Armed With Federal Waivers, Red States Are Steadily Chipping Away At Their Medicaid Rolls With Added Rules

Experts say that not since Republican President Ronald Reagan, who tried unsuccessfully to cap Medicaid and effectively end its entitlement status, has an administration pushed so hard to shrink the Medicaid rolls. “Generally, when you reduced in one area, you added in others,” said Thomas Scully, who led the U.S. Centers for Medicare and Medicaid Services during the Republican George W. Bush administration.

Stateline: Trump Greenlights Major Medicaid Changes

In a stark departure from past administrations, the Trump administration is allowing states to enact new Medicaid rules that will curtail benefits and reduce, rather than expand, the number of people eligible for the federal-state health program for the poor. New work requirements have received most of the attention. This year, the administration has granted permission to Arizona and Ohio to impose work requirements of 80 hours a month for most able-bodied adults. (Ollove, 3/26)

CQ: House Votes To Renew Health Programs

The House passed by voice vote a bipartisan health care bill on Monday that would extend funding for three Medicaid programs as well as fund a program for children with complex medical conditions. The bill (HR 1839) comes as some of these programs are slated to run out of funding at the end of the month on Sunday, but it’s unclear if the Senate will act before then. (Raman, 3/25)

Medicaid news comes out of Kansas, Georgia and Illinois as well —

Modern Healthcare: Kansas Medicaid Expansion Advances, Giving Hospitals Hope

Hiawatha (Kan.) Community Hospital, in the rural northeast corner of the state, suffered an operating loss last year, driven by $2.2 million in bad debt and $1 million in repayments to Medicare. It had to cut salaries and benefits for its 245 employees. A dozen miles to the south, Horton (Kan.) Community Hospital, another critical-access facility, shut down in March, after it couldn't pay employees for six weeks. It was the third rural hospital to close in Kansas since the end of 2018. (Meyer, 3/25)

Atlanta Journal-Constitution: Georgia Legislature OKs Bill To Seek Federal Health Care Waivers

The Georgia Legislature on Monday approved Gov. Brian Kemp’s proposal to give his office new powers to pursue “waiver” programs that could pave the way to a limited Medicaid expansion and ease insurance costs for some poor and middle-class Georgians. Senate Bill 106 cleared the Georgia House by a 104-67 vote mostly along party lines after more than an hour of tense debate. (Bluestein and Hart, 3/25)

Georgia Health News: An Epic, Hectic Day For Health Care Legislation In Georgia

The state House passed a high-profile bill Monday that would allow Gov. Brian Kemp to seek health care “waivers’’ from the federal government to expand and improve coverage in Georgia. And in another big vote, the Senate approved a bill to change Georgia’s controversial certificate-of-need system regulating medical providers. (Miller, 3/25)

Modern Healthcare: Illinois Sues Feds Over Medicaid Repayment Order

The state of Illinois sued the federal government to reverse an order requiring repayment of about $145 million in long-ago reimbursements to two Chicago safety-net hospitals. The CMS in 2016 required the Illinois Department of Healthcare & Family Services to repay the federal government $140 million in reimbursements to the University of Illinois Hospital and $4.5 million for payments to Mount Sinai Hospital, made between July 1996 and June 2000, according to the complaint. (Goldberg, 3/25)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

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