Senate uses salary threat to push Medicaid work plan
Lansing — Michigan’s Republican-led Senate is pressuring Gov. Rick Snyder to back sweeping changes to the state’s Medicaid health insurance system, including proposed work requirements and a tougher 48-month benefit limit for the Healthy Michigan plan.
The Trump administration has drawn a red line on Medicaid cuts. There are some proposals that the Centers for Medicare and Medicaid Services won’t approve.
In a letter on Monday, CMS Administrator Seema Verma told Kansas officials that her agency would not approve the state’s request to impose lifetime limits, which would have capped a person’s eligibility at three years, after which they could no longer be covered by the program.
Verma noted that the administration had approved proposals by other states to cut off benefits for Medicaid enrollees only if they fail to meet certain work requirements.
I've written quite a bit about the attempt by the GOP-controlled state legislature to push through work requirements for ACA Medicaid expansion here in Michigan. The bill (SB897) was quickly passed on partisan lines in the state Senate last week, and has now been taken up by the appropriations committee in the state House.
I actually shlepped my butt all the way out to Lansing yesterday morning to attend the committee hearing. Unfortunately, there were so many others who wanted to speak during the Public Comment period, I didn't get a chance to chime in.
NOTE: Just to clarify, here's where the headline comes from:
...Sponsoring Sen. Mike Shirkey, R-Clarklake, created exemptions in the Michigan legislation that would waive the work requirement for parents with young children, pregnant women or caretakers for disabled family members. But asked about people like Maitre who could still lose health care, he told reporters the social safety net “by definition, has a lot of holes in it.”
“The best safety net ever invented by God is family,” Shirkey said, “but I’m not sure that government is supposed to supplement that process.”
Well, here we go:
#BREAKINGtomorrow morning the House Appropriations Committee is taking up SB 897. Another Republican attempt to take away healthcare from Michigan familieshttps://t.co/WsUhyntINj
Virginia’s Republican-led legislature is on the verge of doing something that would’ve been almost unthinkable just a year ago: approving legislation that would use money from the Affordable Care Act to expand Medicaid to as many as 400,000 people.
That coverage expansion would come at a price for Democratic legislators, progressive activists and low-income Virginians, however. Any Medicaid expansion bill that makes it out of the General Assembly will carry with it new work requirements for Medicaid enrollees, a priority for the GOP at large and for President Donald Trump’s administration.
Democrats in the Virginia legislature have tried in vain for six years to persuade their GOP counterparts that accepting federal dollars to extend Medicaid coverage to poor adults is the right thing to do. Accepting a work-requirements policy that would create bureaucratic obstacles to eligible Virginians appears to be the compromise needed to win the bigger fight.
As noted earlier, I've been a bit lax with posting for a few days as I've worked on my latest 2-part video explainer about risk pools and #ShortAssPlans.
However, there's been a lot going on, so I figured I should try and at least do a quick update on a few items. First up: Medicaid expansion!
Here in my home state of Michigan, I've written several posts about how the GOP-controlled state legislature trying to shove through a draconian "work requirement" bill for Healthy Michigan, our name for ACA Medicaid expansion program which has been working just fine, thank you very much, for nearly 5 years now. The bill easily passed the state Senate (where the GOP holds a supermajority), and is now under consideration by the state House (where they have a smaller but still solid majority at the moment). The good news is that GOP Governor Rick Snyder--who championed passage of Healthy Michigan in the first place and seems to think it's fine mostly the way it is--is likely to veto the senate version of the bill. The bad news is that it might simply be tweaked somewhat by the House.
After years of fighting Obamacare, Gov. Scott Walker is now seeking to stabilize the state marketplace under the law.
Wisconsin plans to permission to cover expensive medical claims for health insurers on the marketplace, which should lower premium increases and could bring back companies that dropped out, the governor said in an interview with reporters on Friday ahead of his election-year State of the State address Wednesday.
The state will also ask to permanently continue SeniorCare, a prescription drug program Walker has previously sought to pare down, he said.
Walker also said he’ll ask the state Senate to pass a bill authored by Democratic lawmakers and passed by the Assembly that would enshrine into state law access to private insurance for people with pre-existing conditions.
In the most significant of his health care proposals, Walker will ask the Legislature to join a few other states in adopting a reinsurance programto prop up the individual market, which is used by some 216,000 residents, in a state innovation waiver allowed under the Affordable Care Act, or Obamacare.
A week or so I noted that activists in Utah had managed to secure enough ballot petition signatures to get full, no-strings-attached ACA Medicaid expansion placed on the ballot this November...superseding legislation signed by the Governor which would otherwise only expand it to fewer than half as many people, while also imposing a work requirement on enrollees:
If approved, the initiative would require the state to expand Medicaid to people making up to 138 percent of the federal poverty level, and would prohibit enrollment caps.
Under ObamaCare, the federal government would cover 90 percent of the costs of expansion. The state share would be funded through a 0.15 percent increase in the sales tax.
...The ballot initiative would cover more than 150,000 people.
As I noted last week, the Republican-controlled Michigan state Senate rammed through a draconian work requirement bill for ACA Medicaid expansion enrollees in spite of the fact that it would serve no positive purpose and would only "save money" by kicking thousands of low-income Michiganders off their healthcare coverage while actually harming the economy.
I further noted that while I was pretty sure the bill would easily pass the state Senate (where the GOP holds a supermajority) and will likely pass the GOP-controlled state House as well, there is a decent chance that it could be vetoed by GOP Gov. Rick Snyder. Snyder is guilty of a long list of sins during his time as Governor, including being indirectly responsible for the water supply for the entire city of Flint being poisoned a few years back. At the same time, oddly, once in a blue moon he'll actually do something decent and good, and the one he deserves the most praise for on this front is pushing to get Medicaid expansion through in the first place.
(sigh) Dammit, sure enough, as I expected, the full Michigan state Senate has gone ahead and passed the state Senator Mike Shirkey's "God's Safety Net" bill which would impose 29-hour-plus work requirements on 680,000 low-income Medicaid enrollees even though the vast majority of them already work, go to school, are medically fragile, take care of other medical fragile family members, elderly relatives or children and so forth. It was, as you'd expect, a party-line vote:
Able-bodied Medicaid recipients in Michigan may soon have to choose between finding a job or losing health insurance.
...Democrats condemned the proposal as harmful to thousands of Medicaid recipients who would not meet the several exemptions spelled out in SB 897 and said such a move is also illegal. Majority Republicans brushed aside those objections, and the bill passed 26-11.
...Maitre, 62, spends dozens of hours each week babysitting her grandchildren and providing their working parents with free child care. But none of that time or her community service would count as work under an advancing plan that would require Medicaid recipients to spend 29 hours a week at a job or risk losing their health care coverage.
...The Republican-led Senate Competitiveness Committee approved the legislation a short time later in a 4-1 vote. The lone committee Democrat voted against the plan to reform the government health care program for lower-income residents, which has grown significantly in recent years after the state expanded eligibility under former President Barack Obama’s signature health care law.
It now moves on to the full state Senate, as I expected.
Gov. Gary Herbert signed a measure Tuesday to give more than 70,000 needy Utahns access to government health coverage, ending years of failed attempts on Capitol Hill to expand Medicaid in the state.
But whether House Bill 472 ever takes effect still remains uncertain. Under President Obama’s signature Affordable Care Act (ACA), the Utah law needs approval by the federal Centers for Medicare and Medicaid Services (CMS), which has sent mixed signals on whether it will fully sign off.
Even if CMS does approve HB472, it will likely be about a year — even on an aggressive schedule — before the state can begin enrolling people for coverage.
On 7/1/18, in Ky, my Medicaid/ ACA will be canceled. I may still need a brain shunt, LP #8, RXs, PT, etc. I was informed that my PCP could write a letter stating I was "Medically Fragile" but even then the provider has final say. Like fox guarding hen house. Please help me/DM
I am a disabled attorney living with my 76-year-old mother who takes care of me. In 2011, I was bitten by a tick and was infected with Ehrlichiosis Chaffeensis and Rickettsia. A week later, I contracted Coxsackie B4 virus. Because I was kept on antibiotics for 19 years, I had no immune system to fight these illnesses.
As I noted last month, the Republican-controlled Michigan State Senate is planning on jumping on board the pointless, wasteful, cruel "work requirement" bandwagon which is all the rage among the GOP types these days.