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.
Nearly 60 million seniors and disabled persons rely on the Medicare program – and only about one-third of them have any coverage for oral health care. The Medicare statute currently excludes coverage for almost all oral health care. As a result, people with Medicare coverage suffer the physical and financial consequences of untreated dental problems.
In late January, the Trump administration quietly announced two alarming new policies that will lead to more discrimination in health care: a change in Medicaid policy made through executive order, and a proposed rule that is open for comment until March 27, 2018.
Idaho state officials sought to create “state-based plans” for health insurance that would set a precedent for individual market insurance plans that could deny coverage for preexisting conditions. The Idaho health insurance guidelines would put older and sicker residents at a disadvantage.
To protect their residents, some states are considering using their own income tax systems to replace the federal government’s enforcement of the individual mandate. But another approach under consideration in Maryland would both prevent the harm forecast by CBO while taking new steps to insure families who would otherwise remain without coverage.
Not only would Maryland’s approach increase coverage, newly insured young and healthy residents would improve the overall risk pool, stabilizing markets and lowering premiums for numerous insured residents who buy individual coverage.
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.
Funding CSR Payments in the Health Insurance Stabilization Package Could Harm Low- and Middle-Income Consumers
Families USA strongly supports bipartisan efforts to give consumers affordable health insurance in the individual market. A successful stabilization bill would enhance affordability and access by raising advance premium tax credits (APTCs), funding reinsurance, financing outreach and enrollment assistance, and stopping proposed regulations that would let short-term plans and association health plans (AHPs) substantially undermine the individual market.
Trump Administration 'Public Charge' Rule Threatens Health Care for Immigrant Families, Including U.S. Citizen Children
The impact of a proposed Trump administration rule extends well beyond the directly targeted individuals and families whose health will be at risk. A community’s overall health depends on the health of all of its members. The impact of this proposed rule will spill over to others in many ways. Without insurance, families may delay care or forego it altogether. This means there will be more children in school, and adults in the workplace, without needed preventive services and untreated illnesses. More people delaying care until the last possible moment will strain emergency resources. Hospitals’ and clinics’ uncompensated care burdens will increase.