Reform of Safety-Net Programs

  • GOP challenge: Reforming widely accepted ‘safety net’ programs, By Mark Turnbull, July 19, 2017, Christian Science Monitor: “The failure of Senate Republicans to close ranks on health-care reform this week put on display an old challenge: How conservatives can reform social safety-net programs when there’s a growing acceptance of them – even among Republican voters…”
  • Small tweaks to existing policies could make a huge difference for poor families, By Karen Weese, July 20, 2017, Washington Post: “It wasn’t much — just five bucks apiece — but both boys’ eyes sparkled when Carol Moore told them they could spend it on anything they wanted. ‘Meet me back here in 10 minutes,’ Moore told the boys, whom she’d met a few months ago when they came to her church’s homeless shelter. As the boys set out into the aisles of Walmart, she called after them: ‘Just get something you really want, okay?’ Ten minutes later, they came back and held out their treasure. It was deodorant…”

Medicaid Programs

  • Montana faces double quandary over Medicaid expansion, By Bobby Caina Calvan (AP), July 17, 2017, Washington Post: “For all the uncertainty over the fate of a health care overhaul in Washington, tens of thousands of Montana’s working poor are already in a double quandary: Even if Congress leaves Medicaid expansion mostly intact, the future of the state’s program remains uncertain…”
  • Holcomb asks feds to allow Medicaid work requirements, Associated Press, July 21, 2017, Indianapolis Star: “Gov. Eric Holcomb has submitted a finalized proposal allowing for changes to the state’s Healthy Indiana Plan 2.0 serving low-income Hoosiers…”
  • Study suggests why more skin in the game won’t fix Medicaid, By Don Sapatkin, July 19, 2017, Philadelphia Inquirer: “As patients and partisans of all stripes take a deep breath after the latest Republican effort to dismantle Obamacare, they might consider how trying to save health-care dollars can have unintended consequences. In the Netherlands,  the government sought to give people more ‘skin in the game’ in its national health system. The idea —  long supported by U.S. conservatives, even for poor people on Medicaid — is that when patients have to shell out some cash for their care, they won’t seek unnecessary services…”

Medicaid and Addiction Treatment

How Medicaid cuts could exacerbate the opioid epidemic, By Ronald Brownstein, July 13, 2017, The Atlantic: “When Christie Green took her job three years ago as public-health director for the Cumberland Valley District in southeastern Kentucky, she had nearly two decades of experience in the state’s public-health system. But Green still wasn’t prepared for what she saw when her predecessor took her around this hardscrabble swathe of Appalachia centered on Clay County, which The New York Times once described as the hardest place in the United States to live. ‘In the first week,’ Green recently told me, ‘I met more people who were raising their grandchildren than I had in my entire career before that…’”

Medicaid Coverage

Medicaid and Addiction Treatment

Medicaid expansion has delivered access to addiction treatment, report finds, By Sarah Fentem, July 7, 2017, National Public Radio: “This week, as senators have decamped from Washington for the Fourth of July recess, the future of the Senate’s Affordable Care Act replacement plan — and by extension, Medicaid — remains uncertain. Just days before the recess, a report from the Urban Institute, a public policy think tank, detailed big increases in Medicaid spending on opioid addiction treatment under the Affordable Care Act. It’s a trend that could be reversed if the Senate’s plan passes…”

State Medicaid Programs

States move to tighten Medicaid enrollment, even without a new health law, By Charles Ornstein, July 6, 2017, National Public Radio: “No corner of the health care system would be harder hit than Medicaid, the federal-state health insurance program for the poor, if Republican leaders in Congress round up the votes to repeal major portions of the Affordable Care Act. GOP lawmakers have proposed winding down the Medicaid expansion that added 17 million people in 31 states and the District of Columbia under the ACA, and also eventually capping the program’s spending per capita…”

Rural Health Care

  • Deaths from cancer higher in rural America, CDC finds, By Lena H. Sun, July 6, 2017, Washington Post: “Despite decreases in cancer death rates nationwide, a new report shows they are higher in rural America than in urban areas of the United States. The report released Thursday by the Centers for Disease Control and Prevention found that rural areas had higher rates of new cases as well as of deaths from cancers related to tobacco use, such as lung and laryngeal cancers, and those that can be prevented by screening, such as colorectal and cervical cancers…”
  • Kids in pro-Trump rural areas have a lot to lose if GOP rolls back Medicaid, By Noam Levey, July 6, 2017, Los Angeles Times: “Communities like this aging West Virginia coal town along the Kanawha River were key to President Trump’s victory last year; more than two-thirds of voters in surrounding Fayette County backed the Republican nominee. Now, families in this rural county and hundreds like it that supported Trump face the loss of a critical safety net for children as congressional Republicans move to cut hundreds of billions of dollars over the next decade from Medicaid, the half-century-old government health plan for the poor…”

Medicaid Cuts and State Programs

  • From birth to death, Medicaid affects the lives of millions, By Alison Kodjak, June 27, 2017, National Public Radio: “Medicaid is the government health care program for the poor.  That’s the shorthand explanation. But Medicaid is so much more than that — which is why it has become the focal point of the battle in Washington to repeal and replace the Affordable Care Act, also known as Obamacare. President Barack Obama expanded Medicaid under his signature health care law to cover 11 million more people, bringing the total number of people covered up to 69 million…”
  • For people who depend on Medicaid, proposed federal caps in health care plans instill fear, By Guy Boulton, June 24, 2017, Milwaukee Journal Sentinel: “Aaron Christensen was born with a condition so rare that fewer than 100 people have been diagnosed and reported with it worldwide. The boy, now 6, has Nicolaides-Baraitser syndrome, which is characterized by intellectual disability, distinctive facial and other physical features, and often seizures. When he was born, ‘everything kind of changed,’ said his mother, Sara Christensen. ‘We still don’t know what the future looks like.’ Aaron could depend on Medicaid to pay for all or most of his health care his entire life, through a special program. And that’s why they’re extremely anxious about congressional Republicans’ plans to cap what the federal government spends on Medicaid in future years…”
  • The who, what and how much of Mississippi Medicaid, By Sarah Fowler, June 28, 2017, Clarion-Ledger: “Each morning, Samantha Manning rushes to get her family ready for the day. Her eldest, 13-year-old Kennedy, is involved in a number of sports. Combine that with twin 8-year-old boys, and each day is different. Kennedy is a type 1 diabetic and goes to a small school that doesn’t have a nurse on staff. Because of the teen’s diabetes, the school’s policy demands one parent is present at all of her games…”
  • Veterans helped by Obamacare worry about Republican repeal efforts, By Stephanie O’Neill, June 28, 2017, National Public Radio: “Air Force veteran Billy Ramos, from Simi Valley, Calif., is 53 and gets health insurance for himself and for his family from Medicaid — the government insurance program for lower-income people. He says he counts on the coverage, especially because of his physically demanding work as a self-employed contractor in the heating and air conditioning business…”

Medicaid Cuts and State Programs

  • Republicans’ proposed Medicaid cuts would hit rural patients hard, By Bram Sable-Smith, June 22, 2017, National Public Radio: “For the hundreds of rural U.S. hospitals struggling to stay in business, health policy decisions made in Washington, D.C., this summer could make survival a lot tougher. Since 2010, at least 79 rural hospitals have closed across the country, and nearly 700 more are at risk of closing. These hospitals serve a largely older, poorer and sicker population than most hospitals, making them particularly vulnerable to changes made to Medicaid funding…”
  • G.O.P. health plan is really a rollback of Medicaid, By Margot Sanger-Katz, June 20, 2017, New York Times: “Tucked inside the Republican bill to replace Obamacare is a plan to impose a radical diet on a 52-year-old program that insures nearly one in five Americans. The bill, of course, would modify changes to the health system brought by the Affordable Care Act. But it would also permanently restructure Medicaid, which covers tens of millions of poor or disabled Americans, including millions who are living in nursing homes with conditions like Alzheimer’s or the aftereffects of a stroke…”
  • Republicans’ Medicaid rollback collides with opioid epidemic, By Ricardo Alonzo-Zaldivar (AP), June 20, 2017, ABC News: “The Republican campaign to roll back Barack Obama’s health care law is colliding with America’s opioid epidemic. Medicaid cutbacks would hit hard in states deeply affected by the addiction crisis and struggling to turn the corner, according to state data and concerned lawmakers in both parties…”
  • How states like Kansas punish the poor for being both too poor and not poor enough, By Max Ehrenfreund, June 19, 2017, Washington Post: “Obamacare was designed to make it easier for poor Americans to buy insurance. In many states, though, the law has left a hole where less needy households can receive benefits, while millions of Americans living in poverty cannot. They are, in effect, too poor to get help…”
  • In expanding Medicaid, Utah wants to make some enrollees work and cap their lifetime coverage, By Alex Stuckey, June 20, 2017, Salt Lake Tribune: “Utah health officials are proposing lifetime limits and work requirements for childless adults who would gain coverage under a Medicaid expansion plan, hoping the changes will help persuade the federal government to approve it…”
  • With Medicaid under the gun, new study highlights program’s successes in Cheshire County, By Ethan DeWitt, June 23, 2017, Keene Sentinel: “Amid fierce national clashes over the future of health care, and a new Republican bill unveiled Thursday, one federal program has proven a particular emotional flash point: Medicaid. Efforts to pare back the program, which provides coverage to low-income adults and children, have drawn alarm from Democrats and some Republican senators representing rural states…”

Health Insurance Coverage in the US

  • Charity care dips at Wisconsin hospitals, with more people insured; trend could end with Obamacare repeal, By David Wahlberg, June 11, 2017, Wisconsin State Journal: “Hospitals in Madison and throughout Wisconsin have provided less charity care in recent years as more people have gained insurance through the Affordable Care Act, with some hospitals directing the savings to disease prevention. That could change if Congress overturns the law, known as Obamacare, and increases the ranks of the uninsured. And if Medicare payment cuts that helped pay for the law’s expanded coverage also remain, hospitals could end up shifting more costs to people with private insurance, officials say…”
  • What the Obamacare overhaul could mean for Texas’ terrible maternal mortality rate, By Katie Leslie, June 12, 2017, Dallas Morning News: “Texas officials were already investigating why an alarming number of Lone Star women are dying from pregnancy-related complications when a study last year ranked the state’s maternal mortality rate as the nation’s worst. That’s why many doctors and health care advocates are watching Republican-led negotiations in Washington over replacing the Affordable Care Act, with some worried about what the changes could mean for Texas’ maternal health crisis…”
  • Nevada may become first state to offer Medicaid to all, regardless of income, By Alison Kodjak, June 13, 2017, National Public Radio: “Nevadans will find out this week whether their state will become the first in the country to allow anyone to buy into Medicaid, the government health care program for the poor and disabled…”
  • In Texas, people with erratic incomes risk being cut off from Medicaid, By Shefali Luthra, June 14, 2017, Iowa Public Radio: “Worries about whether her children can still get the health care they need are never far from Dawn Poole’s mind. It’s a constant, underlying concern. Much of her anxiety is a direct result of living in Texas. To qualify for Medicaid in the state, most children must come from families with incomes at or below 138 percent of the federal poverty level. In 2017, that’s $33,948 for a family of four. Texas also has one of the country’s strictest Medicaid verification systems: It runs regular checks on family finances after children are enrolled to make sure they continue to qualify…”

Drug Testing and Medicaid – Wisconsin

Wisconsin submits request to drug test Medicaid applicants, By Scott Bauer (AP), June 7, 2017, Chicago Tribune: “Wisconsin submitted a federal request Wednesday to become the first state in the country to drug test applicants for Medicaid health benefits. Republican Gov. Scott Walker expects President Donald Trump’s administration to approve the waiver, which would also impose new requirements on able-bodied, childless adults receiving Medicaid in the state. The request comes as Walker, a one-time GOP presidential candidate, prepares for a likely re-election bid…”

Medicaid Enrollment in Rural Areas

  • Trump’s base in rural America could be disproportionately hurt by Medicaid cuts, By Jose A. DelReal, June 7, 2017, Washington Post: “The Affordable Care Act’s Medicaid expansion disproportionately benefited rural Americans over their urban counterparts, according to a new report, and President Trump’s proposed cuts to the program could negatively affect millions of them who have come to rely on it for coverage…”
  • GOP Medicaid cuts hit rural U.S. hardest, report finds, By Phil Galewitz, June 7, 2016, New Orleans Times-Picayune: “Rural America carried President Donald Trump to his election win in November. Trump Country it might be, but rural areas and small towns also make up Medicaid Country, those parts of the United States where low-income children and families are most dependent on the federal-state health insurance program, according to a report released Wednesday…”

State Medicaid Program – New Mexico

New Mexico considering changes to Medicaid program, By Susan Montoya Bryan (AP), June 2, 2017, Albuquerque Journal: “State officials say keeping costs down while improving the delivery of health care for New Mexico’s poorest residents is the focus as they propose changes to the Medicaid program to ensure sustainability as enrollment grows. More than a quarter-million state residents have enrolled since the program’s expansion in 2014. Now, more than 40 percent of children, the disabled and other low-income adults in New Mexico are covered…”

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…”