The Utah Department of Medicaid released its much-anticipated proposal for a Section 1115 Medicaid waiver seeking a “per capita cap” – or a limit on federal spending – on major portions of its Medicaid program. If approved by the Trump administration, it would set a new precedent that could have catastrophic effects for state budgets and Medicaid programs in the future.
The Return of Churn: State Paperwork Barriers Caused More Than 1.5 Million Low-Income People to Lose Their Medicaid Coverage in 2018
In 2018, enrollment in Medicaid and the Children's Health Insurance Program decreased by about 1.6 million enrollees, 744,000 of which were children. There is strong evidence that a driving factor of the decline in enrollment is state policy decisions to engage in punitive annual (or even monthly) eligibility redetermination processes in which large percentages of Medicaid enrollees lose coverage.
The Administration’s proposed budget is in part a return to policies that Americans have overwhelmingly rejected. It proposes to gut core insurance protections, end the expansion of Medicaid to low income adults, and block grant the Medicaid program, cuts amounting to over a trillion dollars over ten years. But the budget also signals new and deeply concerning policy changes including mandatory new work documentation requirements in Medicaid, and increasing the cost of health insurance premiums for low income people in the non-group market.