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…”

Identification Cards and the Homeless

Without ID, homeless trapped in vicious cycle, By Teresa Wiltz, May 15, 2017, Stateline: “Nearly three years ago, when his fiancee died, Robert Giddings was abruptly evicted from their Flint, Michigan, home. His name wasn’t on the lease, so he had no recourse — and his landlord threw out all his things, including his ID. Terrified, he stumbled through the wintry streets for a day, until police picked him up for public intoxication. Giddings says he wasn’t drunk, but blind from untreated cataracts. Giddings was placed in a shelter, but without ID, he couldn’t get the medical care he needed — or even gain entrance to government buildings so he could apply for a replacement ID…”

State Benefit Program Eligibility Checks

What happens when states go hunting for welfare fraud, By Jen Fifield, May 24, 2017, Stateline: “By the time Illinois decided to crack down on Medicaid fraud in 2012, state officials knew that many people enrolled in the program probably weren’t eligible. For years, caseworkers hadn’t had the time or resources to check. To catch up, the state hired a private contractor to identify people who might not be eligible for the low-income health program and to make recommendations for whose benefits should be canceled. Within about a year, Illinois had canceled benefits for nearly 150,000 people whose eligibility could not be verified — and saved an estimated $70 million…”

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…”

State Children’s Health Insurance Program

As GOP tarries on health bill, funding for children’s health languishes, By Julie Rovner, May 22, 2017, National Public Radio: “Back in January, Republicans boasted they would deliver a “repeal and replace” bill for the Affordable Care Act to President Donald Trump’s desk by the end of the month. In the interim, that bravado has faded as their efforts stalled and they found out how complicated undoing a major law can be. With summer just around the corner, and most of official Washington swept up in scandals surrounding Trump, the health overhaul delays are starting to back up the rest of the 2018 agenda. One of the immediate casualties is the renewal of the Children’s Health Insurance Program. CHIP covers just under 9 million children in low- and moderate-income families, at a cost of about $15 billion a year…”

US State Unemployment

  • Unemployment rates hit record lows in 3 states, By Josh Boak (AP), May 19, 2017, St. Louis Post-Dispatch: “Solid hiring nationwide led unemployment rates to touch record lows in three U.S. states last month. Unemployment rates declined in 10 states in April, increased in one — Massachusetts — and held relatively stable in the other 39, the Labor Department said Friday. A significant number of the job gains occurred in nine states, led by Texas, Minnesota and Wisconsin. Indiana was the only state to see a significant decrease in jobs last month…”
  • 9 years after recession began, some states still unrecovered, By Jeff Amy (AP), May 18, 2017, St. Louis Post-Dispatch: “Call them the unrecovered — a handful of states where job markets, nine years later, are still struggling back to where they were before the recession. That’s true in Mississippi, where job numbers and the overall size of the economy remain below 2008 levels. Unlike states that have long since sprinted ahead, Mississippi is struggling with slow economic growth and slipping population in a place that’s rarely at peak economic health…”

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…”

States and Job Training

Why some states are making short-term training free, By Sophie Quinton, May 3, 2017, Stateline: “Community colleges are known for their associate degree programs. But these days, many community colleges award more certificates than degrees. Certificates typically take less than two years to complete and promise to prepare students for entry-level jobs in fields such as medical insurance coding or welding. Now Kentucky and Indiana have created scholarships that would make some certificates tuition-free. The new grants draw inspiration from the free college idea pushed by Democrats like former President Barack Obama and embraced by Oregon, Tennessee and New York. But they’re less focused on reducing soaring tuition prices and more focused on training students for jobs that are sitting open…”

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…”

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…”