Carolina adults with Medicaid to prove that they work or participate in various community engagement activities will likely be eliminated under the new Biden administration before it even gets off the ground. 

“Healthy Connections Works” was approved by the federal Centers for Medicare & Medicaid Services in 2019, but has not been implemented to date, according to the federal government. It would have eventually required adults with Medicaid coverage in South Carolina to prove that they spend at least 80 hours a month working or engaging in other productive pursuits outside the home, such as education, job skills training or community service. 

In a letter to the South Carolina Medicaid agency dated Feb. 12, the Centers for Medicare & Medicaid Services laid out several reasons why the program was “infeasible.” 

“CMS has serious concerns about testing policies that create a risk of substantial loss of health care coverage in the near term. The COVID-19 pandemic has had a significant impact on the health of Medicaid beneficiaries,” wrote CMS Acting Administrator Elizabeth Richter. “Taking into account the totality of circumstances, CMS has preliminarily determined that allowing work and other community engagement requirements to take effect in South Carolina would not promote the objectives of the Medicaid program.” 

The state will have 30 days to submit information in favor of sustaining the work requirements. 

In the lead-up to its approval three years ago, Gov. Henry McMaster championed the plan, citing that jobs yield healthier lifestyles, financial independence and opportunity. 

“Whenever possible, we should always endeavor to help South Carolinians in need find their path to gainful employment and away from the temporary assistance of government,” McMaster said in 2018. 

 
 

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McMaster’s office did not immediately respond to questions about the federal decision on Saturday.

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Ten states, including South Carolina, approved Medicaid work requirements under the Trump administration, but Arkansas was the only state to fully implement the rules, according to Politico. 

Critics meanwhile argued the plan didn’t take into account a lack of available jobs, child care or transportation. 

Sue Berkowitz, executive director of the Appleseed Legal Justice Center in Columbia, has protested the Medicaid work requirements since they were first proposed. If the rules had been implemented, she said her group would have challenged them in court. 

“The premise that work makes people healthy was just ludicrous. No. When people are healthy, they are able to work,” Berkowitz said. “Needless to say McMaster’s office and our office have differing opinions on this. He was clearly following the lead of Trump … without doing the work of determining if this was really in the best interest of South Carolina.” 

At one point, the state Medicaid agency anticipated 180,000 adult Medicaid beneficiaries in South Carolina would be subject to the work rules, but that most of them already satisfied the requirements or would qualify for an exemption. Former S.C. Medicaid Director Joshua Baker estimated fewer than 10,000 adults with Medicaid coverage would need to look for work or risk losing their health insurance. 

Those estimates are likely low now considering the growth in Medicaid enrollment during the pandemic. Medicaid eligibility rules vary widely from state to state, and in South Carolina, existing rules make it difficult for adults without children to qualify for coverage, no matter their poverty level. Still, adult enrollment in the program has grown substantially during the COVID-19 pandemic. 

In December, more than 1.3 million South Carolinians were enrolled in Medicaid, representing a jump of about 90,000 beneficiaries since last March. About half of all Medicaid enrollees in this state are children, but largest gains in enrollment growth were observed among adults this past year.

Clipped from: https://www.postandcourier.com/health/biden-administration-likely-to-cancel-controversial-sc-medicaid-work-requirements/article_8206b49e-6dfb-11eb-9915-df24179bda51.html

 
 

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Biden’s HHS to rescind Medicaid work requirements; NH attempt thwarted by courts

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Biden’s CMS has let 10 states that requested and received approval for their work requirements features that they are being un-approved.

 
 

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.

 
 

WASHINGTON — The Biden administration was planning Friday to wipe out one of the core health policies of the Donald Trump era, taking actions that will immediately rescind permission for states to compel poor residents to work in exchange for receiving Medicaid benefits.

Federal health officials will withdraw their predecessors’ invitation to states to apply for approval to impose such work requirements and will notify 10 states granted permission that it is about to be retracted, according to a draft plan obtained by The Washington Post and confirmed by two individuals familiar with the decision.

The actions anticipated Friday, outlined in bullet points in the draft, will come two weeks after President Joe Biden signed an executive order instructing officials to remove barriers to Medicaid coverage. Work requirements enabled under President Donald Trump were the one policy mentioned in Biden’s directive.

In practice, the moves have little immediate effect because work requirements adopted in three states — Arkansas, Kentucky and New Hampshire — have been ruled illegal by two levels of federal courts, and other states have held back during the legal challenges to the policy. A case on the constitutionality of such requirements is now before the Supreme Court.

Still, the swift rescinding of the Trump administration’s effort to remake the safety-net program represents a particularly sharp pendulum swing on the ideological divide over the proper roles of government and individuals living under economic strain.

Spokesmen for the Department of Health and Human Services did not respond Thursday night to a request for comment on the plan, first reported by Politico.

Medicaid, a collaboration between the federal government and states, was a pillar of the War on Poverty of the mid-1960s and is the nation’s largest source of public health insurance. For years, conservative state leaders had sporadically asked federal officials to allow them to compel some people on Medicaid to work for their benefits, but such requests always had been rebuffed.

However, in early 2018, Seema Verma, then-administrator of the Centers for Medicare and Medicaid Services, issued a letter to state Medicaid directors inviting them to apply for permission to create what she called “community engagement requirements,” in which certain people on Medicaid would need to work or participate in activities to prepare for employment. That letter is expected to be withdrawn Friday, according to the draft and the individuals who spoke on the condition of anonymity before the actions are made public.

Verma and other proponents have contended that such requirements promote economic self-reliance, eventually weaning poor people off government assistance. Undeterred by court rulings against the requirements, she advocated for them until the Trump administration ended last month. “I support innovative efforts by governors that are trying to help people, trying to lift them out of poverty and find a path forward” she told the Aspen Institute in October.

Opponents of the policy, including most Democrats, counter that insurance that helps poor people to be healthy is a prerequisite to being able to work. Unlike the federal welfare system, which has required work since the mid-1990s, they argue, health coverage should be considered a right, not a privilege that is contingent on following other rules.

In its planned announcement, the Biden administration said the requirements were especially unwise during the coronavirus pandemic, which has sickened millions of Americans and forced many out of work. The agency overseeing Medicaid “has serious concerns that now is not the appropriate time to test policies that risk a substantial loss of health care coverage or benefits,” according to the draft plan.

According to the 15-page document, the Trump administration approved work programs in 13 states, and 10 others were still seeking approval. A few withdrew when GOP governors were replaced by Democrats. Arkansas was the only state that actually implemented its requirements, and 18,000 poor residents there were removed from Medicaid rolls over several months before the program was blocked by a judge on the U.S. District Court for the District of Columbia.

Accompanying the steps to reverse the Trump policy, HHS also plans to release an analysis Friday assessing how the Trump policy limited low-income Americans’ access to health coverage, according to the two individuals familiar with the plans.

The analysis was overseen by Ben Sommers, a longtime Harvard researcher who joined HHS last month as a deputy assistant secretary for strategy and planning and had previously written about the drawbacks of Medicaid work requirements, the officials said. “[W]e found no evidence that the policy succeeded in its stated goal of promoting work and instead found substantial evidence of harm to health care coverage and access,” Sommers and colleagues wrote in a September 2020 analysis in the journal Health Affairs.

Sommers did not respond Thursday night to a request for comment.

Clipped from: https://www.unionleader.com/news/health/bidens-hhs-to-rescind-medicaid-work-requirements-nh-attempt-thwarted-by-courts/article_28c3add2-122c-5f41-abd8-0a572b72a6e3.html

 
 

 
 

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Feds temporarily halt approval of Georgia Medicaid overhaul backed by Gov Kemp

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Biden administration nullified the work requirements requested by GA (and approved by CMS), citing COVID as too much a barrier to compliance.

 
 

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.

 
 

 
 

October 15, 2020 Atlanta – Governor Brian Kemp and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma celebrate with fist bump after they signed on healthcare reform at the Georgia State Capitol on Thursday, October 15, 2020. The federal government approved Gov. Brian Kemp’s plan to reshape Medicaid and individual insurance in Georgia under the Affordable Care Act, the governor and a top Trump administration health official announced on Thursday. (Hyosub Shin / Hyosub.Shin@ajc.com)

The Biden administration pulled back approval of Gov. Brian Kemp’s plan to provide Medicaid coverage to thousands of low-income and uninsured adults in Georgia who meet a work or activity requirement because the still-raging coronavirus pandemic makes meeting some of the key guidelines “unfeasible.”

Federal health officials said Friday the state’s Medicaid overhaul proposal was switched from “approved” to “pending” over concerns that it’s “unreasonably difficult or impossible for many individuals to meet the community engagement requirement” in the plan in the midst of a global coronavirus outbreak.

“Taking into account the totality of circumstances, CMS has preliminarily determined that allowing work and other community engagement requirements to take effect in Georgia would not promote the objectives of the Medicaid program,” according to a letter sent to state officials by Elizabeth Richter, the acting administrator for the Centers for Medicare and Medicaid Services.

The decision could undermine the centerpiece of Kemp’s plan to reshape Medicaid in the state, which was greenlit by President Donald Trump’s top health official in October. At the celebratory press conference, Kemp declared the “status quo is simply unacceptable” as he cited the state’s lofty premium costs and high level of uninsured people — second-worst in the nation.

Kemp’s office said Saturday it was reviewing the decision by President Joe Biden’s administration, which throws into doubt the fate of his plan to allow perhaps as many as 50,000 poor and uninsured adults be added to the Medicaid rolls within two years. Kemp’s health deputies have 30 days to respond.

Advocacy groups and Democrats applauded the move and amplified calls for a full Medicaid expansion to all the state’s very poor, as envisioned by the Affordable Care Act and already carried out by 39 states. State Republican leaders say a full expansion is too costly in the long run, although some GOP elected officials have embraced the idea.

State Sen. Michelle Au, a physician and newly elected Johns Creek Democrat, said she was happy to see the “misguided work requirements” were under new federal scrutiny. And state Sen. Jen Jordan said she hoped the decision scuttled Kemp’s “half-measure” and put full expansion of the program within reach.

“This is really positive news,” said Jordan, D-Sandy Springs. “Because if we can be fiscally responsible, cover more people and make sure everyone has access to expanded health care, it would be a big step forward.”

Georgia Medicaid now mostly covers children, and some adults, such as those who’ve been declared disabled by the government. Under Kemp’s plan, other working-aged Georgians could apply but would have to meet requirements the state would impose. That might include working at a registered employer for 80 hours a month or attending college full time.

A separate Kemp waiver program also approved last year by Trump’s administration appears to remain intact. That plan amounts to a “reinsurance” plan to lower premium prices for those who buy individual insurance. If that proposal moves forward, Kemp plans to pour public money into the private insurance market with a goal to reduce premium prices for some Georgians.

Staff writer Ariel Hart contributed to this report.

WHAT IT MEANS

The decision throws into doubt the fate of the governor’s plan to allow perhaps as many as 50,000 poor and uninsured adults be added to the Medicaid rolls within two years.

 
 

Clipped from: https://www.ajc.com/politics/feds-temporarily-halt-approval-of-kemps-medicaid-overhaul/FVWZNMVD7BCYVFJIZZXIUQIJP4/

 
 

 
 

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GAO: Puerto Rico spent most of its ’18 Medicaid budget on contractors

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GAO dings CMS for not monitoring vendor payments in the PR Medicaid program.

 
 

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 U.S. Government Accountability Office (U.S. GAO) released a report urging the Centers for Medicare & Medicaid Services (CMS) to crack down on Puerto Rico’s procurement process, as in 2018 the Commonwealth paid contractors almost all of its Medicaid spending, or 97% of its $2.5 billion budget.

The GAO’s recommendation of a “risk-based oversight approach” by the CMS received the backing of the US Department of Health and Human Services.

“States and US territories paid contractors about half of their Medicaid spending for health care and other services in 2018,” the GAO said. “We found that the CMS does not oversee contracting in Puerto Rico, where former officials face allegations of contract fraud. We found that Puerto Rico did not always take steps to ensure competition or to lower the risk of fraud, waste, and abuse.”

“We recommended CMS begin risk-based oversight of contracting in Puerto Rico,” the agency said.

In its report, the GAO found that like other US territories and states, Puerto Rico implements major functions of its Medicaid program by procuring services from contractors, such as the delivery of managed care services to Medicaid beneficiaries.

“In 2018, procurement costs represented $2.4 billion of Puerto Rico’s $2.5 billion in total Medicaid expenditures. A 2019 federal indictment alleging Puerto Rico officials unlawfully steered Medicaid contracts to certain individuals has raised concerns about Puerto Rico’s Medicaid procurement process, including whether this process helps ensure appropriate competition,” the GAO said.

The CMS, within the US Department of Health and Human Services, is responsible for overseeing the Medicaid program. CMS requires states and territories to use the same process for Medicaid procurements as they do for their non-federal procurements.

“However, CMS has not taken steps to ensure Puerto Rico has met this requirement. Instead, CMS has relied on Puerto Rico to oversee the territory’s procurement process and to attest to its compliance,” the GAO said.

“CMS approved Puerto Rico’s attestation of compliance in 2004 and has not required subsequent updates. CMS officials told GAO that states and territories are in the best position to ensure compliance with their respective procurement laws,” it added.

The GAO went on to say that it, and others, “have found that competition is a cornerstone of procurement. Using competition can reduce costs, improve contractor performance, curb fraud, and promote accountability.”

“GAO reviewed selected Puerto Rico Medicaid procurements against federal procurement standards designed to promote competition and reduce risks of fraud. States and territories are generally not required to meet such standards. However, GAO and others have found that such standards can indicate whether a state’s or territory’s procurement process includes necessary steps to achieve fair competition,” it added.

In its assessment, GAO found that seven of the eight selected Puerto Rico procurements skipped over key steps to promote competition and mitigate the risk for fraud, waste, and abuse, underscoring the need for federal oversight.

“The requests for proposals for two of the three competitive procurements GAO reviewed did not include certain information on factors used to evaluate proposals and make awards. In contrast, Puerto Rico’s managed care procurement — the largest procurement reviewed —included this information,” the GAO saids.

It further noted that none of the five noncompetitive procurements it reviewed documented circumstances to justify not using competitive procurements, such as a lack of competition or an emergency.

“Puerto Rico officials explained that territorial law allows noncompetitive procurement for professional services regardless of circumstances,” it said.

“Because CMS does not oversee Puerto Rico’s procurement process, the agency lacks assurance that Puerto Rico’s Medicaid program is appropriately managing the risk of fraud, waste, and abuse. Procurements that did not include important steps to promote competition could have unnecessarily increased Medicaid costs, reducing funding for Medicaid services to beneficiaries,” it noted.

The GAO conducted this study following a 2019 federal indictment alleging fraudulent Medicaid procurements in Puerto Rico, which has raised questions about the program’s oversight.

 
 

Clipped from: https://newsismybusiness.com/gao-puerto-rico-spent-most-of-its-18-medicaid-budget-on-contractors/

 
 

 
 

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Department of Human Services Provides Updates on Work Supports System for Medicaid Recipients

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Pennsylvania continues the rollout of its program to connect Medicaid members who want to work to jobs and skills building programs.

 
 

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.

 
 

Harrisburg, PA – Department of Human Services (DHS) Secretary Teresa Miller today outlined the Medicaid Work Supports system, a program designed to connect people whose health care is covered through Medicaid to local employment and training resources, with a goal of supporting people in finding long-term employment and achieving financial independence. As Pennsylvania continues to experience economic challenges from the COVID-19 pandemic, DHS hopes this program can be a bridge to employment for people affected by job or income loss.

Medicaid provides critical access to health care for people who would not otherwise have access to essential services like preventative visits, screenings, and medications – things we all need to stay healthy and lead an enriched, fulfilling life. Many people on Medicaid are over the age of 65 or have a chronic illness or long-term disability. Medicaid also supports people ages 19-64 with incomes at or below 133 percent of the federal poverty income guidelines. Medicaid connects more than 3.1 million Pennsylvanians to basic and life-saving health care, and enrollment in this program has grown by 300,000 people since February 2020, likely due to the economic insecurity created by COVID-19.

Prior to February 2020, most Medicaid recipients did not have a targeted connection to employment resources and support.

“One of the DHS’ top priorities remains increasing employment opportunities for those we serve. We know that many people who use safety-net programs want to work and reach their potential in jobs that lead to independence,” said Secretary Miller. “We recognized an opportunity to offer more support to people who need it in a meaningful way that meets people where they are. The Medicaid Work Supports program – a proactive, direct referral to employment and training resources – is an opportunity to fix disparities and help all people served by this system take a step forward in life.”

DHS worked with partners across the state – including the Department of Labor & Industry, Physical Health Managed Care Organizations (MCOs), Local Workforce Development Boards, and more – to implement a systematic identification and connection framework to increase workforce participation and long-term employment outcomes.

Now, when someone enrolls in Medicaid for the first time or transfers Medicaid plans, they are asked if they are interested in learning about employment resources. If they respond “yes,” they receive one of the following three outreach strategies depending on their circumstances:

  1. A letter that explains the services available at their local PA CareerLink™ office. PA CareerLink™ provides services including help with searching and applying for a job, providing a list of local job openings, and counseling to explore career interests. Some participants may also be eligible to receive support for new training and education opportunities.
  2. If the individual is a recipient of other benefits such as the Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance for Needy Families (TANF), the recipient’s County Assistance Office (CAO) will reach out to discuss the person’s interest in a DHS-approved employment and training program. The CAO will help with the referral and supports as needed.
  3. If the person is not in either of the previous groups, they will receive outreach from their selected MCO, which oversees a range of their health care services. Several MCOs have in-house programs ranging from GED support to general employability skills workshops to trainings for positions within their own healthcare systems.

These outreach and referral efforts are tracked by DHS to ensure that Medicaid beneficiaries receive the supports and information they requested.  DHS is also working with the PA Department of Labor & Industry to collect data on the program’s long-term outcomes for individuals who participate, such as time employed and wage gains. DHS will use this information to inform future decisions regarding Medicaid Work Supports programming.

Since the launch of Medicaid Work Supports in late February 2020, more than 38,000 people have indicated an interest in learning more about local employment resources, averaging about 800 people per week. Early reviews indicate that these efforts are creating space to discuss not only employment, but a range of other complex situations individuals experience, all of which contribute to stability and economic independence. In the future, use of the Resource Information and Services EnterpriseOpens In A New Window (RISE) PA tool will further support these efforts to address social determinants of health as part of the whole-person approach.

The Medicaid Work Supports program is not a work requirement, which as a policy functionally jeopardizes individuals’ access to health care and undermines efforts to help people achieve long-term employment. This program was designed to help people, especially communities that experience greater barriers to finding and retaining employment, move out of poverty.

Through person-centered services and a commitment to reform, DHS’s workforce-focused efforts aim to confront the impact of systemic racism and the inequities that racism has created over many decades. About 25 percent of Medicaid beneficiaries are Black despite being 13 percent of Pennsylvania’s general population. Poverty is not a personal or moral failure, but it is often a consequence of systemic racism and limited resources in particular communities or neighborhoods, which can often be tracked back to segregation-era policies. DHS is focused on uprooting systemic racismOpens In A New Window and promoting economic justice, particularly for all communities and individuals who use public assistance programs.

“As we look to recover from the economic crisis created by COVID-19, we hope that this focus on equity and opportunity for all people will allow us to help people who may not have been reached or meaningfully served by similar efforts previously. Economic recovery for all Pennsylvanians helps all of us, and the Medicaid Work Supports program gives us a way to help people in this journey. If there are individuals who have fallen on difficult circumstances because of the crises and collective trauma we are all facing, help is available,” said Secretary Miller.

Applications for Medicaid and other public assistance programs can be submitted online at www.compass.state.pa.usOpens In A New Window. Those who prefer to submit paper documentation can pick up an application at their local CAOOpens In A New Window, where social distancing protocols are in place, or they can print from the website or request an application by phone at 1-800-692-7462.They can then mail it to their local CAO or place it in a CAO’s secure drop box, if available. You do not need to know your own eligibility in order to apply. While CAOs remain closed, work processing applications, determining eligibility, and issuing benefits continues. Clients should use COMPASS or the MyCOMPASS PA mobile app to submit necessary updates to their case files while CAOs are closed.

For more information on DHS’ E&T Programs visit www.dhs.pa.govOpens In A New Window.

MEDIA CONTACT: Erin James – ra-pwdhspressoffice@pa.gov

# # #

 
 

Clipped from: https://www.media.pa.gov/pages/DHS_details.aspx?newsid=654

 
 

 
 

 
 

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State leaders react to Medicaid bill funded by medical marijuana

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Kansas Governor Kelly is proposing to fund Medicaid expansion with marijuana taxes.

 
 

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.

 
 

(Dakota News Now)

TOPEKA, Kan. (WIBW) – State leaders are backing Governor Laura Kelly’s Medicaid expansion bill that will be funded by medical marijuana.

Governor Laura Kelly announced legislation on Monday to expand Medicaid and provide health insurance for 165,000 Kansans. She said the legislation would also establish a regulatory framework to make Kansas the 48th state to legalize medical marijuana.

Kansas leaders have been speaking of the announcement ever since. Many think the Medicaid overhaul is much needed and will result in a healthier and more productive workforce.

“Making health care available to thousands of low-income, uninsured Kansans would help working Kansans and their families, resulting in a healthier, more productive workforce and benefit employers across the state,” said Tracey Osborne Oltjen, President and CEO of the Overland Park Chamber of Commerce. “We know that people who have health coverage are generally healthier and more productive at work. From a business perspective, that’s why Medicaid expansion is so important. Until we expand Medicaid in Kansas, we risk falling further behind our neighbors. We should not stand as an island on this issue, creating expensive challenges for our residents and our businesses.”

The Kansas Hospital Association says currently, 38 states have implemented or are moving toward Medicaid expansion. It said all of the states that border Kansas have taken steps to expand Medicaid and it is important that Kansas have a serious discussion about it. It said kanCare expansion will help every community in Kansas.

“The Kansas Hospital Association continues to support KanCare Expansion and the benefits it will bring to Kansas,” said the KHA. “Expansion improves the health of Kansans by improving access to tens of thousands of hardworking Kansans who cannot afford to wait another year for affordable health care coverage. We must have a Kansas-based solution – a solution that brings hundreds of millions of our federal tax dollars back home to Kansas – creating jobs, boosting our economy and improving the health of Kansans.”

According to Kansas Appleseed Center for Law and Justice, the COVID-19 pandemic has further exacerbated the Medicaid issue. It said legislators are allowing Kansans to fall through the cracks and expansion of Medicaid will allow the state to mitigate further inequities in Kansas’ healthcare system.

“Accessible, truly affordable healthcare is critical to achieving a more thriving, inclusive and just Kansas. In each corner of our state, COVID-19 has magnified the invaluable role healthcare plays in keeping our loved ones and our communities safe,” said Kansas Appleseed. “Prior to the co-occurring health and economic crisis brought on by the pandemic, nearly 90,000 Kansas fell within the coverage gap, rendering our state ill-prepared to meet the needs of those who would be impacted. Refusing to expand Medicaid has also had disparate impacts on Black, Indigenous, and communities of color, compounding the already-existing disparities created by institutional and systemic racism and oppression dating back to our country’s founding.”

Lt. Governor David Toland said the state’s economic recovery may even depend on the new bill.

“Our economic recovery depends heavily on our ability to attract and retain businesses throughout the state,” said Toland. “Kansas has no business giving companies even one reason to look elsewhere — and I can say, unequivocally, that the availability of healthcare and well-being of all Kansans matters a great deal to companies considering places to locate and grow.”

Many in the Kansas House of Representatives took to Twitter to show support for the bill.

Gov. Kelly said the bill would designate the Kansas Department of Health and Environment to be responsible for the oversight of patients and their use of medical marijuana, KDOR would be responsible for licensure and fee collections as well as regulation of producers and the Board of Healing Arts would be responsible for certifying prescribing doctors. She said it would also establish a bipartisan medical marijuana advisory committee with appointments made by Gov. Kelly, legislative leadership and chaired by the Secretary of Health and Environment.

Clipped from: https://www.wibw.com/2021/02/02/state-leaders-react-to-medicaid-bill-funded-by-medical-marijuana/

 
 

 
 

 
 

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Judge blocks Texas effort to remove Planned Parenthood from Medicaid

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The Texas effort to block state funds to the abortion chain is working its way through the courts.

 
 

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.

 
 

Clipped from: https://thehill.com/regulation/court-battles/537467-judge-blocks-texass-efforts-to-remove-planned-parenthood-from?rl=1

 
 

A district court judge in Texas moved late Wednesday evening to temporarily halt the state’s effort to remove Planned Parenthood from its Medicaid program just hours before the state was set to do so.

A state district judge in Travis County, Maya Guerra Gamble, granted three Planned Parenthood affiliates operating in Texas a temporary restraining order while setting a hearing for Feb. 17.

“It appears from the specific facts set forth in the verified Application for Temporary Restraining Order, and the evidence submitted to the Court, if any, that immediate and irreparable harm will result to Providers before notice can be served on the OIG and HHSC and a hearing can be held on Providers’ request for a temporary restraining order unless the OIG and HHSC are restrained as requested,” Gamble wrote, referring to the Texas Health and Human Services Commission and its Office of Inspector General.

Texas officials had sent a notice to Planned Parenthood providers in late January stating they would be kicked out of Medicaid, the state-federal health program for the poor. 

The organization is seeking to continue to receive Medicaid funding to provide non-abortion services, and filed an emergency lawsuit asking courts to institute a temporary restraining order Wednesday alleging that Texas failed to issue a “proper termination notice” under state law governing which providers are covered by Medicaid.

“For now, if courts don’t immediately step in to block [Texas Gov. Greg] Abbott’s harmful order, 8,000 Texans with low incomes could lose access to critical, life-saving health care, including cancer screenings, STI testing and treatment, and birth control,” Planned Parenthood said in a decision ahead of the judge’s order. The organization’s Texas affiliates did not immediately return requests for comment Thursday evening.

“Texas’s Medicaid ‘defunding’ offers a clear example of how critical it is for the Biden-Harris administration to stop attacks that target the reproductive health care of people with low incomes, women, and people of color,” the organization continued.

Their efforts could end up setting off a battle with the Biden administration, which signaled Thursday that it would enforce federal Medicaid guidelines governing which organizations receive funding.

“Well the president’s views are clear and consistent on this issue,” White House press secretary Jen Psaki

 
 

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MORE said during her daily news briefing. “Just last week in an executive order he reissued guidance specifying that states cannot refuse Medicaid funding for Planned Parenthood and other providers. HHS would certainly have more specific details but they have stated they are committed to protecting and strengthening the Medicaid program as is the President consistent with the Executive Order we released last week.”

Updated 10:30 p.m.

 
 

 
 

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Governor drops proposal for Medicaid budget cut

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Governor Little dropped a planned $30M cut to Medicaid because he says the enhanced federal funds under the Public Health Emergency (PHE) funding will cover the revenue gap this year.

 
 

 
 

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.

 
 

C. Scott Grow
 

BOISE — There was big news at Thursday’s Medicaid budget hearing at the state Legislature: Gov. Brad Little has withdrawn a recommendation in his budget proposal for next year to find $30.2 million in state general fund savings in the Medicaid budget, which would come to a cut of $118.4 million in total funds including federal matching funds, because the state has been informed it’ll get much more than that in Medicaid funding from the federal government due to the COVID-19 pandemic.

The Biden administration notified the state two weeks ago that it will continue a significantly higher federal matching rate for Medicaid throughout calendar year 2021, according to state Health & Welfare Director Dave Jeppesen and Alex Adams, Little’s budget director.

The “cost containment” proposal had aroused big controversy, at a time when Idaho’s health system is struggling with the COVID-19 pandemic.

Idaho also is seeing increased numbers of its residents take advantage of its Medicaid expansion program, which voters authorized in November of 2018 and which started covering Idahoans who earn up to 138% of the federal poverty level just over a year ago, on Jan. 1, 2020. The federal government picks up 90% of the cost of that program.

Joint Finance-Appropriations Committee members expressed concerns over future Medicaid costs. Sen. Jeff Agenbroad, R-Nampa, said although the increased federal funding can “fill in some of the holes,” it’s a temporary fix. “We have to look beyond this year,” he said. “This is an anomaly.”

Once the pandemic is over, he noted, Idaho could see its federal matching rate for traditional Medicaid drop because of the state’s strong economy; that’s part of the federal calculation for the non-expansion portion of Medicaid in normal times.

Agenbroad said long-term reforms, including moving Idaho’s Medicaid program to a value-based, rather than fee-for-service, payment system, are “probably the longer-term solution.”

Jeppesen agreed. He noted that the Legislature last year enacted significant cost-containment moves for Medicaid that are underway, including shifting more and more of Medicaid onto value-based, rather than fee-for-service, payment models, in which payment is based on good health outcomes rather than number of services provided. Contracts with major hospital systems and nursing homes to accomplish that change are set to be signed by July 1, he said.

“We will continue to look at other cost containment efforts and will be back next session,” Jeppesen said, possibly proposing other cost-containment legislation.

Earlier in this year’s legislative session, the department proposed legislation to allow it to cut reimbursements to providers at its discretion to achieve savings; lawmakers rejected it.

Jeppesen said the administration is recommending that rather than cut $30 million in in state funds from Medicaid next year to achieve cost savings, the Legislature tap the additional federal matching funds to cover that amount, and funnel additional savings from the boost in federal funding into a “stabilization account” to hedge against future Medicaid cost increases.

Because of the COVID-19 pandemic, the federal government has temporarily increased the amount of Idaho’s regular Medicaid costs it covers from about 70 percent to about 76%, through an increase in the Federal Medical Assistance Percentage, or FMAP. Now, that increase will last through the end of the year. Jeppesen said that means $28.7 million more in Medicaid funds for Idaho this year, “and additional savings of $56 million in fiscal year ’22 that was not otherwise built into the governor’s budget recommendation.”

In addition to the direct impact of the pandemic on Idaho’s health care system, Idaho has been seeing significantly increased costs in Medicaid in part because of pent-up demand for medical care among new enrollees in Medicaid expansion, and in part because the federal government has cut off disenrollment of those who no longer qualify during the pandemic. That’s led to roughly 32,000 Idahoans currently staying on the Medicaid rolls who otherwise wouldn’t be eligible, including more than 13,000 in Medicaid expansion.

Legislative budget analyst Jared Tatro told lawmakers, “As of Jan. 27, it was 32,914 individuals, and of those, 13,217 were related to Medicaid expansion. … When the public health emergency ends, the department knows who they are, and they’re ready to start the process of disenrolling effective immediately.”

JFAC members had lots of questions about how much Medicaid expansion has actually cost the state and how much the state has saved in offsets in existing programs that now are 90% federally funded, rather than 100% state-funded as they were previously. Tatro said, “There are cost offsets.” For the first year, the net cost to the state was zero, he said, due to about $32 million in cost offsets in Corrections, courts, Health & Welfare and the Catastrophic Health Care program. Since then, Tatro said, estimates forecast by Milliman, an actuarial consulting firm, now appear to be off and costs are expected to be higher than anticipated, “basically almost double.” But there still are offsets, he said, “And we know there are more offsets coming.”

Initial Milliman projections put the state’s cost for the first full year of Medicaid expansion, this current year, at around $41 million, which is where it was budgeted; all of those costs were offset through a combination of savings in existing state programs and an allocation of $12.6 million from the Millennium Fund, a state fund that holds tobacco settlement proceeds. But now Milliman has issued a revised report projecting costs this year will be nearly 66% higher than it originally projected, based on higher medical and pharmacy costs, COVID-19 impacts and economic conditions. That would mean another $22.8 million in state costs this year.

Tatro said the new report bases its projections on just a few months of Idaho experience during a pandemic, while the original forecasts were based on experiences of other states, so there are still plenty of unknowns.

“With hospitals shut down, it’s going to be hard to realize what is the cost of these individuals,” he said, “so we won’t know the net impact this session.” Longer term, additional savings from Medicaid expansion are expected in the state’s Catastrophic Health Care fund, mental health services and psychiatric hospitals, child welfare and public health, he said.

“We’re just going to have to be a little patient before we fully realize the actual net. But right now about half is being offset,” he said.

Rep. Ron Nate, R-Rexburg, called the increased Milliman projections “a disturbing increase,” and said, “These costs are outrageous, and I wonder if the voters who voted for Medicaid expansion really knew what it was going to cost us and all the trouble it’s causing with budgeting, (if they) would have voted for it.”

Idaho voters approved Medicaid expansion by a more than 60% margin in 2018, after the Legislature discussed it but didn’t act for six straight years. The expansion covers Idahoans who previously fell into an insurance gap: They made too much to qualify for Medicaid, but not enough to qualify for subsidized health insurance through the Your Health Idaho insurance exchange.

Sen. C. Scott Grow, R-Eagle, noted the way Medicaid expansion costs doubled from the first year of enactment to the second, and asked whether that’s likely to continue. Tatro responded, “If we double again I’ll take you to lunch. … We don’t anticipate doubling year after year after year. That is six months compared to one year.” That’s because expansion started halfway through Idaho’s state fiscal year, which runs from July 1 to June 30.

Jeppesen told lawmakers, “I just wanted to close by reminding the committee that the department exists to serve the people of Idaho and specifically to promote their health safety and independence. I remain committed to working as I have been for the last three years in a collaborative, transparent way, and I only know of one way to solve problems, and that’s to talk through them.”

JFAC is scheduled to start setting agency budgets Feb. 19.

Clipped from: https://www.idahopress.com/news/local/governor-drops-proposal-for-medicaid-budget-cut/article_d464ebf8-999b-5369-bb26-ea7661757912.html

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Indiana Lawmakers Propose Using Cigarette Tax For Medicaid

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The state is considering a new $1 tax to cigarettes and redirect 40% of the existing tax to Medicaid providers.

 
 

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 proposal, now headed to the House Ways and Means Committee, would add $1 to the state’s current 99.5 cents per pack cigarette tax.

 
 

INDIANAPOLIS (AP) — A House committee made significant changes Thursday to the way Indiana would spend proceeds from a proposal to hike the state’s cigarette tax for the first time in more than a decade and impose a new state tax on vaping liquids.

House legislators revised the measure in committee to direct 40 percent of Indiana’s cigarette tax revenue toward Medicaid reimbursements for health care providers. That’s a change from the original proposal, which would have deposited a majority of the new revenue generated by the tax hike — estimated to be nearly $290 million a year — into the state’s general fund and pension programs.

The proposal, now headed to the House Ways and Means Committee, would add $1 to the state’s current 99.5 cents per pack cigarette tax. It also would charge a 39 percent tax on the liquids used in e-cigarettes, which bill sponsor Rep. Julie Olthoff, a Crown Point Republican, said would be roughly equivalent to the cigarette tax.

Olthoff said Thursday she welcomed the change, noting Medicaid covers the health care expenses of eligible smokers. The lawmaker has maintained that the legislation is aimed at reducing Indiana smoking rates. The state’s 21.1 percent smoking rate among adults was the fourth-highest in the country for 2018, according to the federal Centers for Disease Control and Prevention.

A separate amendment seeking to allocate more of the tax revenue toward public health initiatives was voted down by committee members. The proposal, authored by Democratic Rep. Robin Shackleford, would create a health improvement fund to help the State Department of Health treat and prevent tobacco addiction, drug addiction, diabetes, mental illness, obesity and other health disparities.

Republicans on the committee said they prefer the proposal be reconsidered in Ways and Means, and after more progress has been made on the state budget.

Casey Smith is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

 
 

Clipped from: https://www.wfyi.org/news/articles/indiana-lawmakers-propose-using-cigarette-tax-for-medicaid

 
 

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Medicaid expansion cost-share deal would stay put in Warnock, Ossoff bill

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A Georgia Senator has introduced a bill to expand Medicaid at 100% federal costs for states who did not take the money under ACA.

 
 

 
 

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.

 
 

 
 

Newly seated U.S. Sen. Raphael Warnock of Georgia unveiled legislation Friday, Feb. 5, to give states that skipped out on early Medicaid expansion equal federal cost-sharing coverage if they join later.

The bill, called the “States Achieve Medicaid Expansion (SAME)” Act, aims to quell concerns over possible future changes to the federal-state payment arrangement for Medicaid under the Affordable Care Act (ACA), which has been a stumbling block for many states opposed to full coverage expansion.

Its leader sponsors are Warnock and U.S. Sen. Mark Warner of Virginia. Georgia’s U.S. Sen. Jon Ossoff, who teamed with Warnock in the 2020 elections to flip both of the state’s Senate seats, is also joined on the bill.

Currently, the federal government pays 100% of the costs for the first three years for states that provide Medicaid to residents with incomes up to 138% of the federal poverty level, the definition of full coverage. Georgia is set to partially expand coverage this year but remains among about a dozen states that have declined full expansion.

Warnock, a Democrat who is Georgia’s first Black senator and remains senior pastor of Atlanta’s Ebenezer Baptist Church, campaigned on a platform to expand Medicaid, institute a national $15-an-hour minimum wage and bolster voting rights. He called his bill a push to blanket all Americans with health-insurance coverage.

“Health care is a human right, and for too long, too many Georgians have been denied access to affordable health care through Medicaid,” he said. “I’ve long believed that expanding Medicaid in Georgia is an important step toward making affordable health care for all a reality.”

Medicaid enrollment has spiked during the COVID-19 pandemic that began last March. In Georgia, Medicaid rolls increased by 338,000 between March and December 2020, raising the total number of children, adult and family recipients to roughly 2,104,000, according to state Department of Community Health (DCH) data.

Opponents have warned covering thousands more people could bust Georgia’s budget for Medicaid, even with the extra federal spending. Currently, the federal government pays about two-thirds of the more-than $10 billion Georgia spends on Medicaid each year.

Critics also worry policy changes now could saddle Georgia with costly terms for jumping on the full-expansion train late in the ballgame, years after other states joined the Obama-era health-care program.

“I don’t know if the federal government will ever return to a period of budget austerity,” Chris Denson, policy and research director for the nonprofit Georgia Public Policy Foundation (GPPF), said last week (week of Jan. 24). “But there’s always a chance that the feds will drop that matching rate.”

Medicaid coverage is now available for Georgia adults with incomes about 35% below the federal poverty line, as well as children in households making up to 138% above the poverty line and low-income senior, blind and disabled adults.

Gov. Brian Kemp, a Republican, gained federal approval last October from the Trump administration for a partial Medicaid expansion, covering adults earning up to 100% of the poverty level. That would cover about 50,000 Georgians, according to state estimates.

Kemp’s plan also requires Georgia Medicaid recipients to work, attend school or volunteer at least 80 hours each month – a controversial provision critics argue strips deserving low-income Georgians and families of a safety net.

Warnock’s bill leveling Medicaid cost-sharing percentages stands a good chance to win approval in Congress, thanks to his and Democratic co-campaigner Ossoff’s wins in last month’s runoff elections.

Warnock and Ossoff defeated Georgia’s two incumbent Republican senators, shifting control of both chambers in Congress to Democrats at the same time President Joe Biden – a Democrat – took office.

Ossoff, who is Georgia’s first Jewish senator and currently the chamber’s youngest member, called his colleague’s bill both a moral document and good incentive for states like Georgia that have not expanded Medicaid.

“This bill would ensure Georgia gets the same funding as other states that expanded Medicaid years ago – and create even more incentive for our state government to do what should have been done a decade ago and expand Medicaid for Georgia families,” Ossoff said.

Both of Georgia’s new senators have been busy since taking office on Jan. 20. They have called for showering Georgians with more dollars for COVID-19 pandemic relief, as well as bolstering voting rights even as Republican state lawmakers move to put new restrictions on absentee voting.

 
 

Clipped from: https://www.northwestgeorgianews.com/catoosa_walker_news/medicaid-expansion-cost-share-deal-would-stay-put-in-warnock-ossoff-bill/article_a24b316e-67e1-11eb-8fb5-b7a65dab9e59.html