Assistance Programs and Work Requirements

  • Trump executive order strengthens work requirements for neediest Americans, By Tracy Jan, April 10, 2018, Washington Post: “President Trump on Tuesday signed an executive order directing federal agencies to strengthen existing work requirements and introduce new ones for low-income Americans receiving Medicaid, food stamps, public housing benefits and welfare as part of a broad overhaul of government assistance programs…”
  • Wisconsin Gov. Scott Walker signs new limits on welfare programs into law, By Jason Stein, April 10, 2018, Milwaukee Journal Sentinel: “Wisconsin Gov. Scott Walker on Tuesday signed new limits on welfare programs into law, committing state and federal taxpayers to nearly $80 million in spending to draw more people into the labor force…”

Medicaid Expansion – Louisiana, Montana

  • Medicaid expansion created 19,000 new jobs in Louisiana, according to study, By Maria Clark, April 10, 2018, New Orleans Times-Picayune: “Louisiana’s decision to expand Medicaid in 2016 led to a $1.85 billion direct economic impact, according to an economic impact report released Tuesday (April 11). The report called Medicaid Expansion and the Louisiana Economy was commissioned by the Louisiana Department of Health and prepared by Dr. Jim Richardson and the Public Administration Institute at Louisiana State University…”
  • Report: Medicaid expansion pays for itself; future economic impact seen as bright, By Holly K. Michels, April 10, 2018, Billings Gazette: “In the first two years after Montana expanded Medicaid, the savings to the state have eclipsed the costs. Though that could flip by 2020, increased activity in Montana’s economy because of the expansion will more than make up the difference. That’s according to a report commissioned by the Montana Healthcare Foundation and Headwaters Foundation…”

States and Medicaid Expansion

Republicans lead Medicaid expansion push in 2 holdout states, By Mattie Quinn, March 30, 2018, Governing: “After five years of failed attempts to expand Medicaid, Utah Gov. Gary Herbert signed a bill last week to do just that. It may come as a surprise that the bill was sponsored by a Republican. Republicans have historically opposed making more low-income people eligible for the government health insurance program. Under the Affordable Care Act (ACA), President Obama’s signature legislation, the federal government pays 90 to 100 percent of the costs for any state that expands. But Republican-led states have been slow to expand Medicaid, and nearly 20 of them still have not…”

Medicaid Work Requirements

  • Northern Ky. expected to be first area affected by new Medicaid work/training requirement, By Lisa Gillespie, April 6, 2018, Cincinnati Public Radio: “A top Kentucky official says northern Kentucky will likely be the first area where Medicaid enrollees will have to meet the state’s new ‘community engagement’ requirement, starting July 1. Kristi Putnam, program manager for the Medicaid changes in Kentucky, said the state sent out post-cards this week…”
  • Ohio’s plan to add work requirements for Medicaid gets push back, By Kaitlin Schroeder, April 5, 2018, Dayton Daily News: “Dozens of medical and social service lobbying groups are pushing back against Ohio Medicaid’s request to create work requirements for able-bodied adults covered through Medicaid expansion. The Trump administration opened the door for states to add the first-ever work requirements associated with the state-federal health insurance program for the poor. In response, the Republican-dominated legislature inserted language in last summer’s budget bill ordering the Kasich administration to apply…”
  • Several groups sign letter opposing HIP work requirement, By Jill Sheridan, March 28, 2018, Indiana Public Media: “A group of non-profits organizations sent a letter to Governor Eric Holcomb this week, urging him to reconsider a new Healthy Indiana Plan, HIP, rule.  More than 400,000 Hoosiers are currently enrolled in HIP which is Indiana’s Medicaid expansion program.  Last month the state became the second state to receive federal permission to add a work requirement…”

State Medicaid Programs

  • Medicaid is a lifeline for nearly half of this county’s residents, By Phil Galewitz, March 27, 2018, CNN Money: “On a crisp sunny day, Tyson Toledo, a precocious 5-year-old boy, hobbled into a private health clinic to have his infected foot examined. Pediatrician Gayle Harrison told his mother to continue to apply antibiotic ointment and reminded them to come back if the swelling and redness worsened. The appointment at Rehoboth McKinley Christian Health Care Services’ outpatient center in Gallup, New Mexico, comes at no charge for the Toledo family, who live 30 miles away on the Navajo Nation Reservation. That’s because Tyson is covered by Medicaid, the government health insurance program for the poor…”
  • California Medicaid expansion enrolled hundreds of thousands of ineligible people, federal report finds, By Chad Terhune, March 26, 2018, Los Angeles Times: “California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services Department’s chief watchdog…”
  • Utah governor signs Medicaid expansion bill. Now, Utah waits to see if the feds will approve it., By Luke Ramseth, March 28, 2018, Salt Lake Tribune: “Gov. Gary Herbert signed a measure Tuesday to give more than 70,000 needy Utahns access to government health coverage, ending years of failed attempts on Capitol Hill to expand Medicaid in the state. But whether House Bill 472 ever takes effect still remains uncertain. Under President Obama’s signature Affordable Care Act (ACA), the Utah law needs approval by the federal Centers for Medicare and Medicaid Services (CMS), which has sent mixed signals on whether it will fully sign off…”

Assistance Programs and Work Requirements

  • Proposed work requirements could add uncertainties to Wisconsin’s Medicaid system, By Guy Boulton, March 28, 2018, Milwaukee Journal Sentinel: “Wisconsin is among the 10 states that want to impose work requirements on some healthy adults who get health insurance through their Medicaid programs. However, unlike Kentucky, Indiana and Arkansas, which have received federal approval for work requirements that they plan to implement immediately, Wisconsin’s requirement wouldn’t kick in until a healthy adult hasn’t worked for four straight years…”
  • Republicans’ new welfare reform focus: Low-income men, By Tami Luhby, March 28, 2018, CNN Money: “A generation ago, Republicans focused on reforming the nation’s safety net by requiring poor mothers to work. These days, the Trump administration and Republican leaders are once again looking to overhaul government assistance programs. But now they are zeroing in on a new group: low-income men.  Much of the focus this time centers on requiring able-bodied, working age recipients to get jobs or participate in other community activities if they want to receive Medicaid or food stamps — two of the largest public aid programs in the US with tens of millions of enrollees each…”
  • WV Gov. Justice quietly signs SNAP work requirement bill, By Jake Zuckerman, March 27, 2018, Charleston Gazette-Mail: “Gov. Jim Justice signed a bill into law Tuesday that will impose work requirements on certain adults receiving benefits through the Supplemental Nutrition Assistance Program…”

State Medicaid Programs

  • Virginia Republicans divided on Medicaid expansion, By Megan Pauly, March 14, 2018, National Public Radio: “Virginia is among 18 states that have not expanded Medicaid under the Affordable Care Act. But this year, the state legislature is going into a special session to continue discussions about whether or not to include it in its budget. By the time the regular session adjourned Saturday, members of Virginia’s GOP-controlled House of Delegates and Senate could not reach agreement on whether or not to expand Medicaid…”
  • Proposed Medicaid work requirements could end up costing Minnesota, By Glenn Howatt, March 18, 2018, Star Tribune: “Republican legislators who are proposing work requirements for Minnesota’s Medicaid recipients say it would promote personal responsibility and save taxpayer dollars, but doctors and county officials who work in the system predict that people would lose needed health care in exchange for savings that are likely to disappoint…”
  • Mississippi Medicaid saves $4.6M in one year by identifying unnecessary, expensive scripts, By Anna Wolfe, March 22, 2018, Clarion Ledger: “By identifying unnecessary, expensive prescriptions covered by the state’s Medicaid program, Mississippi officials say they’ve saved nearly $5 million…”
  • Expanding Medicaid to cut Medicaid: Texas turns to Trump administration to fund family planning, By Phil Galewitz and Anna Gorman, March 22, 2018, St. Louis Post-Dispatch: “President Donald Trump’s administration is weighing whether to allow Texas to receive millions of federal Medicaid dollars for its family planning program, which bars abortion providers.  The Lone Star State eliminated its Medicaid-funded family planning program five years ago when state officials said they wanted to specifically exclude Planned Parenthood because the group provides abortions. Dozens of women’s health clinics closed as Texas established a wholly state-funded program that officials say today serves 220,000 women…”

States and Medicaid Expansion

Medicaid expansion’s troubled future, By Vann R. Newkirk II, March 13, 2018, The Atlantic: “In 2012, the Supreme Court’s decision in the NFIB v. Sebelius case sent shockwaves through the health-policy community, with Chief Justice John Roberts’s majority opinion causing much teeth-gnashing all around. Among many conservatives, the preservation of the Affordable Care Act’s individual mandate constituted ‘one of the worst Supreme Court decisions in American history.’ For supporters of the law, the decision to turn the ACA’s expansion of Medicaid into a state-optional program threatened to destabilize the entire project of expanding coverage to the poorest Americans…”

Medicaid and Dental Care – Wisconsin

  • For those on Medicaid, it can be a struggle to find dental care in the Twin Ports, By Brady Slater, March 3, 2018, Duluth News Tribune: “Zymrie Bekteshi is doing the best she can in the world. She’s a single mother raising a boy and girl, both under the age of 10. She sews for a local company serving the aviation industry. Her employer lets her work from home. ‘Work from home is good,’ she said. ‘I have nobody to help me, no family if kids get sick. So they give me a machine to work with in my home.’ Even with the job she’s held for 11 years, she described herself as ‘low-income.’ Not long ago, Bekteshi, of Duluth, experienced one of the risks concomitant with living near the poverty line: trouble finding a dentist for her kids…”
  • Wisconsin pilot program aims to increase access to dental care for low-income children, By Shamane Mills, February 26, 2018, Wisconsin Public Radio: “Dental care for low-income children has been a problem in Wisconsin for years. One reason is that parents can’t find dentists who will accept Medicaid, known in Wisconsin as BadgerCare. To help address this gap, the state is paying some dentists who take Medicaid patients more to see if it will improve access to care. The Enhanced Dental Reimbursement Pilot Program began in October 2016 and includes Brown, Marathon, Racine and Polk counties…”
  • Dentists ask for more funding for treating patients with Medicaid, By Shamane Mills, February 27, 2018, Wisconsin Public Radio: “Medicaid is one of the biggest cost drivers in the state budget, but dentists say they’re getting less than 1 percent of that money. They’re asking the state to pay them more for taking on patients who get insurance through Medicaid. In an attempt to address the gap in dental care for low-income children across Wisconsin, the state began a pilot program that does just that…”
  • Dentists: Slights in funding, respect at the root of Wisconsin’s dental care disparity, By Shamane Mills, February 27, 2018, Wisconsin Public Radio: “Dentists will tell you they deal with a lot of neglect. They often see patients who put off flossing or brushing, or let cavities sit unfilled. And like a tooth problem that gets ignored for too long, some Wisconsin dentists say state officials neglect their sector of care, slighting the industry with what they consider inadequate state funding which ultimately makes it harder for their patients to get treatment…”

Medicaid Work Requirements – Arkansas

Thousands of Arkansas Medicaid recipients must start working in June, By Tami Luhby, March 5, 2018, CNN Money: “Tens of thousands of low-income Arkansas residents will have to start working in June if they want to keep their Medicaid benefits. The state received approval from the Trump administration Monday to impose work requirements on certain non-elderly, non-disabled beneficiaries who don’t have dependent children at home. It joins Kentucky and Indiana in being granted such a waiver, but Arkansas plans to put the requirement into effect earlier than the other states…”

Medicaid Spending to School Districts

Medicaid’s little-known benefits for millions of US students, By Anna Gorman and Carmen Heredia Rodriguez, March 6, 2018, CNN: “Gerardo Alejandrez used to punch classmates, throw chairs and curse at his teachers, conduct that forced him to switch from school to school. ‘I had a lot of anger issues,’ the 16-year-old said recently. Then Gerardo entered a class at Oakland Technical High School for students who have mental health or behavior issues. In that classroom, the teacher gets support from Erich Roberts, a psychiatric social worker assigned to the group. Oakland Unified School District bills Medicaid, the nation’s insurance program for low-income residents, for Roberts’ services…”

State Medicaid Programs

  • All those Medicaid experiments? States often fail to evaluate the results, By Phil Galewitz, February 26, 2018, Governing: “With federal spending on Medicaid experiments soaring in recent years, a congressional watchdog said state and federal governments fail to adequately evaluate if the efforts improve care and save money…”
  • Tens of thousands of Medicaid recipients don’t pay their premiums, By Phil Galewitz, February 28, 2018, CNN Money: “When Arkansas lawmakers debated whether to renew the state’s Medicaid expansion in 2016, many Republican lawmakers were swayed only if some of the 300,000 adults who gained coverage would have to start paying premiums. This ‘skin-in-the-game’ provision — endorsed by conservatives in Washington and in many statehouses — is designed to make Medicaid recipients value their government health insurance more and lead healthier lives…”

State Medicaid Programs – Kentucky, Kansas

Medicaid and Work Requirements

  • Work for it. What Trump’s tough new Medicaid rules mean., By Benjy Sarlin, February 20, 2018, NBC News: “Every day that Steve Olshewsky can convince himself to get out of bed and face the world is a small victory in his eyes. After a series of panic attacks forced him out of work in 2009, Olshewsky returned to his hometown to recover with family. He’s made great strides since then, thanks to medication and his work at Participation Station, a peer-run outpatient clinic for serious mental illness. There, he sits in on group sessions, teaches tai chi to members, and talks clients through rough days on the clinic phone line. But Olshewsky, who pays for his prescriptions through Medicaid, could soon have to prove he deserves to keep his coverage under a new set of restrictions on able-bodied Medicaid recipients. The Trump administration approved the rules in January through a waiver program that allows states to experiment with changes to Medicaid…”
  • Should Medicaid come with work requirements? Ohio says yes, By Kaitlin Schroeder, February 20, 2018, Dayton Daily News: “Ohio for the first time is seeking federal approval to create job requirements as a condition to qualify for Medicaid. Most Ohio residents enrolled through the expansion of Medicaid, the state-federal health insurance program for the poor, are already working or would be exempt because of things like their age, disability or care taking responsibilities…”

Budget Proposal and Safety Net Programs

  • Trump’s budget hits poor Americans the hardest, By Tracy Jan, Caitlin Dewey and Jeff Stein, February 12, 2018, Washington Post: “President Trump proposed a budget Monday that hits the poorest Americans the hardest, slashing billions of dollars in food stamps, health insurance and federal housing subsidies while pushing legislation to institute broad work requirements for families receiving housing vouchers, expanding on moves by some states to require recipients of Medicaid and food stamps to work…”
  • Trump wants to end states’ power to make food stamps more accessible during recessions, By J.B. Wogan, February 14, 2018, Governing: “The Trump administration, which often stresses the need for states to have more flexibility, wants to give them less when it comes to food stamps, formally known as the Supplemental Nutrition Assistance Program (SNAP)…”
  • New study lauds food stamps’ anti-poverty impact as Trump weighs alternative, By Steve Goldstein, February 15, 2018, MarketWatch: “As the Trump administration weighs slashing and dramatically reshaping the food-stamp program, a new study finds the program dramatically cuts the poverty rate. The Urban Institute released a study on what’s called the Supplemental Nutrition Assistance Program, which is better known as food stamps…”
  • Trump’s proposal to end heating assistance called dangerous for rural Minnesotans, seniors, By Maya Rao and Jim Spencer, February 14, 2018, Star Tribune: “In northwestern Minnesota, Corann Fladhammer has relied on $1,400 in federal assistance to heat her home as temperatures plunged in recent months. Without it, she said, it would be difficult for seniors like her to stay in their homes…”

Medicaid Work Requirements

  • Trump’s historic Medicaid shift goes beyond work requirements, By Michael Ollove, February 16, 2018, Stateline: “Requiring able-bodied adults to work for their Medicaid is just part of the Trump administration’s drive to remake the decades-old health insurance program for the poor. The administration signaled late last year that it welcomes state-based ideas to retool Medicaid and ‘help individuals live up to their highest potential.’ At least 10 states have requested waivers that would allow them to impose work requirements and other obligations…”
  • Bevin’s Medicaid changes actually mean Kentucky will pay more to provide health care, By Deborah Yetter, February 14, 2018, Louisville Courier Journal: “Within Gov. Matt Bevin’s complex plan to reshape the state Medicaid program to cut costs and hold people accountable is this fact that may surprise some Kentuckians: Under Bevin’s plan, it actually will cost Kentucky more to provide health coverage to people affected by the Medicaid changes than if the state did nothing…”

Medicaid Work Requirements

  • Medicaid bill would require ‘able-bodied’ Iowa adults to work or study, By Tony Leys, February 7, 2018, Des Moines Register: “In order to qualify for Medicaid health insurance, ‘able-bodied’ Iowans would have to work at a job or attend school or job training under a bill introduced recently in the Legislature. Under the bill, Iowa would join several other states in seeking federal permission to implement such work requirements on Medicaid, which is jointly financed and run by federal and state governments…”
  • Medicaid work requirement wouldn’t change much in Louisiana, February 7, 2018, New Orleans Times Picayune: “Even though requiring Medicaid recipients to work is one of the few areas in which Gov. John Bel Edwards and Republican legislators agree, experts say implementing the rules may not have much of an impact…”

Suburban Poverty and Access to Health Care

Upsurge of suburban poor discover health care’s nowhere land, By Elaine Korry, February 9, 2018, Washington Post: “The promise of cheaper housing brought Shari Castaneda to Palmdale, Calif., in northern Los Angeles County, about nine years ago. The single mom with five kids had been struggling to pay the bills. ‘I kept hearing that the rent was a lot cheaper out here, so I moved,’ she said. But when she developed health problems — losing her balance and falling — Castaneda found fewer care options in her new town. Unable to find local specialty care, she traveled nearly 65 miles to a public hospital in Los Angeles, where doctors discovered a tumor on her spine…”

State Medicaid Programs – Indiana, Kentucky

  • Indiana’s brand of Medicaid drops 25,000 people for failure to pay premiums, By Phil Galewitz, February 1, 2018, National Public Radio: “As the Trump administration moves to give states more flexibility in running Medicaid, advocates for the poor are keeping a close eye on Indiana to see whether such conservative ideas improve or harm care. Indiana in 2015 implemented some of the most radical changes seen to the state-federal program that covers nearly 1 in 4 low-income Americans — including charging some adults a monthly premium and locking out for six months some of those who don’t pay their premiums…”
  • Indiana wins federal permission to adopt Medicaid work requirements, By Amy Goldstein, February 2, 2018, Washington Post: “Indiana has become the second state to win permission from the Trump administration to require certain low-income residents on Medicaid to work, study or perform public service to qualify for the safety-net health insurance…”
  • Are Bevin’s new Medicaid rules ‘all about putting up roadblocks’ for poor people?, By John Cheves, February 2, 2018, Lexington Herald-Leader: “Ronnie Stewart spent years as a state social worker. Given his experience in government bureaucracy, Sewart said he understands why Gov. Matt Bevin is going to make many of Kentucky’s Medicaid recipients pay monthly premiums and regularly report their work and income status…”

Medicaid Transportation Services

No car, no care? Medicaid transport program faces cuts in some states, By Jonel Aleccia, January 27, 2018, National Public Radio: “Unable to walk or talk, barely able to see or hear, 5-year-old Maddie Holt of Everett, Wash., waits in her wheelchair for a ride to the hospital. The 27-pound girl is dressed in polka-dot pants and a flowered shirt for the trip, plus a red headband with a sparkly bow, two wispy blond ponytails poking out on top of her head. Her parents can’t drive her. They both have disabling vision problems; and, besides, they can’t afford a car. When Maddie was born in 2012 with the rare and usually fatal genetic condition called Zellweger syndrome, Meagan and Brandon Holt, then in their early 20s, were plunged into a world of overwhelming need — and profound poverty…”