Category Archives: Medicaid Work Requirements

Expect More Hunger in America with Big New Rips to the Safety Net

Posted on by • Posted in 2026 Mid Term Election Issues, 2028 Election Issues, Health Policy, Healthcare Cuts, Healthcare Reform, Hunger, Medicaid, Medicaid Cuts, Medicaid Eligibility, Medicaid Funding, Medicaid Work Requirements, Public Good, Public Health, Public Interest, Public Welfare, Safety Net, Supplemental Nutrition Assistance Program (SNAP) • Tagged , , , , • Leave a comment

https://healthcareuncovered.substack.com/p/expect-more-hunger-in-america-with

The recently passed One Big Beautiful Bill Act, which makes deep cuts to the Medicaid program, also puts the food assistance that 41 million low-income Americans rely on in jeopardy. Many of the families currently getting food provided by  the Supplemental Nutrition Assistance Program (SNAP) stand to lose that support.  

SNAP may well disappear for some families as the federal government moves to trim it. “The cuts are massive and extremely cruel when families need more support, not less,” says Signe Anderson, senior director of nutrition advocacy, at the Tennessee Justice Center in Nashville. 

Government food assistance was established during the Great Depression, but it wasn’t until 1977 that the program became more accessible when the requirement that recipients had to pay for a portion of their food stamps was ended. Throughout its history, foes of the program have tried to dismantle it and may have succeeded as a result of provisions in the bill President Trump signed on July 4. 

The new legislation calls for cutting spending for food stamps by $186 billion through 2034. “Everyone on food stamps will be affected in some way, and many will lose benefits,” Anderson says. “I don’t think the Congress understands the level of necessity in the community for food, health care and mental health treatment, some for the rest of their lives.” 

One major change is being made to work requirements that have historically been part of the Medicaid program, which is administered and partially funded by the states. Anderson points out that under the new arrangements, participants may find the task of enrolling and staying enrolled more onerous. “We see a lot of people cut off already because too many life circumstances make it difficult for them to meet work requirements.”  

Indeed when you look at the changes to SNAP, the first word that might come to mind is ‘draconian.’

To receive benefits those new to the program, and those already on it who are between 55 and 64 and do not have dependent children or who have children 14 and older, will have to prove they work. Or they will have to volunteer at least 20 hours a week or enroll in training programs. Parents of school-aged children will now be required to work.

Some five million people, including about 800,000 children and about a half million adults who are 65 and older, could lose their food benefits.  

The programs the new law targets have been a lifeline for some. Nikole Ralls, a 43-year-old woman in Nashville, who was once a drug addict but now counsels others who need help, says, “I got my life turned around because of Medicaid and SNAP.”  

In a recent memo to state agencies administering the SNAP program, Agriculture Secretary Brooke Rollins said she was concerned about what was described as abuse of the waiver system by states, noting that the new approach for the SNAP program would prioritize work, education and volunteering over what the department characterized as “idleness and excessive spending.” 

Anderson said, “The public doesn’t understand what hunger looks like and are misinformed about how well-run and streamlined the SNAP program is.”   

“Most of the people who can, do work.  We have parents working two and three jobs,” Anderson said. For families in this predicament food banks, which have become default grocery stores, may be of little help.  They, too, are stretched thin. The Wall Street Journal reported food banks across the country are already straining under rising demand, and some worry there won’t be enough food to meet demand.

What Trump and the GOP have planned for healthcare

Posted on by • Posted in ACA, Congressional Budget Office (CBO), Health Insurance Coverage Adequacy, Health Insurance Denial, Health Insurance Industry, Health Policy, Health System, Healthcare Reform, Hospital, Hospital Industry, Medicaid, Medicaid Block Grants, Medicaid Eligibility, Medicaid Expansion, Medicaid Work Requirements, Medicare, Medicare 340B Drug Discount Program, Medicare Advantage, Medicare Cuts, Medicare Denials, Medicare Hospital Fund, Medicare Payment, Medicare Payment Advisory Commission (MedPAC), Medicare Reimbursement, Medicare Site Neutral Payment, Project 2025, State of the Union, Tax Exempt Debt, Tax Exempt Status • Leave a comment
https://www.healthcarefinancenews.com/news/what-trump-and-gop-have-planned-healthcare?leadId=1234536&mkt_tok=NDIwLVlOQS0yOTIAAAGYKMuOSDpr4HmVgwoir-sctcWYrTCmAMidk2ElOKJYQgYV2OewZexaTT7OGNmdoOgJX4esGPrurXZW_6oPMprQ0Mc5ph-PR7Pcrbc3LivGTNmd

Health systems are rightly concerned about Republican plans to cut Medicaid spending, end ACA subsidies and enact site neutral payments, says consultant Michael Abrams, managing partner of Numerof, a consulting firm.

“Health systems have reason to worry,” Abrams said shortly after President Donald Trump was inaugurated on Monday. 

While Trump mentioned little about healthcare in his inauguration speech, the GOP trifecta means spending cuts outlined in a one-page document released by Politico and another 50-pager could get a majority vote for passage.

Of the insurers, pharmaceutical manufacturers and health systems that Abrams consults with, healthcare systems are the ones that are most concerned, Abrams said.

At the top of the Republican list targeting $4 trillion in healthcare spending is eliminating an estimated $2.5 billion from Medicaid. 

“There’s no question Republicans will find savings in Medicaid,” Abrams said.

Medicaid has doubled its enrollment in the last couple of years due to extended benefits made possible by the Affordable Care Act, despite disenrolling 25 million people during the redetermination process at the end of the public health emergency, according to Abrams.

Upward of 44 million people, or 16.4% of the non-elderly U.S. population are covered by an Affordable Care Act initiative, including a record high of 24 million people in ACA health plans and another 21.3 million in Medicaid expansion enrollment, according to a KFF report. Medicaid expansion enrollment is 41% higher than in 2020.

The enhanced subsidies that expanded eligibility for Medicaid and doubled the number of enrollees are set to expire at the end of 2025 and Republicans are likely to let that happen, Abrams said. Eliminating enhanced federal payments to states that expanded Medicaid under the ACA are estimated to cut the program by $561 billion.

If enhanced subsidies end, the Congressional Budget Office has estimated that the number of people who will become uninsured will increase by 3.8 million each year between 2026 and 2034. 

The enhanced tax subsidies for the ACA are set to expire at the end of 2025. This could result in another 2.2 million people losing coverage in 2026, and 3.7 million in 2027, according to the CBO.

WHY THIS MATTERS

For hospitals, loss of health insurance coverage means an increase in sicker, uninsured patients visiting the emergency department and more uncompensated care.

“Health systems are nervous about people coming to them who are uninsured,” Abrams said. “There will be people disenrolled.”

The federal government allowed more people to be added to the Medicaid rolls during the public health emergency to help those who lost their jobs during the COVID-19 pandemic, Numerof said. Medicaid became an open-ended liability which the government wants to end now that the unemployment rate is around 4.2% and jobs are available.

An idea floating around Congress is the idea of converting Medicaid to a per capita cap and providing these funds to the states as a block grant, Abrams said. The cost of those programs would be borne 70% by the federal government and 30% by states.

This fixed amount based on a per person amount would save money over the current system of letting states report what they spent.

Another potential change under the new administration includes site neutral Medicare payments to hospitals for outpatient services.

The HFMA reported the site neutral policy as a concern in a list it published Monday of preliminary federal program cuts totaling more than $5 trillion over 10 years. The 50-page federal list is essentially a menu of options, the HFMA said, not an indication that programs will actually be targeted leading up to the March 14 deadline to pass legislation before federal funding expires.

Other financial concerns for hospitals based on that list include: the elimination of the tax exemption for nonprofit hospitals, bringing in up to $260 billion in estimated 10-year savings; and phasing out Medicare payments for bad debt, resulting in savings of up to $42 billion over a decade.

Healthcare systems are the ones most concerned over GOP spending cuts, according to Abrams. Pharmacy benefit managers and pharmaceutical manufacturers also remain on edge as to what might be coming at them next.

THE LARGER TREND

President Donald Trump mentioned little about healthcare during his inauguration speech on Monday.

Trump said the public health system does not deliver in times of disaster, referring to the hurricanes in North Carolina and other areas and to the fires in Los Angeles.

Trump also mentioned giving back pay to service members who objected to getting the COVID-19 vaccine.

He also talked about ending the chronic disease epidemic, without giving specifics.

“He didn’t really talk about healthcare even in the campaign,” Abrams said.

However, in his consulting work, Abrams said, “The common thread is the environment is changing quickly,” and that healthcare organizations need to do the same “in order to survive.”

Musk’s DOGE could leave millions uninsured

Posted on by • Posted in ACA, Health Insurance Coverage Adequacy, Health Policy, Healthcare Reform, High Deductible Health Plans, Medicaid, Medicaid Block Grants, Medicaid Eligibility, Medicaid Expansion, Medicaid Redeterminations, Medicaid Retroactive Eligibility, Medicaid Section 1115 Waiver, Medicaid Unwinding, Medicaid Work Requirements, Medical Debt, Out of Pocket Expenses, State of the Union, Underinsured, Uninsured, Unnecessary Deaths • Leave a comment

https://www.linkedin.com/pulse/musks-doge-could-leave-millions-uninsured-robert-pearl-m-d–xl8dc/?trackingId=7TewioXWRzScafytDRqrQQ%3D%3D

As Donald Trump begins his second term, America’s healthcare system is in crisis: medical costs are skyrocketing, life expectancy has stagnated, and burnout runs rampant among healthcare workers.

These problems are likely to become worse now that Trump has handed the federal budget over to Elon Musk. The world’s richest man now co-heads the Department of Government Efficiency (DOGE), a non-government entity tasked with slashing $500 billion in “wasteful” spending.

The harsh reality is that Musk’s mission can’t succeed without gutting healthcare access and coverage for millions of Americans.

Deleting dollars from American healthcare

Since Trump’s first term, the country’s economic outlook has worsened significantly. In 2016, the national debt was $19 trillion, with $430 billion allocated to annual interest payments. By 2024, the debt had nearly doubled to $36 trillion, requiring $882 billion in debt service—12% of federal spending that is legally untouchable.

Add to that another 50% of government expenditures that Trump has deemed politically off-limits: Social Security ($1.35 trillion), Medicare ($848 billion) and Defense ($1.13 trillion). That leaves just $2.6 trillion—less than 40% of the $6.75 trillion federal budget—available for cuts.

In a recent op-ed, Musk and DOGE co-chair Vivek Ramaswamy proposed eliminating expired or misused funds for programs like Public Broadcasting and Planned Parenthood, but these examples account for less than $3 billion total—not even 1% of their target.

This shortfall will require Musk to cut billions in government healthcare spending. But where will he find it?

With Medicare off limits to DOGE, the options for major reductions are extremely limited. Big-ticket healthcare items like the $300 billion in tax-deductibility for employer-sponsored health insurance and $120 billion in expired health programs for veterans will prove politically untouchable. One will raise taxes for 160 million working families and the latter will leave veterans without essential medical care.

This means DOGE will have to attack Medicaid and the ACA health exchanges. Here’s how 20 million people will likely lose coverage as a result.

1. Reduced ACA exchange funding

Since its enactment in 2010, the Affordable Care Act (ACA) has provided premium subsidies to Americans earning 100% to 400% of the federal poverty level. For lower-income families, the ACA also offers Cost Sharing Reductions, which help offset deductibles and co-payments that fund 30% of total medical costs per enrollee. Without CSRs, a family of four earning $40,000 could face deductibles as high as $5,000 before their insurance benefits apply.

If Congress allows CSR payments to expire in 2026, federal spending would decrease by approximately $35 billion annually. If that happens, the Congressional Budget Office expects 7 million individuals to drop out of the exchanges. Worse, without affordable coverage alternatives, 4 million families would lose their health insurance altogether.

2. Slashing Medicaid coverage and tightening eligibility

Medicaid currently provides healthcare for over 90 million low-income Americans, including children, seniors and individuals with disabilities. To meet DOGE’s $500 billion goal, several cost-cutting strategies appear likely:

  • Reversing Medicaid expansion: The ACA expanded Medicaid eligibility to those earning up to 138% of the federal poverty level, reducing the uninsured rate from 16% to 8%. Undoing this expansion would strip coverage from millions in the 40 states that adopted the program.
  • Imposing work requirements: Proponents argue this could encourage employment, but most Medicaid recipients already work for employers that don’t provide insurance. In reality, work requirements primarily create bureaucratic barriers that disqualify millions of eligible individuals, reducing program costs at the expense of coverage.
  • Switching to block grants: Unlike the current Medicaid system, which adjusts funding based on need, less-expensive block grants would provide states with fixed allocations. This will, however, force them to cut services and reduce enrollment.

Medicaid currently costs $800 billion annually, with the federal government covering 70%. Reducing enrollment by 10% (9 million people) could save over $50 billion annually, while a 20% reduction (18 million people) could save $100 billion.

Either outcome would devastate families by eliminating access to vital services including prenatal care, vaccinations, chronic disease management and nursing home care. As states are forced to absorb the financial burden, they’ll likely cut education budgets and reduce infrastructure investments.

The first 100 days

The numbers don’t lie: Musk and DOGE could slash Medicaid funding and ACA subsidies to achieve much of their $500 billion target. But the human cost of this approach would be staggering.

Fortunately, there are alternative solutions that would reduce spending without sacrificing quality. Shifting provider payments in ways that reward better outcomes rather than higher volumes, capping drug prices at levels comparable to peer nations, and leveraging generative AI to improve chronic disease management could all drive down costs while preserving access to care.

These strategies address the root causes of high medical spending, including chronic diseases that, if better managed, could prevent 30-50% of heart attacks, strokes, cancers, and kidney failures according to CDC estimates.

Yet, in their pursuit of immediate budgetary cuts, Musk and DOGE have omitted these kinds of reform options. As a result, the health of millions of Americans is at major risk.

GOP Eyes Medicaid Overhaul

Posted on by • Posted in Health Policy, Healthcare Reform, Medicaid, Medicaid Expansion, Medicaid Work Requirements, Safety Net Hospitals, Safety-Net Providers • Leave a comment
https://www.axios.com/newsletters/axios-vitals-b7e6f780-a872-11ef-8351-d77555a9e21b.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top

Congressional Republicans are beginning to discuss overhauling Medicaid using a process that would allow the Senate to bypass the required 60-vote threshold to pass certain priorities, according to GOP lawmakers.

Why it matters: 

The changes could significantly reshape a safety net program that covers more than 70 million people, reducing federal spending and potentially leading to significant coverage losses.

Driving the news: 

Perhaps the most likely Medicaid change would be imposing work requirements for recipients, according to GOP sources.

  • That idea was discussed as part of last year’s debt ceiling talks and is familiar to GOP lawmakers.
  • House Majority Leader Steve Scalise (R-La.) told Axios that Medicaid work requirements “potentially” could be included in a legislative package brought up under the fast-track budget procedure known as reconciliation.
  • Asked about other Medicaid spending changes, Scalise said members “have a lot of internal conversations to have about all the things that will be included.”

Yes, but: 

It’s not clear how much, if any, health policy will be packed into a reconciliation bill, since the overriding focus of the package would be on extending major provisions of the Trump 2017 tax law.

  • There has been less recent enthusiasm for controversial health policy changes among Republicans, who’d prefer to focus on taxes, energy and immigration.
  • However, a health package could generate valuable savings to help pay for some of the tax cuts, and Medicaid is a large pot of money, costing over $800 billion per year.
  • Congressional scorekeepers previously estimated work requirements would save over $100 billion over 10 years — and 600,000 people would become uninsured.

What they’re saying: 

Rep. Brett Guthrie (R-Ky.), one of two leading contenders to be chair of the House Energy and Commerce Committee in the next Congress, told Axios he is interested in capping Medicaid spending on each enrollee, known as a “per capita cap” or allotment.

  • This would be a revival of a proposal from the 2017 Affordable Care Act repeal-replace plan.
  • “We offered Medicaid reform in reconciliation in the repeal-and-replace package, and it was per capita allotments, which didn’t cut Medicaid but it does limit the growth,” Guthrie said.
  • “I do think it has to be discussed as part of the package” next year, he said, adding he hadn’t discussed the idea with leadership yet.

Between the lines: 

Another potential change is reducing the federal share of spending on the Medicaid expansion population, currently at 90%, so that it matches the lower federal share for the traditional Medicaid population.

  • “It makes no sense for federal policy to pay states more for able-bodied enrollees than for disabled people, children and pregnant women on the program,” said Brian Blase, president of the Paragon Health Institute and a former Trump administration health official.
  • The flip side is that a cash crunch in the states could lead some to drop the Medicaid expansion altogether. Forty states have expanded their programs.

The big picture: 

The first Trump administration approved Medicaid waivers for conservative-led states that imposed work and reporting requirements. But courts struck down many of the approvals.

  • Republicans could be wary of political blowback from efforts to reshape the entitlement program this time around.
  • Protests against Medicaid cuts, as well as possible resistance from some Republican governors, helped doom the repeal-replace effort in 2017.
  • Democrats also are sure to portray any Medicaid cuts as penalizing the poor to help lower taxes on the wealthy.

Rep. Morgan Griffith (R-Va.), an Energy and Commerce Committee member, acknowledged “people get scared” when Medicaid work requirements are discussed, but he noted the possibility of exemptions for people with disabilities or those in school.

  • There have been “some private conversations” though “nothing formal” in the committee about Medicaid changes, he said.

The bottom line: 

“It’s hard to make adjustments to reduce federal spending without touching people who rely on the program,” said Robin Rudowitz, director of the Program on Medicaid and the Uninsured at KFF.

Why a deep-red state could be on the verge of expanding Medicaid

Posted on by • Posted in ACA, Financial Strength, Financial Viability, Financially Distressed, Health Insurance Coverage Adequacy, Health Policy, Medicaid Expansion, Medicaid Work Requirements • Leave a comment

https://www.axios.com/2024/04/11/mississippi-medicaid-expansion-republicans-obamacare

Mississippi, one of the country’s poorest and least healthy states, could soon become the next to expand Medicaid.

Why it matters: 

It’s one of several GOP-dominated states that have seriously discussed Medicaid expansion this year, a sign that opposition to the Affordable Care Act coverage program may be softening among some holdouts 10 years after it became available.

  • A new House speaker who strongly backs expansion and growing fears that the state’s rural hospitals can’t survive without it have kept up momentum in Mississippi’s legislature this year.
  • As many as 200,000 low-income adults could gain coverage if lawmakers clinch a deal in the closing weeks of the Mississippi session.

State of play: 

Mississippi’s House and Senate this week began hashing out differences between two very different plans passed by each chamber.

  • The House bill is the traditional ACA expansion, extending coverage to adults earning 138% of the federal poverty level, or about $21,000.
  • The Senate’s version, which leaders have dubbed “lite” expansion, covers people earning up to the poverty line and wouldn’t bring in the more generous federal support available for full expansion.
  • Both plans include a work requirement, but only the House version would still allow expansion to take effect without it. The Biden administration opposes work rules, but former President Trump could revive them in a second term.

Zoom out: 

State lawmakers in Alabama and Georgia gave serious consideration to Medicaid expansion this year, though they ultimately dropped it. Kansas’ Gov. Laura Kelly, a Democrat, is trying again to expand Medicaid, but the GOP-run legislature remains opposed.

  • Shuttering rural hospitals and an acknowledgement that the ACA is unlikely to be repealed have made Republicans more willing to take a closer look at expansion, Politico reported earlier this year.
  • The fact that the extra federal funding from the ACA expansion could lift state budgets as pandemic aid dries up has also piqued states’ interest, said Joan Alker, executive director of the Georgetown University Center on Children and Families.

Zoom in: 

Mississippi’s expansion effort has advanced further than other states this year largely because new House Speaker Jason White has made it a priority. Lt. Gov. Delbert Hosemann, who presides over the Senate, has also pushed the issue.

  • “We see an unhealthy population that’s uncovered. And we see this as the best way” to insure them, White told Mississippi Today this week.
  • “I just think it’s time for us to realize that there’s not something else coming down the pipe.”

The state’s crumbling health infrastructure has also made expansion more urgent, said Democratic state Sen. Rod Hickman. More than 40% of the state’s 74 rural hospitals are at risk of closing, a report last summer found.

  • “The dire need of our hospital systems and the state finally recognizing that Medicaid expansion could assist in those issues is what has kind of brought that to the forefront,” he told Axios.

Yes, but: 

Republican Gov. Tate Reeves has reportedly pledged to oppose any Medicaid expansion deal that may emerge before the legislature adjourns in early May, so lawmakers would likely need a veto-proof majority to approve an expansion.

  • Austin Barbour, a Republican strategist who works in Mississippi politics, said he expects lawmakers will reach a deal.
  • But if they don’t, “I know this will be an issue that’ll pop right back up next session,” he said.

Georgia implements partial Medicaid expansion with work requirements

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https://mailchi.mp/7f59f737680b/the-weekly-gist-june-30-2023?e=d1e747d2d8

On July 1st, Georgia will launch its Pathways to Coverage program, which partially expands its Medicaid program to enroll individuals with incomes up to 100 percent of the federal poverty line (FPL), but only if they demonstrate at least 80 hours a month of work, education, job training, or community service. 

This expansion is only projected to extend Medicaid coverage to an additional 50K state residents, far short of the 400K that full Medicaid expansion (without work requirements, to individuals earning up to138 percent of the FPL) would have covered. Georgia’s plan was approved by the Trump administration in 2020, but the Biden administration rescinded its waiver prior to implementation. Georgia then sued the Biden administration, and a Federal District Court sided with the state, allowing the partial expansion with work requirements to proceed. The Biden administration chose not to appeal. 

The Gist: Though Georgia’s implementation is more limited in scope compared with other states which are currently pursuing Medicaid work requirements, Georgia sets a precedent to motivate those states that are looking to pursue similar strategies. 

Research has shown that most adults on Medicaid who do not face barriers to work are already working, and that the cost of systems to monitor beneficiary work status likely offsets any savings in reduced Medicaid spending. 

The burden of having to report work status is onerous for potential Medicaid enrollees, discouraging some from seeking coverage altogether.

Healthcare provisions of the debt limit deal: COVID-19 funding clawbacks, no Medicaid work requirements

Posted on by • Posted in Clawbacks, Health Policy, Health System, Hospital, Hospital Industry, Medicaid, Medicaid Work Requirements, Medicare • Leave a comment
https://www.healthcaredive.com/news/debt-limit-deal-healthcare-provisions-medicaid-covid-funding/651489/?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202023-05-30%20Healthcare%20Dive%20%5Bissue:50871%5D&utm_term=Healthcare%20Dive

Congressional Republicans and the White House reached a deal over the weekend to raise the debt ceiling that includes healthcare wins for both sides of the aisle, creating a path forward to prevent economic upheaval roughly a week before a potential federal default.

The 99-page agreement released Sunday to suspend the debt ceiling until January 2025 doesn’t include Medicaid work requirements, a key priority for the White House, but it does claw back billions of unspent COVID-19 relief funds.

The bill, which already faces opposition from some hard-right Republicans, could still be halted in Congress. The government could run out of money to meet its payment obligations as early as Monday without a debt ceiling increase, according to the Treasury Department, with a default threatening Medicare and Medicaid reimbursements to states and providers.

What’s in the agreement

The deal claws back roughly $30 billion in unspent pandemic relief funds from dozens of programs under the CMS, National Institutes of Health and Centers for Disease Control and Prevention, among other agencies.

However, the White House did retain money for some COVID priorities. The Biden administration will retain about $5 billion to develop coronavirus vaccines and treatments in Project NextGen, and to cover the cost of those therapies for uninsured people, according to The New York Times.

The deal leaves healthcare-related federal entitlement programs mostly untouched, a key win touted by the White House in its messaging to Democrats. Despite being targeted by Republicans during negotiations, Medicare, Medicaid and the Inflation Reduction Act emerged unscathed.

Medicaid was particularly at risk. Though the final agreement excludes Medicaid work requirements, last month Republicans in the House passed a debt ceiling bill that would have included the controversial policy. Those requirements would have resulted in an estimated 600,000 people being booted from the safety-net insurance coverage, according to the Congressional Budget Office.

“One thing this budget deal suggests: Democrats won’t go along with Republican proposals to cut or impose restrictions on Medicaid,” tweeted Larry Levitt, executive vice president of health policy at the Kaiser Family Foundation.

If passed, however, the deal would enact work rules for people receiving federal food stamps and those on the family welfare benefits program. Veterans and homeless people would be exempt from food stamp work requirements.

Those provisions put food assistance at risk for very low-income older adults, and “will increase hunger and poverty among that group,” nonpartisan think tank the Center on Budget and Policy Priorities said in a statement on the bill.

The agreement also increases funding for the Cost of War Toxic Exposures Fund, created by bipartisan legislation last summer that expanded healthcare and disability benefits for veterans exposed to toxic burn pits.

The House Rules Committee, which includes a number of critics of House Speaker Kevin McCarthy, R-Calif., who spearhead the negotiations for Republicans, will discuss the legislation Tuesday afternoon.

A full House vote on the bill could come as soon as Wednesday. Senate Majority Leader Chuck Schumer, D-N.Y., has said the Senate will immediately move to consider the bill once it leaves the House.

If Economists Chose the Health Care System

Posted on by • Posted in ACA, Adverse Selection, Economist, Employer-Based Health Insurance, Health Insurance Industry, Health Policy, High Drug Prices, Medicaid, Medicaid Block Grants, Medicaid Work Requirements, Medical Loss Ratio (MLR), Medicare, Medicare Age Eligibility, Medicare Based on Income, Pharmaceutical Industry, Preexisting Conditions, Sin Tax, Social Determinants of Health, Voucher Based Health Insurance System • Leave a comment
If Economists Chose the Health Care System
If Economists Chose the Health Care System - YouTube

Health economists study the economic determinants of health. They also analyze how health care resources are utilized and allocated, and how health care policies and quality of care can be improved. In this episode, we discuss what exactly a healthcare system would look like if these professionals were calling all the shots.

Biden rescinds Medicaid work rules in 2 more states

Posted on by • Posted in ACA, Health Insurance Coverage Adequacy, Health Policy, Medicaid, Medicaid Work Requirements, Pandemic • Leave a comment
https://www.beckershospitalreview.com/payer-issues/biden-rescinds-medicaid-work-rules-in-2-more-states.html?origin=PayerE&utm_source=PayerE&utm_medium=email&utm_content=newsletter&oly_enc_id=2893H2397267F7G
The Reality of Work Requirements for Medicaid - YouTube

President Joe Biden moved to unwind Medicaid work requirements in Michigan and Wisconsin, after pulling the rules in Arkansas and New Hampshire.

CMS sent letters to health officials in Michigan and Wisconsin April 6 withdrawing their approval to implement work requirements for Medicaid beneficiaries. In both letters, CMS noted that combined with the COVID-19 pandemic, the work rules risk “significant coverage losses and harm to beneficiaries.”

In March, the Biden administration revoked approval for similar Medicaid work requirements in Arkansas and New Hampshire.

Supreme Court pulls Medicaid work requirements case off docket

Posted on by • Posted in Dept of Health and Human Services (HHS), District Court, District Court of Appeals, Health Equity, Health Inequity, Health Policy, Medicaid, Medicaid Work Requirements, Supreme Court • Leave a comment
https://www.fiercehealthcare.com/payer/supreme-court-to-no-longer-hear-arguments-over-medicaid-work-requirements-appeals?mkt_tok=Mjk0LU1RRi0wNTYAAAF7xhFjCSm6ilv4rlEXJ6hB0V9iXd9WOcySq0tC4rDHcBZBEgqU7mAFK4wFhJtgpgD5pVELwWrsfWzEnbioPfAaCqb9kYmjYOmXCXvqKQqVfet1JiE&mrkid=959610

The Supreme Court announced Thursday it will no longer hear oral arguments later this month on an appeal over the controversial Medicaid work requirements program in New Hampshire and Arkansas.

Legal experts say the move likely means the case won’t be heard this term and possibly may not be heard at all, especially with the Biden administration signaling a different approach to work requirements.

“By taking the cases off the docket, the court is signaling that it won’t hear them this term and probably that it’ll never hear them at all,” University of Michigan Law Professor Nicholas Bagley told Fierce Healthcare.

A major question mark, though, is whether the court will vacate the decisions by several appellate courts that upheld lower court rulings that the programs should be struck down. 

“If the Supreme Court is not going to vacate the D.C. Circuit ruling, that means the decision on the books is one that clearly explains why work requirements are not permitted under the Medicaid statute,” said Rachel Sachs, associate professor of law at Washington University, in an interview with Fierce Healthcare. 

She added that it is unlikely for the case to come back and “extremely unlikely that this issue will return in the near future.”

The Biden administration asked the court back in February to cancel the oral arguments originally scheduled for March 29. The administration said in a filing that allowing the requirements to take effect won’t promote the objectives of Medicaid to extend health insurance to low-income people.

President Joe Biden’s Department of Justice called for the court to vacate judgments of appeals courts and remand the case back to the Department of Health and Human Services so it can finish a review of all the waivers.

Arkansas Attorney General Leslie Rutledge said in a statement back in February that the legal filing seeking the delay was a “politically motivated stunt designed to avoid a Supreme Court decision upholding a program that encourages personal responsibility while still providing healthcare coverage for those seeking gainful employment.”

Arkansas’ work requirements program was installed in 2018 and led to approximately 18,000 people losing Medicaid coverage before the program was struck down by a federal judge.

Appellate courts upheld judgments from lower courts that New Hampshire and Arkansas’ programs did not meet the objectives of the Medicaid program. The states appealed to the Supreme Court, which agreed to hear the cases late last year.

Court rulings have also struck down programs in other states including Kentucky and Michigan. Kentucky pulled its program in 2019 after a Democrat was elected governor.

Arkansas and New Hampshire’s attorneys general did not return requests for comment on the Supreme Court’s decision Thursday.