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.
The partial government shutdown enters its 27th day and no end is in sight. Although major health care programs like Medicaid and Medicare are funded, this is not true for the Indian Health Services (IHS). The IHS is a health care agency run by the Department of Health and Human Services but funded by the Department of the Interior (DOI).
UPDATE: 1/8/19 - Links to Families USA's comments on the proposed Program Integrity Rule are available here.
New Guidance on Section 1332 waivers, issued in October 2018, can undermine key consumer protections and pave the way for federal dollars to subsidize plans that provide few benefits. The public can comment on the federal guidance through December 24, 2018. People should also find out if their states are developing waiver proposals, and comment on those to both the state and federal governments. This analysis explains what issues to watch.
On October 10, 2018, the Trump administration published a proposed rule in the Federal Register that would make it much harder for immigrants to obtain visas (including visas to study or work in the U.S.), extend their visas, or adjust their status to become lawful permanent residents.
The Trump Administration’s Continued Attacks on Immigrant Children and Families: Dismantling the Flores Settlement Agreement
On September 7, the Trump administration took another step toward eliminating basic protections for immigrant children and their families who enter the U.S. without documentation—including those legally seeking asylum, by issuing a notice of proposed rulemaking (proposed regulation) that would dismantle constitutional protections for children established by the Flores Settlement Agreement governing the detention and treatment of children in U.S.
NOTE (January 17, 2019): From August through December 2018, Arkansas disenrolled over 18,000 from Medicaid for failure to meet the work hours reporting requirement. Each individual disenrolled was locked out of Medicaid coverage from the point of disenrollment until January 2019, when they can reapply for coverage. At the point individuals re-enroll, the three month “clock” for reporting work hours begins again.
Update: Judge O’Connor heard oral arguments in Texas v. United States on September 5, summarized in this Health Affairs article. It is not clear how quickly the judge will rule on a preliminary injunction. The Department of Justice, despite arguing to undo preexisting condition protections, has admitted that a negative decision, even if appealed, would bring chaos and uncertainty during open enrollment this fall.