Tag: Medicare (United States)

Trump’s Medicaid Work Requirement Will Backfire

Trump’s Medicaid Work Requirement Will Backfire

Image Just because President Trump and the Republican Congress were unable to pass health care legislation that would have unwound the coverage benefits of the Affordable Care Act doesn’t mean such attacks are behind us.
The administration’s new approach — one that no administration before it has taken — is to provide waivers to states that allow them to impose work requirements for Medicaid benefits.
Now the administration will be considering waivers that are likely to deprive thousands of low-income people of health care.
Some of these people will lose coverage because they can’t find jobs to fulfill the work requirements.
They would instead, she said, “let states kick people off coverage if they don’t comply with new requirements that have nothing to do with health insurance.” People losing coverage could suffer severe harm.
A study of Medicaid expansion in Kentucky and Arkansas found that it led to significant gains in access to care, financial security and health, with increases in the share of low-income adults going for checkups, getting regular care for chronic conditions and reporting that they are in excellent health.
Among adults on Medicaid who don’t work and could be subject to the work requirement, more than a third have a chronic health problem or disability, about half take care of their family or go to school, and just under 10 percent can’t find work.
By providing coverage for workers in jobs that are unlikely to provide such benefits, and by helping to stabilize the finances of people with illnesses, Medicaid has been found to help people stay employed or find work.
Medicaid is working, as are most able-bodied adults who are eligible for it.
The administration’s bid to cut the program under the guise of mobility-enhancing work requirements must be seen for what it is.

Trump Administration Says States May Impose Work Requirements for Medicaid

Trump Administration Says States May Impose Work Requirements for Medicaid

WASHINGTON — The Trump administration said Thursday that it would allow states to impose work requirements in Medicaid, a major policy shift in the health program for low-income people.
Federal officials said they would support state efforts to require able-bodied adults to engage in work or other “community engagement activities” as a condition of eligibility for Medicaid.
Ms. Verma said the Trump administration was responding to requests from Medicaid officials in 10 states that wanted to run demonstration projects testing requirements for work or other types of community engagement like training, education, job search, volunteer activities and caregiving.
The proposals, she said, came from Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin.
Advocates for Medicaid beneficiaries said the new policy was likely to be challenged in court if people were denied coverage for failure to meet a state’s work requirement.
Federal law gives the secretary of health and human services broad authority to grant waivers for state demonstration projects that promote the goals of the Medicaid program.
In the past, federal officials said that work was not one of the purposes of Medicaid.
But Trump administration officials said Thursday that work requirements were consistent with the goals of Medicaid, because work and other community engagement activities could improve the health of Medicaid beneficiaries.
“Productive work and community engagement may improve health outcomes,” Brian Neale, the director of the federal Medicaid office, said Thursday in a letter to state Medicaid directors.
“For example, higher earnings are positively correlated with longer lifespan.” In addition, Mr. Neale said, researchers have found “strong evidence that unemployment is generally harmful to health,” while employment tends to improve “general mental health.” A 2013 Gallup poll found that unemployed Americans are more than twice as likely as those with full-time jobs to say they have or are being treated for depression, Mr. Neale said.

Trump administration allows states to make Medicaid recipients work

Trump administration allows states to make Medicaid recipients work

The Trump administration will allow states for the first time to impose work requirements on Medicaid recipients.
The Centers for Medicare & Medicaid Services released a guidance Thursday outlining what states need to do to mandate that certain Medicaid enrollees work to qualify for benefits.
The agency is expected to start approving state waivers promoting “community engagement activities” in coming weeks. “Medicaid needs to be more flexible so that states can best address the needs of this population.
States should take these issues — as well as recipients’ employability — into consideration and allow for modifications or exemptions, the agency said.
Many governors, including Republican ones, have defended the Medicaid program as being critical to addressing the substance abuse crisis.
States will be required to describe strategies to assist recipients in meeting the requirements and to link them to job training and support resources, including child care and transportation.
The agency is encouraging states to align their Medicaid work requirements with those mandated by other federal safety net programs.
Republicans have long wanted to add work requirements to the Medicaid program, which covers nearly 75 million low-income children, adults, elderly and disabled Americans.
South Dakota’s governor said in his State of the State address Tuesday that he would also look to require certain recipients to work.

Trump Officials, After Rejecting Obama Medicare Model, Adopt One Like It

Trump Officials, After Rejecting Obama Medicare Model, Adopt One Like It

WASHINGTON — In a notable back flip, the Trump administration has decided that maybe the Obama administration was right in its efforts to change the way doctors and hospitals are paid under Medicare.
Participation in the new project is voluntary.
Seema Verma, the administrator of the federal Centers for Medicare and Medicaid Services, said the new bundled payments were “an important step in the move away from fee-for-service and toward paying for value.” The Obama administration tried to accelerate that shift by testing new methods of payment under the supervision of an office created by the Affordable Care Act.
Medicare will make bundled payments for 32 types or “episodes” of care.
The lump sum payment will cover the services of doctors and hospitals, clinical laboratories, nursing homes, home health agencies and hospices, as well as reimbursement for some medical equipment like wheelchairs and certain drugs given to patients in doctors’ offices.
2 official at the Centers for Medicare and Medicaid Services under President Barack Obama, praised the new initiative as “a very good model.” In similar programs started in the Obama administration, “quality over all seems to be going up, and costs down,” said Dr. Conway, who is now the president of Blue Cross and Blue Shield of North Carolina.
As a member of the House, Mr. Price denounced bundled payment initiatives.
But Mr. Trump’s new nominee for health secretary, Alex M. Azar II, said Tuesday that mandatory participation might sometimes be needed.
In unveiling the pilot project, the Trump administration said doctors and hospitals must not restrict patients’ access to “medically necessary care” as a way to reduce Medicare spending.
The Trump administration said Medicare beneficiaries could not opt out if they were receiving services in an episode of care covered by the new bundled payment program.

The Case for More Medicare

The Case for More Medicare

This article is part of the Opinion Today newsletter.
Health care has been the top policy priority of each of the past two Democratic presidents.
(Education, by the way, also improves public health.)
The idea is more politically feasible than single-payer Medicare for All, which would involve forcing many people to give up their current insurance plans.
A larger Medicare could also have an enormous secondary benefit: The program holds down medical costs more than any other part of the health care system.
Starr’s new article goes into much more detail on both politics and policy.
His proposal isn’t the only one worth considering for improving health coverage.
But it does fall into the broad category that I think is the only one worth considering: It tries to expand public programs, not the less popular private ones, and it takes political constraints into account.
The Republican candidate in a tied Virginia statehouse district won a random drawing yesterday, giving Republicans control of the chamber.
Virginia Democrats, Wasserman writes, “probably didn’t seriously contest as many GOP seats as they should have” in 2017.

New CBO Score Confirms: Trumpcare Kills For Profit
Social Security Disability

New CBO Score Confirms: Trumpcare Kills For Profit

Trumpcare” doesn’t have any stock in the American people.
By 2026, the number of people killed by Trumpcare could grow to approximately 29,000 in that year alone.” The Senate Trumpcare bill would cause 22 million Americans to lose their health care over the next decade—including 15 million in the next year alone.
The result is that millions of Americans would either see their health care costs go up, or be left with skimpy plans that will be worthless when they most need care.
Indeed, Medicaid will only be more important to seniors in the coming years—an estimated 70 percent of Americans ages 65 and older will one day need long-term care, which is not covered by Medicare.
Given that coverage for seniors and people with disabilities accounts for the majority of Medicaid spending, there would simply be no way for states to enforce the bill’s strict Medicaid provisions without cutting their care.
Now that they have an anti-Obamacare president who has abandoned his promises to protect Medicare, Medicaid, and Social Security, and a Health and Human Services secretary who has proposed even more harmful health care legislation, Trumpcare’s architects feel empowered to make their cruel health care vision a reality, despite the massive opposition from their constituents.
Americans are understandably tired of having to tell their senators what should be obvious: that they don’t want a cruel bill that will increase health care costs and reduce coverage for tens of millions of Americans to become law.
Senators Susan Collins, Dean Heller, Rand Paul and Ron Johnson have currently indicated that they will probably vote no — we need to hold them to it, and find more senators to vote no.
Below are some of the Republican senators who, for a variety of reasons, might vote no on Trumpcare.
Don’t stop calling, and getting others to call, until the bill is defeated!

House Republicans put final touches on budget deal

House Republicans put final touches on budget deal

(CNN)House Republicans are putting the final touches on a bold budget proposal they will roll out later this week that would boost military spending beyond what President Donald Trump wants and slash billions from welfare and other entitlement programs.
The fiscal blueprint is expected to propose more than $1.1 trillion for the next fiscal year and would provide more money for the military and domestic spending than President Donald Trump requested in his budget, which he sent to the Hill in May, according to several congressional aides familiar with the proposal.
Republicans reached an agreement on the discretionary funding levels for the Pentagon and domestic agencies, and the last sticking point Republican leaders had to overcome was over how much deficit-reduction should be taken out of mandatory programs like Social Security, Medicare and Medicaid.
The House budget blueprint would set domestic discretionary spending at $511 billion, an increase compared to the Trump administration’s $462 billion budget request, which proposed deep cuts to agencies like the State Department and EPA.
When President Barack Obama was in the White House, final spending deals in recent years included equal increases for defense and domestic spending, but Republicans are trying to move away from that construct now that they control the legislative and executive branches.
But with a budget deal near, the House’s defense authorization and appropriations bills were finalized at the same level as the emerging budget agreement.
Thornberry told reporters last week that he was willing to come down from $640 billion, but he would need assurances there would be future growth for military spending in future years.
Some in the House Freedom Caucus were hoping they could get a significantly higher number, and House Budget Chair Diane Black also appealed to top GOP leaders to make those savings a major component of the final deal, according to several House Republican sources.
The budget proposal does not provide details on how each committee could achieve these savings targets, but including the provision in the budget resolution gives Republicans in Congress the ability to say they are following through on their pledge to reduce the size of the federal government.
Republicans don’t need to pass a budget — the various spending bills that detail how much each agency will get for federal programs are the measures that keep the government operating.

The Senate’s Stealth Raid on Seniors’ Health Care
Social Security Disability

The Senate’s Stealth Raid on Seniors’ Health Care

He is preparing to ram the disastrous health care repeal bill that House Republicans passed last month through the Senate and down the throats of the American people.
The health care repeal bill, often known as “Trumpcare”, would be a disaster for tens of millions of Americans, and especially those over fifty.
Trumpcare would allow health insurance corporations to charge older Americans up to five time as much for coverage.
Currently, a 64-year-old with total income of $26,500 pays an average of $1,700 a year for health insurance bought in an Affordable Care Act exchange.
Millions of Americans, low-income seniors and people with disabilities, are eligible for both Medicare and Medicaid.
Medicaid is particularly essential for those who require long-term care, which will be most of us one day.
To stop McConnell’s health care repeal bill, we need to convince three Republicans to vote no.
If your Senators are Republicans, demand that they vote no.
If one of them represents your state, call today!
Don’t stop calling, and getting others to call, until the bill is defeated!

The Overlooked Trumpcare Threat: A Medicare Time Bomb
Social Security Disability

The Overlooked Trumpcare Threat: A Medicare Time Bomb

In that speech, he promised that he would not cut Social Security, Medicare, or Medicaid.
But six months into his presidency, Trump has already betrayed those voters by breaking his promise.
Trump also champions the Republican health care repeal bill (also known as Trumpcare), which includes yet more massive cuts to Medicaid.
Indeed, Trumpcare is bait-and-switch: It claims to repeal and replace Obamacare, which it modifies, but doesn’t completely undo.
What it does do, without broadcasting the fact, is repeal and replace Medicaid.
Trumpcare repeals Medicaid as we know it.
He said that he planned to enact legislation as soon as possible that would end Medicare’s guaranteed benefit and replace it with voucher coupons.
Trump ran on a promise to protect Medicare and Medicaid.
But he now champions a bill that would destroy Medicaid and tees up the destruction of Medicare.
To become law, the bill must first pass the Senate and then be voted on a second time in the House.

Cuts to Medicaid May Limit Access to Nursing Homes

Cuts to Medicaid May Limit Access to Nursing Homes

But years in an assisted living center drained her savings, and now she relies on Medicaid to pay for her care at Dogwood Village, a nonprofit, county-owned nursing home here.
Medicaid pays for most of the 1.4 million elderly people in nursing homes, like Ms. Jacobs.
Under federal law, state Medicaid programs are required to cover nursing home care.
“They’d have to be more disabled before they qualify for Medicaid assistance.” States might allow nursing homes to require residents’ families to pay for a portion of their care, she added.
A combination of longer life spans and spiraling health care costs has left an estimated 64 percent of the Americans in nursing homes dependent on Medicaid.
“Certainly, nursing homes would be part of those cuts, not only in reimbursement rates but in reductions in eligibility for nursing home care.” 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.
“If you’re going to cut that much money out, it’s going to be coming from older people and people with disabilities.” The House health care bill targets nursing home coverage directly by requiring every state to count home equity above $560,000 in determining Medicaid eligibility.
None of them can take care of her at home.
“I’ve been here years,” she said.
Major Medicaid cuts would compel Dogwood Village to cut staff, supplies and amenities — changes that would affect the quality of care for all residents, not just those on Medicaid.