State Medicaid Programs

  • At Trump’s urging, states try to tilt Medicaid in conservative directions, By Amy Goldstein and Juliet Eilperin, May 25, 2017, Washington Post: “Wisconsin is preparing to recast its Medicaid program in ways that no state has ever done, requiring low-income adults to undergo drug screening to qualify for health coverage and setting time limits on assistance unless they work or train for a job. The approach places BadgerCare, as the Wisconsin version of Medicaid is known, at the forefront of a movement by Republican governors and legislatures that is injecting a brand of moralism and individual responsibility into the nation’s largest source of public health insurance. From Maine to Arizona, some states are seizing on an invitation by the Trump administration to redesign a program that was created as part of the 1960s Great Society and now covers 69 million Americans…”
  • Wisconsin GOP advances measure that would make state first to drug test for health benefits, By Jason Stein, May 25, 2017, Milwaukee Journal Sentinel: “Wisconsin could become the first state in the nation to require needy but able-bodied adults to work and submit to drug tests to qualify for public health coverage, under a proposal advanced by lawmakers Thursday. Republicans on the Legislature’s budget committee outvoted Democrats 12-4 to approve these provisions in Gov. Scott Walker’s budget along with the bill’s requirement that some parents on food stamps work in order to receive benefits…”

States and Medicaid Expansion

3-state study sizes up gains via Medicaid; coverage soars in Arkansas, Kentucky, less so in Texas, By Andy Davis, May 23, 2017, Arkansas Democrat-Gazette: “Three years after their states expanded Medicaid, low-income people in Arkansas and Kentucky continued to be more likely to have a doctor and less likely to have trouble paying medical bills or to delay seeking care because of the cost, a study has found. The study, conducted annually since 2013 by researchers with the Harvard School of Public Health and Brigham and Women’s Hospital in Boston, found those and other improvements in Arkansas and Kentucky continued to be significant compared with smaller or nonexistent gains in Texas, which did not expand Medicaid…”

States and Medicaid Coverage

  • Medicaid is helping poor patients get needed care, even as Republicans push to cut it, study finds, By Noam N. Levey, May 17, 2017, Los Angeles Times: “As the Trump administration and congressional Republicans push for sweeping cuts to the Medicaid safety net, a study released Wednesday provides new evidence the program is significantly improving poor Americans’ access to vital medical care. Low-income patients in Arkansas and Kentucky, two states that expanded Medicaid under the Affordable Care Act, are getting check-ups more regularly and delaying care because of cost less frequently…”
  • Nebraska’s new Medicaid managed care system blamed for problems with billing and getting approval for care, By Martha Stoddard, May 15, 2017, Omaha World-Herald: “Nebraska’s new system for administering the bulk of its Medicaid program has gotten off to a rocky start. Nearly five months after its launch, the system has left behavioral health and home health providers fuming over unpaid claims and frustrated about getting care authorized for patients…”
  • Medicaid spending caps in Republican proposal would cut coverage for Florida children, By Daniel Chang, May 18, 2017, Miami Herald: “Low-income children in Florida gained Medicaid coverage under the Affordable Care Act despite the state’s refusal to expand eligibility for the public health insurance program, according to a study published Wednesday by the non-partisan Urban Institute, a health policy think tank. But those gains may end if the American Health Care Act — the Republican-sponsored bill to repeal and replace the health law known as Obamacare — creates spending caps for Medicaid, according to the consulting firm Avalere Health in a separate report this week…”
  • Big health gains in Medicaid expansion states elude Texas’ poor, By Jenny Deam, May 18, 2017, Houston Chronicle: “The health of Texas’ poor is worse – at times significantly so – than those who live in two Southern states that expanded Medicaid under the Affordable Care Act. A report Wednesday in Health Affairs, a health policy journal, examined four years of medical outcomes in Texas, Arkansas and Kentucky and found that health measurements in the latter two states, both of which expanded Medicaid, dramatically improved in nearly all categories…”

Health Insurance Coverage in the US

Progress reducing U.S. uninsured rate comes to a halt, By Ricardo Alonso-Zaldivar (AP), May 16, 2017, Seattle Times: “Five years of progress reducing the number of Americans without health insurance has come to a halt, according to a government report out Tuesday. More than a factoid, it shows the stakes in the Republican drive to roll back the Affordable Care Act. The report from the Centers for Disease Control and Prevention estimates that 28.6 million people were uninsured in 2016, unchanged from 2015. It was the first year since passage of the health care overhaul in 2010 that the number of uninsured did not budge…”

Medicaid Spending to School Districts

Schools brace for impact if Congress cuts Medicaid spending, By Sally Ho and Carolyn Thompson (AP), May 14, 2017, Arizona Daily Star: “For school districts still getting their financial footing after the Great Recession, the Medicaid changes being advanced as part of the health-care overhaul are sounding familiar alarms. Administrators say programming and services even beyond those that receive funding from the state-federal health care program could be at risk should Congress follow through with plans to change the way Medicaid is distributed. They say any reduction in the estimated $4 billion schools receive in annual Medicaid reimbursements would be hard to absorb after years of reduced state funding and a weakened tax base…”

Medicaid and Maternity Care – Alabama

Some Medicaid mothers must wait weeks, months before first doctor’s visit, By Anna Claire Vollers, May 8, 2017, AL.com: “When Katie Silvia learned she was pregnant in November 2016, her first call wasn’t to her obstetrician – it was to the Alabama Medicaid office. Her husband had received a letter from Blue Cross Blue Shield of Alabama that his insurance, a Blue Cross plan purchased through the health exchange, was not going to cover her pregnancy because their income level qualified her for pregnancy Medicaid. But according to doctors and patients, Alabama’s complex maternity Medicaid process can mean some moms don’t get their first OBGYN appointment until they’re well into their second trimester, 13 or more weeks into their pregnancies…”

State Medicaid Programs – Florida, Ohio, Indiana

  • Florida deal would reverse key part of Obama’s Medicaid expansion, By Robert Pear, April 30, 2017, New York Times: “The Trump administration appears to have scrapped one of the key tools the Obama administration used to encourage states to expand Medicaid under the Affordable Care Act. The shift involves funding that the federal government provides to help hospitals defray the cost of caring for low-income people who are uninsured. Under a deal with Florida, the federal government has tentatively agreed to provide additional money for the state’s ‘low-income pool,’ in a reversal of the previous administration’s policy…”
  • Ohio GOP renews fight over Medicaid, By Jessie Balmert, May 1, 2017, Cincinnati Enquirer: “Republican lawmakers have backed off from an attempt by some to kill Gov. John Kasich’s expansion of Medicaid to lower-income Ohioans, but they are battling to rein it in. A new Ohio House proposal would force the Medicaid director to get approval for Medicaid expansion money every six months. To get the money, the director would go before the Controlling Board, a panel of six lawmakers and a Kasich appointee – the same group Kasich leveraged in 2013 when his party would not move the Medicaid expansion portion of Obamacare through the Legislature…”
  • How Medicaid can help you find a job, or get a ride, or land a free cellphone, By Shari Rudavsky, May 4, 2017, Indianapolis Star: “When Leona Cullen moved to Noblesville from Hawaii in December, she knew she would need health insurance in her new home. She also knew she would need a job. What she didn’t know was that an Indiana Medicaid provider could help her achieve both those goals. One month away from giving birth, Cullen, 42, visited a hospital emergency room in January, where staff helped her sign up for CareSource’s Healthy Indiana Plan. Not only did the plan cover the medical expenses associated with the birth of her daughter at the end of January, it also connected Cullen with Jessica Rockhill, a life coach who helped her organize her life…”

Medicaid and Children’s Dental Care – Minnesota

Feds warn Minnesota: Improve kids’ dental care in Medicaid, By Glenn Howatt, May 1, 2017, Star Tribune: “Minnesota has been warned that its main government health insurance program risks losing federal funding if it doesn’t provide more preventive dental care to children. The problem is familiar to many families on Medical Assistance: Many dentists don’t accept new patients covered by the program because Minnesota pays some of the lowest dental reimbursement rates in the country…”

State Medicaid Programs

  • Work requirements for Florida Medicaid recipients move forward in House, By Michael Auslen, April 26, 2017, Miami Herald: “Some low-income people who rely on Medicaid may have to meet new work requirements to keep their healthcare under legislation passed by the Florida House on Wednesday. Medicaid recipients who are able to work would have to prove to the state that they are working, actively seeking work or enrolled in a job-training program. It wouldn’t apply to people with disabilities, the elderly and children, groups that make up the majority of Florida’s Medicaid enrollment…”
  • Study: Nearly all Ohio Medicaid expansion enrollees would lose coverage if expansion is repealed, By Maria Castellucci, April 26, 2017, Crain’s Cleveland Business: “About 95% of Medicaid expansion beneficiaries in Ohio would have no insurance option available if repealing the Affordable Care Act eliminates Medicaid expansion, according to a new study…”
  • Unemployed Ohioans would lose healthcare coverage under proposed changes to Medicaid expansion, By Ginger Christ, April 28, 2017, Cleveland Plain Dealer: “A new state budget proposal presented in the Ohio House of Representatives would limit the number of people eligible for Medicaid through the expansion. The proposed budget would only cover under the expansion those who are 55 or older or medically fragile, employed, enrolled in a workforce training program or a recovery program…”

Drug Testing and Medicaid – Wisconsin

Wisconsin seeks to mandate drug tests for Medicaid recipients, By Astead W. Herndon, April 25, 2017, Boston Globe: “Low-income residents seeking government help in Wisconsin often slog through a frustrating, outdated bureaucracy at a run-down state building in Milwaukee, enduring a process that generates complaints about the difficulties of signing up for food assistance, unemployment benefits, and Medicaid. Now, in a first-in-the-nation experiment, Wisconsin Governor Scott Walker plans to raise the bar higher for people seeking Medicaid, with an expansive program of mandatory drug screening, testing, and treatment as a condition of receiving benefits…”

State Medicaid Programs

  • Advocates worry Medicaid patients may not be aware of changes to system, By Samantha Liss, April 16, 2017, St. Louis Post-Dispatch: “On May 1, 250,000 additional Medicaid recipients in Missouri will be enrolled in a managed care system, and advocates and health policy experts say they are worried that not enough has been done to make them aware of the changes. Patients could fall through the cracks because of the confusion, say policy experts with the Missouri Foundation for Health…”
  • Wisconsin seeks to drug test some Medicaid enrollees, By David Wahlberg, April 18, 2017, Wisconsin State Journal: “Childless adults who sign up for Wisconsin’s Medicaid program would be screened for drug use and required to pay premiums under a proposal Gov. Scott Walker’s administration plans to submit next month to the federal government. The state Department of Health Services released a summary of the proposal Monday…”
  • Gov. Matt Bevin’s likely Medicaid shake-up scares Kentucky patients, By Deborah Yetter, Louisville Courier-Journal: “Before he got dental coverage, David Thompson, who works at various construction jobs, said he suffered for years with untreated dental pain and decay. ‘I’d go to work and the pain would be so excruciating that I would literally at lunch go in the parking lot and pull my own teeth,’ said Thompson, 49, who lives in South Louisville. Now, having just gained health coverage through Kentucky’s expansion of Medicaid under the Affordable Care Act, Thompson is hurrying to schedule dental and eye exams — care he said he urgently needs but realizes could be eliminated under major changes to Kentucky’s Medicaid program proposed by Gov. Matt Bevin…”

Medicaid and Work Requirements

  • Under Trump, states may demand work for Medicaid, By Ricardo Alonso-Zaldivar (AP), April 20, 2017, San Francisco Chronicle: “Work requirements for Medicaid could lead to major changes in the social safety net under President Donald Trump. It sounds like a simple question: Should adults who are able to work be required to do so to get taxpayer provided health insurance? The federal-state Medicaid program for low-income and disabled people covers more than 70 million U.S. residents — about 1 in 5 — including an increasing number of working-age adults. In a break from past federal policy, the Health and Human Services department under Secretary Tom Price has already notified governors it stands ready to approve state waivers for ‘meritorious’ programs that encourage work…”
  • Medicaid may require work, payments from the poor, as Indiana tried, By Jayne O’Donnell, April 18, 2017, USA Today: “Katie Josway is a liberal musician and massage therapist in a conservative state that gave her health care coverage two years ago. She has to make monthly payments and can lose her plan if she misses one. She’s fine with that. There’s a ‘common misperception’ that people who need government assistance are looking for a handout, she says. ‘We are all doing the best we can,’ says Josway, who turns 31 Wednesday. ‘Instilling a little bit of accountability and cutting people a break where needed will lead to a better functioning and happier society.’ Far more people may also have to adjust to the new reality of formerly free health coverage through Medicaid: It will cost money…”

Medicaid Expansion – Louisiana

Poll: Louisiana residents largely support Medicaid expansion but find ‘Obamacare’ unfavorable, By Elizabeth Crisp, April 11, 2017, Baton Rouge Advocate: “Nearly three-fourths of Louisiana residents approve of the state’s decision to expand Medicaid, a new poll suggests, even as President Donald Trump, who remains widely popular in the state, continues his quest to repeal the federal Affordable Care Act that made expansion possible.  The 2017 Louisiana Survey’s findings on health care suggest a disconnect in the relationship between Medicaid health care coverage and the ACA…”

State Medicaid Program – Florida

On Medicaid? You may soon have to work or pay to keep benefits, By Michael Auslen, April 7, 2017, Miami Herald: “Medicaid recipients in Florida could soon have to meet work requirements and pay a premium to stay in the government-funded healthcare program. The Florida House is moving ahead with a plan to force able-bodied Medicaid recipients to prove they are employed, participating in job training or searching for work in order to receive benefits, the same requirements the state puts on welfare recipients. The House also wants to require most Medicaid recipients pay $10 or $15 a month, depending on their income…”

Drug Testing and Public Assistance Programs

  • Want Medicaid coverage? A drug test should come first, Wisconsin governor says, By Paige Winfield Cunningham, April 2, 2017, Washington Post: “Now that House Republicans have squandered their shot at reordering Medicaid, governors who want conservative changes in the health program for ­low-income Americans must get special permission from the Trump administration. Near the front of the line is Wisconsin Gov. Scott Walker, a Republican who not only supports work requirements and premium payments but also a new additional condition: to make applicants undergo a drug test if they’re suspected of substance abuse…”
  • In need of public assistance? You might need $40 and a drug test to get it., By Michael Auslen, March 13, 2017, Miami Herald: “Welfare recipients with a history of drug convictions could have to pass a drug test before receiving benefits under legislation pushed by two Tampa Bay lawmakers, a narrow rewrite of a much-maligned 2011 state law that federal judges threw out as unconstitutional…”
  • Few Maine welfare recipients tested for drugs despite state law, By Maria Villeneuve (AP), Portland Press Herald: “Republican Gov. Paul LePage has long contended that drug-testing welfare recipients will help protect taxpayers’ dollars, but only a handful have submitted to tests under the current law. His administration blames Democrats for the scant results…”

State Medicaid Program – Indiana

Indiana’s Medicaid alternative life-saving and frustrating, By Maureen Groppe, April 3, 2017, Indianapolis Star: “Indiana’s alternative Medicaid program enabled one Hoosier to get life-saving back surgery. Others who have told the federal government about their experiences with the Healthy Indiana Program also credit HIP 2.0 with saving their lives through care they would not have previously been able to afford. ‘If it wasn’t for HIP 2.0, I would be dead,’ one patient wrote in comments the U.S. Department of Health and Human Services collected as part of the agency’s consideration of Indiana’s request to continue the program, which has been touted as a model for other states. Criticism, however, was more prevalent than praise in the nearly 100 comments submitted…”

States and Medicaid Expansion

  • In health bill’s defeat, Medicaid comes of age, By Kate Zernike, Abby Goodnough and Pam Belluck, March 27, 2017, New York Times: “When it was created more than a half century ago, Medicaid almost escaped notice. Front-page stories hailed the bigger, more controversial part of the law that President Lyndon B. Johnson signed that July day in 1965 — health insurance for elderly people, or Medicare, which the American Medical Association had bitterly denounced as socialized medicine. The New York Times did not even mention Medicaid, conceived as a small program to cover poor people’s medical bills. But over the past five decades, Medicaid has surpassed Medicare in the number of Americans it covers. It has grown gradually into a behemoth that provides for the medical needs of one in five Americans — 74 million people — starting for many in the womb, and for others, ending only when they go to their graves…”
  • Medicaid expansion becomes trendy with death of GOP health bill, By Maggie Fox, March 31, 2017, NBC News: “All of a sudden, Medicaid is trendy again. The governor of Kansas vetoed a bill on Thursday that would have expanded Medicaid in his state. But the legislature is reserving the option of trying to override the veto and Virginia and North Carolina are moving toward expansion. Several other states are considering it.  It’s a fast turnaround made by states that had resolutely resisted taking part on a major plank of the 2010 Affordable Care Act — the expansion of Medicaid to cover more people…”
  • The states where Obamacare’s footprint might get even bigger, By Russell Berman, March 29, 2017, The Atlantic: “Now that the Affordable Care Act has survived its most serious threat in Congress, the law’s footprint across the country might grow even larger in the months ahead. Several states that initially opted out of Obamacare’s Medicaid expansion are now reconsidering their decision as a result of last year’s elections and as Republicans come under new pressure to accept the billions in federal dollars available under the law. The most aggressive push is coming in deep-red Kansas, where the Republican-controlled Senate on Tuesday sent Governor Sam Brownback legislation that could expand the state’s version of Medicaid to as many as 150,000 new enrollees…”
  • Brownback vetoes Medicaid expansion; House pauses override debate, By Jonathan Shorman, March 30, 2017, Wichita Eagle: “The fate of Medicaid expansion in Kansas remains undecided – at least until Monday – as supporters of expansion scramble to find votes to override Gov. Sam Brownback’s veto. Brownback vetoed the proposal Thursday morning, one day after receiving it. ‘The cost of expanding Medicaid under ObamaCare is irresponsible and unsustainable,’ he said in his veto message…”
  • Arkansas lawmakers send Medicaid expansion to governor, By John Lyon, March 31, 2017, Times Record: “The House on Thursday approved and sent to the governor’s desk a bill that will fund Arkansas’ Medicaid expansion program for another year. House members voted 77-13 to approve Senate Bill 196 by the Joint Budget Committee, a bill to appropriate $8.3 billion in federal and state Medicaid money for traditional Medicaid and the Medicaid expansion program…”
  • Georgia to explore Medicaid changes after GOP health plan’s implosion, By Greg Bluestein, March 27, 2017, Atlanta Journal-Constitution: “Gov. Nathan Deal said Monday his administration is exploring changes to Georgia’s Medicaid program after a sweeping Republican overhaul of the Affordable Care Act was scuttled in a stunning rebuke to Donald Trump and Congressional leaders. The Republican governor said there are limits to what the state can request ‘as long as mandates under the basic Obamacare legislation stand in place.’ But he said the state would review healthcare options that could include changes to ‘mandated minimum coverage’ provisions that require the state Medicaid program to cover a range of health services to recipients…”

Medicaid Births – New Mexico

NM has highest rate of Medicaid-covered births, By Rick Nathanson, March 28, 2017, Albuquerque Journal: “New Mexico leads the nation in the percentage of babies born into Medicaid families – which can be taken as a reflection of the state’s high poverty rate or an indication that government here takes care of its own. According to figures from 2015, 72 percent of the births reported in New Mexico were paid for by Medicaid, a jointly funded federal-state health insurance program for low-income, disabled and other people who qualify…”

Medicaid Privatization – Iowa

Medicaid firms spending less on care for Iowa’s poor, disabled, By Tony Leys, March 15, 2017, Des Moines Register: “The three private firms running Iowa’s Medicaid program have found ways to trim spending on care for the poor or disabled Iowans they cover, a new report suggests. But all three continue to lose tens of millions of dollars on the controversial project.  The companies’ per-member monthly spending on health care for adults fell by as much as 28 percent from the three months ending in September 2016 to the three months ending in December 2016, the new report shows…”

Access to Health Clinics and Medicaid Births

Cutting Planned Parenthood would increase Medicaid births, C.B.O. says, By Kate Zernike, March 14, 2017, New York Times: “Cutting off federal funding for Planned Parenthood — a longstanding conservative goal that is included in the Republican bill to replace the Affordable Care Act — would reduce access to birth control for many women and result in thousands of additional Medicaid births, according to the Congressional Budget Office.  Because nearly half of all births nationwide are to Medicaid patients, and many of those babies are Medicaid patients themselves, the budget office estimated that defunding Planned Parenthood even for a year would increase Medicaid spending by $21 million in the first year, and $77 million by 2026…”