To balance budgets, states are trimming provider rates even before President Trump’s tax law strips $1 trillion in federal Medicaid support over 10 years.
Work requirements remain on the table but Congress will not cut the matching rate for the Affordable Care Act expansion or impose per capita limits on states.
States are anxiously awaiting potential cuts from Congress. In the meantime, their costs are already rising even as enrollment has decreased.
By cutting out middlemen and dealing directly with pharmacies, Ohio’s Medicaid system saved money even as it dramatically increased payments to pharmacists.
Voters in three states enshrined Medicaid expansions in their state constitutions. Those states could be on the hook if Congress cuts program funding significantly.
Congress and some red states are pushing for work requirements but most recipients already work. Medicaid and other state programs typically don’t offer job assistance or training.
The program has grown far beyond its original target populations. Congress needs to pare it back.
Proposals to cut Medicaid will not only end coverage for millions but undermine the health-care system as a whole.
Much has been said about the health consequences of severe Medicaid cuts. A new analysis from the Commonwealth Fund considers the jobs and revenue that states could lose.
Medicaid covers nearly half of all births in the U.S. and 80 million children. But the age and working status of recipients varies widely across the country.
GOP Gov. Mike DeWine wants more able-bodied recipients to work to receive benefits. Such requirements in other states have been held up in court but Congress might make them universal.
A proposal to set a per-enrollee limit on federal money for the program is gaining traction. But states know how to game Medicaid rules and federal oversight is woefully inadequate.
Safety net systems should be integrated with workforce support programs. Mostly they aren’t. More states should implement the kind of “One Door Model” that Utah has proven effective.
Republicans are exploring cuts to Medicaid in an effort to pay for the president’s priorities. But public opinion, a divided Senate, and state governors worried about the impact to their budgets could dash those efforts.
Gov. Gretchen Whitmer has signed a bill overturning the state’s work requirements, which had previously been blocked in court. The bill passed in December while Democrats still controlled the Legislature, with Republicans complaining it sent the wrong message to recipients.
States face a tricky year, with their own revenues stalling and federal aid running low.
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