Many factors could prevent numerous communities from fully participating in the 2020 Census. These factors include underfunded Census outreach, a proposed Census question asking about citizenship, and broader policy changes that could increase immigrants’ fears about responding to the Census. Without vigorous action to prevent a significant undercount, states will suffer major cuts to federal health care funding, with grim results for health care and other critical state services.
An increasing number of states are making harmful changes to their Medicaid programs using “Section 1115 waivers.” Families USA is tracking state Medicaid waivers that restrict access to quality, affordable health care for low-income families and adults. This new grid offers an overview of the status of each state’s waiver proposal, the restrictive elements of the waiver proposal, and CMS’s decision on each element.
As the largest single source of health insurance and coverage for behavioral health services in the country, Medicaid plays a pivotal role in addressing substance use disorder (SUD). Medicaid covers nearly 4 in 10 non-elderly adults in the country with opioid addiction. But this coverage could go further: at least 17 percent of opioid addicts are uninsured, a rate nearly 50 percent higher than the general population.
On March 5, 2018, CMS approved Arkansas’ request to add a work requirement to its Medicaid program. Equally important, it did not approve the state’s request to roll back Medicaid eligibility to a partial Medicaid expansion. Both tell us a lot about what’s behind CMS’s approach to Medicaid waivers, and what states can expect to have, and not have, approved. View factsheet here.
CMS has approved work requirements (sometimes spun as “community engagement” requirements) in three states: Arkansas, Kentucky, and Indiana. Eight additional states have similar requests pending, and CMS appears likely to approve those requests, as well. Litigation challenging the authority of the executive branch to approve work requirements—rules that are contained nowhere in Medicaid law—have also begun.
The Center for Medicare and Medicaid Services’ approval of Kentucky’s Medicaid waiver on January 12, 2017, opens a new front in the Trump Administration’s campaign to roll back the gains in coverage and health care achieved under the Affordable Care Act and Medicaid.
One of the most destructive ways the tax bill attacks health care has gotten the least attention.
In addition to kicking people off coverage by repealing the individual mandate and setting the stage for huge funding cuts down the road because of the ballooning deficit, the tax bill will sap states’ ability to fund vital health care programs.
Section 1115 of the Social Security Act gives the Secretary of Health and Human Services (HHS) the discretion to let states waive certain Medicaid requirements to carry out an “experimental, pilot or demonstration project which, in the judgment of the Secretary, is likely to assist in promoting the objectives of” the Medicaid program.
The House Republican bill to repeal the Affordable Care Act (ACA) and cut the Medicaid program would cause immediate and critical problems for American Indian and Alaska Native peoples. Repeal would take funding away from federally recognized tribes and tribal organizations that now provide comprehensive health services in Alaska.