Latest Morning Briefing Stories
New Hampshire residents are challenging the Trump administration’s approval of work requirements for Medicaid recipients, after suits filed in Arkansas and Kentucky. Critics of the work requirement waivers say they are an attack on the poor. “This approval will not promote coverage, but it will result in significant coverage losses, and that is the administration’s goal,” said Jane Perkins, legal director of the National Health Law Program, which filed the suit on behalf of the New Hampshire residents. Meanwhile, an analysis finds that most of the 18,000 people kicked of Arkansas’ Medicaid program because they didn’t report work hours are still uninsured. The data contradicts statements from Trump administration and state officials, who have claimed that most of the people who lost Medicaid have found jobs.
News from state legislatures comes out of Connecticut, Georgia and Massachusetts.
MedPAC said that the way Congress made changes to the Medicare Part D program disincentivizes insurers from trying to manage high drug costs because it puts pharma on the hook for a higher percentage of the drugs. In other news, MedPAC advisers are also expected to call on Congress to boost payments to hospitals, and Medicaid advisers will urge lawmakers to rethink cuts to hospitals.
Some states are weighing the possibility of adding drug-testing to their programs, while others are investigating capped payments from the federal government. And as Republican-led states move to further restrict Medicaid, the divide between red and blue states is likely to mean wider geographic disparities in health-care coverage and access. Meanwhile, Ohio’s request to add work requirements has been approved by the government.
Where to move forward with health care has become a sharply dividing issue with the Democrats. Moderates want to make improvements to the health law, while the left-wing is charging full-tilt toward “Medicare for All.” With their budget, Democrats will signal what their health care priorities are, and the road to decide that will likely be far from smooth.
News from the state legislatures comes out of Maryland, Georgia, Connecticut, Florida, New Hampshire, Virginia and Arizona.
President Donald Trump wants to give hundreds of millions of dollar to fight the HIV epidemic domestically, yet he is also proposing cutting global aid for the disease, as well calling for sharp spending reductions to Medicaid, a program many people with HIV rely upon. The president has taken aim at childhood cancer and the opioid crisis, but also would chip away at infrastructure in health care that would support those goals. Meanwhile, the Washington Post Fact Checker takes a look at Democrats’ take on the proposed Medicare changes in the budget.
“It seems to me that your fiscal sustainability [argument] relies on the fact that they’re lucky to have Medicaid at all,” said Judge James E. Boasberg who is hearing cases out of Arkansas and Kentucky on whether the Trump administration has the authority to grant states the flexibility to add work requirements to their Medicaid programs. Boasberg hopes to issue both decisions simultaneously before Kentucky’s changes are slated to take effect April 1. Meanwhile, CMS is rolling out new tools to help states apply for a work requirement waiver.
When running as a politician in Texas in 2012, Beto O’Rourke said he didn’t support the health law “in its current form.” Now in 2020, he has touted the importance of universal health care, but like other moderates in the race has been careful to avoid coming out for one particular “Medicare for All” plan.
“Many consumers are being misled to believe that these plans comply with the patient protections of the Affordable Care Act,” said House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.). The lawmakers want to know how companies market the short-term plans, what percentage of applicants are denied coverage, and what brokers who sell the insurance are paid.
The American Hospital Association and Federation of American Hospitals project that Medicare buy-in legislation–which would allow Americans to buy into the program instead of moving everyone onto Medicare–would cost hospitals $800 billion over a decade. Meanwhile, candidates are rushing to show their support for “Medicare for All,” but what does the public think?
HHS Secretary Alex Azar faced four hours of questioning at a congressional hearing fending off criticism of President Donald Trump’s proposed budget, which was released yesterday. The plan that drew the most heat was the president’s desire to replace the current open-ended federal commitment to Medicaid with a lump sum of federal money for each state in the form of a block grant, a measure that would essentially cap payments and would not keep pace with rising health care costs. Azar refused to completely rule out the possibility of allowing states to move in that direction. Trump’s proposed Medicare cuts also drew fire from lawmakers.
Although “Medicare for All” has become a rallying cry for many 2020 Democratic hopefuls, Republicans view it another way. GOP lawmakers are eager to use the push to paint their opponents as extremists and socialists. But, really, it’s unclear how the whole debate will play out 21 months from now.
The president’s budget proposes converting all the health law’s funding into block grants. It would also convert Medicaid into a per capita cap system that would dole out funding based on the state’s population. It’s highly unlikely the proposals will make it into law, but it highlights a continued effort by the administration to reshape the Medicaid program. Meanwhile, HHS sees a sharp decrease in funding in the budget.
President Donald Trump, in his budget, called for some belt-tightening when it comes to Medicare in aim to reduce “waste, fraud and abuse” in the popular program. Democrats seized on the proposed Medicare cuts as an example of the GOP seeking to balance the budget on the backs of the elderly and the poor after giving broad tax breaks to the wealthy. Meanwhile, hospitals came out as vocally opposed to the deep cuts.
President Donald Trump released his $4.75 trillion budget, which included a big increase in military spending and deep cuts to other domestic spending. The presidential budget is all but dead-on-arrival on Capitol Hill and can be viewed more as a symbolic roadmap for priorities than a realistic spending plan. House Speaker Nancy Pelosi called Trump’s cuts “cruel and shortsighted … a roadmap to a sicker, weaker America,” while other Democrats were also quick to condemn the proposal.
News from state legislatures comes from Georgia, Montana, Vermont, Ohio, and Florida.
Both House Speaker Nancy Pelosi (D-Calif) and Democratic Congressional Campaign Committee head Rep. Cheri Bustos (D-Ill.) spoke recently about concerns over the cost of “Medicare for All” legislation. Progressive Democrats, however, continue to push for a vote this year on the proposal, setting up a showdown between the two sides of the party. In other news from Capitol Hill: gun violence, disaster funding, and military housing.
Editorial pages focus on these health issues and others.
A provision in the health law already allows such sales through state agreements, and, in fact, six states have passed laws to set up interstate sales. But no policies currently are being sold. That’s because the complexities of trying to regulate interstate sales deter most insurance providers from even trying. And any new insurers entering a state also face daunting competition from companies that are already well-established. On the consumer side, experts say it would do little to lower premiums.