Welfare, Medicaid & Economic Security Issues
Welfare, Medicaid & Economic Security Issues
"Our nation, so richly endowed with natural resources
and with a capable and industrious population,
should be able to devise ways and means of insuring
to all our able-bodied men and women,
a fair day's pay for a fair day’s work."
Franklin Delano Roosevelt, 1937
Updated: February 17, 2018
- Medicaid Cuts May Force Retirees Out of Nursing Homes - Under federal law, state Medicaid programs are required to cover nursing home care. But state officials decide how much to pay facilities, and states under budgetary pressure could decrease the amount they are willing to pay or restrict eligibility for coverage. While most Medicaid enrollees are children, pregnant women and nonelderly adults, long-term services such as nursing homes account for 42 percent of all Medicaid spending — even though only 6 percent of Medicaid enrollees use them.
- Kentucky Rushes to Remake Medicaid as Other States Prepare to Follow - At least eight other Republican-led states are hoping to follow — a ninth, Indiana, has already won permission to do so — and some want to go even further by imposing time limits on coverage. Such restrictions are central to Republican efforts to profoundly change Medicaid, the safety net program that has provided free health insurance to tens of millions of low-income Americans for more than 50 years. The ballooning deficits created by the budget deal that President Trump signed into law Friday and the recent tax bill are likely to add urgency to the party’s attempts to wring savings from entitlement programs.
- Trump Administration to Allow Lifetime Limits on Medicaid, Coverage for Thousands at Risk - Just weeks after unveiling guidance that will allow states to impose Medicaid work requirements, Trump’s Health and Human Services agency is reportedly attempting to limit the number of months adults have access to the safety net program. The cap, if approved, would be the first of its kind in Medicaid’s history. In reality, many of the federal waivers mean that thousands of people will lose vital coverage.
- Trump Administration Approves Medicaid Work Requirements for Indiana, Thousands to Lose Coverage - The Trump administration approved Indiana’s request requiring some Medicaid recipients to work to get benefits, meaning thousands of people in the state could soon be without health insurance. Under the new proposal, Indiana residents will need to work 20 hours a week, on average, or participate in a job training program in order to be eligible for Medicaid. The rule kicks off in 2019. The state would not require pregnant women, students, the homeless, and some other current recipients to work. The state expects the changes will affect 130,000 of the current 438,604 enrollees, and 33,000 of those people will lose coverage. Indiana officials say many Medicaid beneficiaries will transition to commercial health insurance.
- How Trump may end up expanding Medicaid, whether he means to or not - If successful, the efforts could make hundreds of thousands of Americans newly eligible for health coverage, while also opening the door to Medicaid changes that could kick some current beneficiaries out of the program and reduce its benefits to recipients — broadening the program’s reach into red states but with a decidedly conservative bent. The new Trump administration rules may also shake up the balance of power in state-level struggles over Medicaid expansion. Thirty-two states and the District have expanded Medicaid since the Affordable Care Act was enacted, giving health care to approximately 13 million additional people.
- N.Y., Minnesota sue Trump admin to block healthcare funding cuts - The attorneys general for New York and Minnesota are suing the Trump administration for abruptly cutting off federal funding for health care coverage for more than 800,000 low-income residents in the two states. The majority of the recipients — more than 700,000 — are in New York state, while most of the funding — $1 billion-plus — went to New York. Minnesota has about 87,000 recipients in the program and received $130 million per year.
- Medicaid Patients Sue Over Trump Administration's New Work Requirement Policy - Kicking off what will likely be a long legal battle over the Trump administration's push to reshape Medicaid, 15 low-income Kentucky residents sued the federal government Wednesday, challenging the recent move to allow states to impose work requirements on some Medicaid enrollees. The lawsuit — spearheaded by three public-interest legal groups — accuses the federal Department of Health and Human Services of violating the core purpose of the half-century-old government health plan for the poor by granting a request from Kentucky to impose the work mandate.
- The Nation's First Medicaid Work Rules Loom, and Many Fear Losing Health Coverage - Gov. Matt Bevin is exultant as his administration sets out to transform Medicaid. Only a week ago, he won federal permission to pursue a goal that has animated his two years in office: making hundreds of thousands of poor Kentuckians hold jobs or engage in their communities in other ways to keep their health insurance. It is an approach never tried by any state, and it will also transform lives. The unorthodox plan, Bevin has faith, will lift people into economic self-reliance, ease Kentucky’s stubbornly high rates of addiction and ill health and propel the needy to “derive a sense of dignity by your own power.” From this capital city in the state’s Bluegrass region, he is buoyed by a sense of mission. “It’s a .?.?. joy that we are doing right by people,” Bevin says. Whatever they learn will have broad relevance because other states are waiting in line. Nine more — almost all led by Republicans — have applied to the federal Centers for Medicare and Medicaid Services for permission to adopt similar “community engagement” requirements, and others are considering them. There is little doubt that more approvals lie ahead. Before becoming CMS administrator, Seema Verma was a consultant who helped design Kentucky’s plan, traveling to Frankfort at least every other week to coach the governor’s aides.
- Imposing Medicaid Work Requirements Would Be Bad for Children’s Health Too - Last week, the Trump administration introduced new guidance that would allow states to take away people’s health care if they are unable to find work. Imposing work requirements could put at least 6.3 million Americans at risk of losing their health care and would impede—not promote—participation in the workforce. This new guidance has significant implications for children because a child’s health insurance coverage—and well-being—are closely tied with their parents’ coverage. Imposing work requirements for parents could introduce instability to children’s coverage when they need continuous care and healthy caregivers the most. Furthermore, increasing financial stress in the homes of American families who are struggling to make ends meet would undermine healthy child development. Rather than support another barrier toward growing healthy families, policymakers must focus their efforts on promoting programs that support healthy child development and help families meet their basic needs.
- Smoking Penalties, ER Fees, Premiums on the Poor: How States Want to Shrink Medicaid - The Trump administration is giving at least some of these initiatives the green light. On Thursday, health officials issued new guidance to state Medicaid directors, saying the administration would allow states to impose work requirements on certain Medicaid recipients — a first in the program's 53-year history. Doing so will help Medicaid recipients who are not disabled find employment, Seema Verma, administrator of the Centers for Medicare and Medicaid Services, argued in announcing the changes. Ten states have already filed requests for waivers to add work requirements to their Medicaid policies, and the Trump administration approved a proposal Friday from Kentucky to overhaul its Medicaid program, including by imposing new work requirement and premiums.
- Trump’s Work Requirements Could Put At Least 6.3 Million Americans at Risk of Losing Health Care - This week, the Trump administration issued policy guidance that effectively ends Medicaid as we know it, allowing states to place punitive work requirements on certain Medicaid recipients—more than 7 in 10 of whom are caregivers or in school. President Donald Trump’s actions are just the latest shoe to drop in his party’s deeply unpopular crusade to undermine Americans’ health care and come on the heels of a tax cut that rewards the massively wealthy over working Americans. These so-called work requirement policies may seem reasonable at first glance. In practice, they’re a way to strip away health insurance from struggling unemployed and underemployed workers, with disproportionate impacts on women, African Americans, and Native Americans. New CAP analysis shows that at least 6.3 million Americans—including students, caregivers, and retirees—could be at risk of losing their health care. This includes nearly 640,000 people in the 10 states that have already filed for waivers to implement Trump’s plan.
- Instead of Work Requirements, Why Not a Jobs Guarantee? - Paying people to work would be a more direct—and less expensive—way to lift them out of poverty. - Yet if states want work requirements to increase the health and self-sufficiency of Medicaid beneficiaries—their stated goal—most available data suggest they’ll fall short. As the Kaiser Family Foundation reported in 2017, most people on Medicaid who can work do work. Around 60 percent of adult enrollees have a job, and for the most part those who don’t report impediments in their ability to work. Even those who are not officially disabled often attest to having debilitating conditions—like severe back problems—that make full-time jobs difficult or impossible. Others may be in school, work as primary caretakers for loved ones, or may have retired.
- Kentucky becomes the first state allowed to impose Medicaid work requirement - Becoming the first-in-the-nation state to move forward with the profound change to the safety-net health insurance program is a victory for Kentucky’s Republican governor, Matt Bevin, who during his 2015 campaign for office vowed to reverse the strong embrace of the Affordable Care Act by his Democratic predecessor. Bevin first pledged to undo the state’s expansion of Medicaid, which had helped to shrink the ranks of uninsured Kentuckians more than in almost any other state. He then pivoted to the idea of keeping the additional people in the program — with strings attached that the federal government had never permitted in Medicaid’s half-century history.
- States will be allowed to impose Medicaid work requirements, top federal official says - The government will give states broader leeway in running their Medicaid programs and allow them to impose work requirements on enrollees, a top federal health official said Tuesday in outlining how the Trump administration plans to put its mark on the insurance program for low-income Americans.
- How Medicaid Expansion Affected Out-of-Pocket Health Care Spending for Low-Income Families - Providing people with health insurance improves access to care by reducing financial barriers, which are most evident at the point of care — that is, when people try to get health care services. In addition, expanding insurance coverage reduces the cost of care; previous research has shown that expanding eligibility for Medicaid reduces bankruptcy and debt. This is particularly important for low-income families with little flexibility in their budgets to accommodate unexpected medical spending. For families with incomes under 138 percent of the federal poverty level (i.e., less than $33,600 for a family of four), housing, food, and transportation spending make up 73 percent of their total monthly budget.
- Medicaid hit by rising costs of common medicines - Rising costs for 313 brand-name drugs lifted Medicaid’s spending by as much as $3.2 billion in 2016, the analysis shows. Nine of these brand-name drugs have been on the market since before 1970. In addition, the data reveal that Medicaid outlays for 67 generics and other nonbranded drugs cost taxpayers an extra $258 million last year.
- Medicaid benefits rural residents most, especially children, study finds - Medicaid has a larger impact on residents of small town and rural areas than those in cities, according to a study by Georgetown University’s Health Police Institute. In New York state, well over a third of all children in small towns and rural areas — 42 percent, in fact — rely on Medicaid health coverage.
- How Medicaid Cuts Could Hurt Education and Lead to Middle-Class Tax Hikes - The House of Representatives recently passed the American Health Care Act (AHCA), which would repeal the Affordable Care Act (ACA) and cut Medicaid by $834 billion over 10 years. Due to cuts in Medicaid, as well as other changes, the Congressional Budget Office (CBO) estimates that the AHCA would take health insurance from 23 million Americans by 2025. And the AHCA is only the beginning. President Trump’s budget calls for $610 billion in additional Medicaid cuts over 10 years on top of the cuts in the AHCA. States that want to avoid deep cuts in health programs would have to either raise taxes or cut other programs.
- The Near Impossibility of Moving Up After Welfare - In the wake of welfare reform, unemployed people are pushed to quickly find work, any work. But too often those jobs lead nowhere.
- Expanding Medicaid Eligibility Would Help Low-Income Workers Find Better Jobs: Study - A recently study suggests that more Americans would be emboldened to switch jobs if their access to health insurance wasn’t tethered to their employers. This uniquely American system encourages so-called job lock, in which workers are fearful of migrating to potentially better-paying jobs out of fear of losing access to employer-subsidized access to medicine and doctor’s visits.
- Drug Testing and Public Assistance - In the last decade, numerous states have made drug screening and testing an eligibility condition for Temporary Assistance for Needy Families (TANF) cash assistance under certain circumstances. As of November 2015, 13 states have adopted such regulations. Very few applicants have tested positive for drug use in states that have implemented these policies. Consequently, operating costs far exceed the fiscal savings from denying benefits. This is consistent with previous research that found only a small share of welfare recipients experience substance abuse disorders.
- Medicare premiums will be going up for many - what it means for your taxes - The Doc Fix will increase the Medicare Part B and Part D premium surcharges that many higher-income individuals must pay, starting in 2018. The increased surcharges will affect singles with 2016 MAGI between $133,501 and $214,000 and married joint-filing couples with 2016 MAGI between $267,001 and $428,000. It is estimated that the higher surcharges will cost the average affected individual about $1,000 per year and the average affected married couple about $2,000 per year.
- Another 50 Years: Protecting Medicaid and Medicare - Fifty years ago, the idea of creating a social health care safety net was far from a sure thing. When President Lyndon B. Johnson signed Medicaid and Medicare into law on July 30, 1965, it was amidst much controversy regarding whether the government should involve itself in health insurance. Decades later, the idea of ensuring that all Americans have health care is still disputed by our elected leaders. What is not in doubt are the health care needs of our nation's most vulnerable. Despite differences in opinion and spending cutbacks over time, Medicaid and Medicare have endured.
- Why Quitting My Job and Going on Medicaid Was My Best Option When I Got Cancer - There shouldn't be a stigma about using Medicaid.
- 1.1 million New Yorkers added to roll for Medicaid - New York has added 1.1 million people to Medicaid since the state health exchange opened last year in the national effort to connect the uninsured with low-cost coverage. More than 6.2 million New Yorkers are now enrolled, almost one-third of the state's 19 million people.
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