Some notes on Medicaid news from this week. First some good news:
This is the fourth successful campaign for a Medicaid ballot initiative. Voters in Idaho, Nebraska, and Utah will get a chance to decide whether to expand coverage. Mainers voted in favor of this last year.
— Jeffrey Young (@JeffYoung) July 5, 2018
People want healthcare. People want to be able to go to the doctor when something is not right and not worry that it will screw them over for the next decade because of debt. And the initiative process is one route forward. Emma Sandoe has noted that Nebraska’s unicarmal legislature has assembled a majority for Medicaid expansion in the past but not the super majority needed. The odds are probably pretty decent that Medicaid expansion will pass in the Cornhusker state.
Breaking News: A federal judge blocked Kentucky's plan to impose new Medicaid rules requiring the poor to work to maintain their health coverage. https://t.co/nwlElTdeoP
— NYT Health (@NYTHealth) June 29, 2018
A federal judge ruled that the Kentucky Medicaid waiver for work requirements is arbitrary and capricious and sent the approval decision back to CMS for reconsideration. CMS did nothing to consider the massive enrollment losses. He also noted that the point of Medicaid is to cover medical costs first and foremost. Everything else is a secondary point.
And now some messed-up news. Arkansas has work requirements for its Medicaid population. The first round of reporting ended last night and the early reports are that at least half of the people failed to jump through the paperwork:
11,000 enrollees who had to report whether they met the requirement or qualified for an exemption in June, more than 8,000 remained out of compliance as of late last week, Marci Manley, a spokesman for the state Department of Human Services, said in an email.
And in Catch-22 news, Mississippi modified their proposed work requirements. Remember, Mississippi does not have Medicaid expansion and they have very tight eligibility requirements in general (via Modern Healthcare:
Any person who works 20 hours per week in a minimum-wage position would earn $7,540 annually, but the state’s income eligibility cutoff is 27% of the federal poverty level, or an annual income of $4,444.
Work to meet the requirement and a non-disabled, non-pregnant adult makes too much for Medicaid and not enough to meet tax credit eligibility for a CSR Silver plan on the Exchange. Not work to keep Medicaid, and the work requirements limit Medicaid. It is one hell of a catch even as there are volunteer and job training options that don’t produce income that could qualify as “community engagement”.