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25, 2017, Boston Globe: “Low-income residents seeking government help in Wisconsin often slog through a frustrating, outdated bureaucracy at a run-down state building in Milwaukee, enduring a process that generates complaints about the difficulties of signing up for food assistance,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…”

State SNAP programs

Republicans hope Trump amenable to food stamp restrictions, By Marina Villeneuve (AP), April 8, 2017, Denver Post: “Maine resident Zak McCutcheon says he likes soda but acknowledges he’d drink less of it if his governor convinced Republican President Donald Trump to put restrictions on the approximately $200 a month he receives in food stamps. He thinks it may even make recipients healthier and less overweight.  ‘If I was more restricted to what I could buy, I would become more of a veggie eater,’ said McCutcheon, who recently perused grapes and packages of pre-chopped vegetables at an Augusta food bank with his pregnant girlfriend.  But another one of Maine’s 180,000 food stamp recipients, Samantha Watson, said she believes a ban from using food stamps on soda and candy won’t make low-income people any healthier. It would take more than that to change eating habits, she said, since food stamps cover only a fraction of the monthly grocery bill for herself and her 3-year-old daughter…”

Homelessness in Wisconsin

GOP lawmakers offer legislation to address homelessness, including key council, By Dean Mosiman, April 12, 2017, Wisconsin State Journal: “Following spending initiatives in Gov. Scott Walker’s proposed budget, Republican state lawmakers are offering a series of bills intended to reduce homelessness in Wisconsin, including a high-powered council that’s at or near the top of a key state advocate’s wishlist.  State Assembly Majority Leader Jim Steineke, R-Kaukauna, and Sen. Alberta Darling, R-River Hills, on Wednesday will offer a legislative package of four bills that would provide new structure to state efforts to reduce and end homelessness, adjust some current programs and test new approaches…”

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…”

Court Fines and the Poor

An alternative to paying court debt: Working it off, By Rebecca Beitsch, April 4, 2017, Stateline: “When Steven Robinson first landed in county jail here for cocaine possession about a year ago, he had about $12,000 in court debt and his driver’s license had been suspended for more than 20 years because he never paid off earlier fines and fees. But Robinson, 47, and other inmates in the Albemarle-Charlottesville Regional Jail are allowed to do community service to work off the debt that they rack up in fines and fees on their way through the court system. By doing more than 1,000 hours of community service while serving time, Robinson has gotten his debt down to about $5,000…”

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…”

Ex-Offenders and Occupational Licenses

To help ex-offenders get jobs, some states reconsider licenses, By Sophie Quinton, March 8, 2017, Stateline: “Robert Lewis didn’t think it would be hard to get a job selling insurance. He was a car salesman for decades and sold insurance for a while after graduating from college. But in Lewis’ home state of Illinois, felons can’t get a license to sell insurance. And in 1985, Lewis was arrested for felony theft.  Lewis says he long ago kicked the drug habit that contributed to his arrest, and these days the 62-year-old can often be found running around after his grandkids.  ‘I was a whole other person back then,’ Lewis said of his Reagan-era brush with the law. But the criminal record derailed his recent job application…”

States and Medicaid Expansion

  • Study: Medicaid expansion made it easier to get a doctor’s appointment, By Michelle Andrews, March 6, 2017, Governing: “More than 14 million adults have enrolled in Medicaid since the health law passed, and that has caused some hand-wringing over whether there would be enough primary care providers to meet the demand. But a study out this week suggests that the newly insured people are generally able to get timely appointments for primary care…”
  • Stakes high in Illinois as Congress rethinks Medicaid, By Lisa Schencker, March 3, 2017, Chicago Tribune: “Soccer coach Lesly Durand noticed last fall that he was running out of breath more easily on the field, and getting unusually tired carrying bags of equipment.  The 61-year-old Evanston man didn’t know why, so he called his doctor. That call led to tests, which led to the discovery of five blocked arteries and then, ultimately, bypass surgery.  ‘The doctors said, ‘I can’t believe you’re still alive,”said Durand, who gained insurance a couple of years ago under the Affordable Care Act’s expansion of Medicaid…”
  • U.S. House ACA reform may turn up heat on N.C. Medicaid expansion, By Richard Craver, March 8, 2017, Winston-Salem Journal: “North Carolina Republican legislative leaders may have more incentive — but likely no new motivation — to expand the state’s Medicaid program as part of a proposal in the U.S. House for repealing and replacing the federal Affordable Care Act…”

Drug Overdose Deaths and Indigent Burial

Drugs are killing so many people in West Virginia that the state can’t keep up with the funerals, By Christopher Ingraham, March 7, 2017, Washington Post: “Deaths in West Virginia have overwhelmed a state program providing burial assistance for needy families for at least the fifth year in a row, causing the program to be nearly out of money four months before the end of the fiscal year, according to the state’s Department of Health and Human Resources (DHHR). Funeral directors in West Virginia say the state’s drug overdose epidemic, the worst in the nation, is partly to blame…”

States and Medicaid Coverage

  • The adults a Medicaid work requirement would leave behind, By Abby Goodnough, February 25, 2017, New York Times: “On a frigid morning here, Nancy Godinez was piling bread and other staples into her car outside a food pantry. She had lost her job as a custodian, her unemployment checks had run out, and her job search had proved fruitless.  One thing she still had was health insurance, acquired three years ago after Arkansas’ Republican-controlled legislature agreed to expand Medicaid under the Affordable Care Act. The coverage, she said, has allowed her to get regular checkups and treatment for tendinitis in her foot.  But unless she finds a new job, Ms. Godinez, 55, could be at risk of losing her insurance, too…”
  • Obamacare 101: What’s going to happen to 70 million Americans who rely on Medicaid?, By Noam N. Levey, March 2, 2017, Los Angeles Times: “It’s the program that everyone confuses with Medicare.  But Medicaid, the half-century-old government health plan for the poor, is actually bigger than its more famous cousin, covering some 70 million Americans at any one time.  Expanding Medicaid was a central pillar of the Affordable Care Act, helping to bring health coverage to more than 20 million previously uninsured people…”
  • Who are the 700,000 Ohioans receiving health insurance under Medicaid expansion?, By Rich Exner, Cleveland Plain Dealer: “Who are the 700,000 Ohioans who have received health insurance under Medicaid expansion? And has the insurance really made a difference?  A state report conducted for the Ohio General Assembly provides a snapshot, based on questioning of new Medicaid recipients added as a result of Obamacare…”
  • Texas brings ‘disadvantages’ to debate of federal Medicaid spending caps, study warns, By Robert T. Garrett, February 28, 2017, Dallas Morning News: “For years, Texas GOP leaders have said they’d gladly give up open-ended flows of federal Medicaid money for a set ‘block grant’ that lets them run the health insurance program for the poor the way they want.  They may get their wish.  As part of repealing and replacing Obamacare, U.S. House Speaker Paul Ryan and Republican House leaders such as Rep. Kevin Brady of The Woodlands have proposed that states choose between Medicaid block grants and per capita caps. President Donald Trump and Senate Republican leaders have called for similar changes…”

Health Insurance Coverage

  • Major hospitals pull out of Alabama Medicaid reform, call for delay, By Amy Yurkanin, February 14, 2017, Birmingham News: “An overhaul of the state’s Medicaid program that has already been postponed a year could face more delays after the departure of several health care systems over concerns about the program’s direction and costs.  State leaders have been working since 2012 to transform the Medicaid program from a system that pays for unlimited services to managed care that caps costs at a certain amount per patient to control spending. Last year, federal authorities approved a plan for managed care for Medicaid, which provides health coverage to about a million low-income Alabamians. Regional care organizations in five regions are a key part of the reform effort…”
  • As GOP plows forward on Obamacare repeal, new data show the nation’s uninsured rate hit a record low last year, By Noam N. Levey, February 14, 2017, Los Angeles Times: “The nation’s uninsured rate tumbled further last year, hitting the lowest rate on record, according to new government data that underscored what is at stake in the Republican effort to repeal the Affordable Care Act.  In the first nine months of 2016, just 8.8% of Americans lacked health coverage, survey data from the federal Centers for Disease Control and Prevention show…”
  • Republican health care proposal would cover fewer low-income families, By Alison Kodjak, February 16, 2017, National Public Radio: “House Republicans are debating a plan to replace the Affordable Care Act that would give consumers tax credits to buy insurance, cut back on Medicaid and allow people to save their own money to pay for health care costs.  The outline plan is likely to take away some of the financial help low-income families get through Obamacare subsidies, and also result in fewer people being covered under the Medicaid health care program for the poor…”

State Medicaid Programs

  • Indiana looks to extend Medicaid experiment started under Obamacare, By Phil Galewitz, February 1, 2017, National Public Radio: “As Congress weighs repeal of the Affordable Care Act, the home state of Vice President Mike Pence Tuesday sought to keep its conservative-style Medicaid expansion under the federal health the health law.  Indiana applied to the Trump administration to extend a regulatory waiver and funding until Jan. 31, 2021, for its package of incentives and penalties that are intended to encourage low-income Hoosiers on Medicaid to adopt healthful behaviors. Beneficiaries pay premiums, get health savings accounts and can lose their benefits if they miss payments…”
  • Kasich keeps Medicaid expansion in state budget proposal, By Catherine Candisky, January 31, 2017, Columbus Dispatch: “Amid uncertainty about the expected repeal of the Affordable Care Act, Gov. John Kasich’s final two-year budget proposal maintains Medicaid health coverage for 3 million poor and disabled Ohioans, including the 700,000 childless adults added to the rolls under Obamacare.  To curb costs, Kasich’s plan for Ohio’s tax-funded health insurance program would save hundreds of millions by cutting payments to hospitals and nursing homes, charging premiums to some beneficiaries, and moving nursing home residents and others into private managed-care plans…”
  • Arizona plan to tighten Medicaid eligibility likely to stand better chance under Trump’s watch, By Ken Alltucker, February 1, 2017, Arizona Republic: “State officials again will seek to tighten Medicaid eligibility with new restrictions that could affect tens of thousand of adults enrolled in the government insurance program for low-income Arizonans.  The state’s Medicaid agency is preparing to seek federal permission to require ‘able-bodied’ Medicaid recipients to either be employed or searching for a job while enrolled. The state also proposes to cap lifetime eligibility for Medicaid at five years…”

State Medicaid Programs

  • Obamacare, Medicaid-expansion recipients in Ohio fear repeal, By Catherine Candisky, Alan Johnson and JoAnne Viviano, January 22, 2017, Columbus Dispatch: “Breast-cancer survivor Susan Halpern said she is terrified about losing her health-care coverage if the Trump administration follows through with its promise to repeal the Affordable Care Act.  Bankruptcy could be on the horizon, the Columbus woman said.  ‘I’m trying to figure out a way to survive and keep some kind of health insurance,’ said Halpern, 57, who owns a small social-media business.  Nearly 1 million Ohioans, and 20 million nationwide, are covered under the law’s expansion of Medicaid coverage and creation of an insurance exchange marketplace that offers federal subsidies to help many Americans pay premiums…”
  • Republican states look to customize Medicaid expansion, not eliminate it, By Christine Vestal, January 23, 2017, Stateline: “As candidates two years ago, the Republican governors of Kentucky and Arkansas swore they would do away with ‘Obamacare’ if elected. But a funny thing happened between the campaign trail and the governor’s mansion: Reality set in.  After promising to uproot Kentucky’s Medicaid expansion under the Affordable Care Act, Republican Gov. Matt Bevin simply renamed his Democratic predecessor’s health care plan for low-income adults and proposed changes designed to help people find jobs and get off the rolls…”

State Medicaid Programs

  • Criticizing Kansas, feds deny extension of KanCare privatized Medicaid program, By Bryan Lowry and Hunter Woodall, January 19, 2017, Kansas City Star: “Federal officials have rejected Kansas’ request to extend its privatized Medicaid program, KanCare, saying it has failed to meet federal standards and risked the health and safety of enrollees. Kansas is ‘substantively out of compliance with Federal statutes and regulations, as well as its Medicaid State Plan’ based on a review by federal investigators in October, according to a letter sent to the state Jan. 13 from the Centers for Medicare and Medicaid Services…”
  • GOP governors who turned down Medicaid money have hands out, By Thomas Beaumont (AP), January 19, 2017, Seattle Times: “Republican governors who turned down billions in federal dollars from an expansion of Medicaid under President Barack Obama’s health care law now have their hands out in hopes the GOP-controlled Congress comes up with a new formula to provide insurance for low-income Americans.  The other GOP governors, such as Ohio Gov. John Kasich, who agreed to expand state-run services in exchange for federal help — more than a dozen out of the 31 states — are adamant that Congress maintain the financing that has allowed them to add millions of low-income people to the health insurance rolls…”

State Minimum Wage Increases

A higher minimum wage in 2017, By Karl Russell, January 5, 2017, New York Times: “With the federal minimum wage of $7.25 an hour unchanged since 2009, many states have taken matters into their own hands and raised the statewide minimum wage. While a higher floor for pay is a powerful tool for improving the lot of the least-skilled workers, some economists worry it could result in slower job creation or cuts as employers confront higher labor costs…”

States and Medicaid Expansion

  • State alternatives to Obamacare, expanded Medicaid to get tested, By Jayne O’Donnell, December 22, 2016, USA Today: “Blocked sweat glands turn into searingly painful growths that send Brittany Young rushing back to the emergency room at Upson Regional Medical Center here.  Young also has the chronic intestinal disease Crohn’s to contend with. Without a job or health insurance, the single mother can’t get the ongoing treatment needed to keep her Crohn’s from progressing. She’s visited the ER six times since losing her Medicaid coverage after her baby was born in June.  Young says she has no money, so she pays nothing.  ‘I guess someone ran the numbers and figured out it saves money to do it this way,’ says Anthony Marchetti, an Upson emergency physician who has treated Young…”
  • Montana may be model for future Medicaid work requirement, By Eric Whitney, December 23, 2016, National Public Radio: “Montana State Senator Ed Buttrey is a no-nonsense businessman from the central part of the state. Like a lot of Republicans, he’s not a fan of the Affordable Care Act and its expansion of Medicaid, health insurance for the poor and disabled…”

Medicaid Expansion – Indiana

Indiana’s Medicaid experiment may reveal Obamacare’s future, By Alana Semuels, December 21, 2016, The Atlantic: “Nearly 20 governors turned away the federal funding to expand Medicaid offered under the Affordable Care Act. Their states’ opposition to Obamacare meant that tens of thousands of low-income people in their states continued to live without health insurance.  But Mike Pence, governor of Indiana, was not one of them. After two years of negotiation, Pence in January 2015 reached an agreement with the Obama administration granting Indiana a waiver to try its own form of Medicaid expansion, called Healthy Indiana Plan (HIP) 2.0. The state would become one of the 31 that participated in the Medicaid expansion, receiving federal money through the Affordable Care Act to cover people between 100 percent and 138 percent of the federal poverty line. (Medicaid already covered a limited number of people living below the poverty line.) But it could also add its own modifications, the most salient being that participants would be required to contribute monthly fees to continue to receive access to health care…”

Minimum Wage Increases

Minimum wage going up in 21 states, 22 cities, By Jeanne Sahadi, December 19, 2016, CNNMoney: “Come the new year, millions of the lowest-wage workers across the country will get a raise.  Some of those raises will be very minor — a cost of living adjustment amounting to an extra nickel or dime an hour. But in several places the jump will be between $1 and $2 an hour…”