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The New Year Brings New Changes to State Medicaid Programs

While the ongoing government shutdown certainly has slowed government response and action on countless critical health issues, changes with the nation’s various Medicaid programs continue full-steam, worrying advocates about inevitable losses of coverage and resulting gaps in care.

At the national level, significant staffing changes at the Centers for Medicare & Medicaid Services (CMS) have occurred: Mary Mayhew has stepped down as the Director of CMS Center for Medicaid and CHIP Services after only three months in the post. Mayhew was formerly Maine’s top health official under former Gov. Paul LePage and gained notoriety for assisting his efforts to undermine his citizens’ unequivocal support for Medicaid expansion in the state. Mayhew transitions out of her role at the national office to again work at the state level, this time for Florida’s newly elected GOP Gov. Ron DeSantis. Chris Traylor, a longtime state and national health official with experience as executive commissioner of the Texas Health and Human Services Commission and the Texas Director of Medicaid, has been appointed as her successor.

Maine, with dissenting former Gov. LePage out-of-office due to term limits, is finally set to implement the Medicaid expansion approved by voters in November 2017. Although a section 1115 waiver to implement work requirements for Medicaid beneficiaries in Maine was submitted and approved by CMS in late December, it is not expected that new Democratic Gov. Janet Mills will implement them.

Arkansas, the first state to actually implement work requirements as a part of Medicaid, is validating advocates’ fears of widespread loss of health coverage and is moving forward with new expansions of the plan certain to cause even more eligible people to have their health insurance stripped from them. It is estimated that roughly 17,000 Arkansas citizens have lost coverage under the new work requirements. As the non-partisan Kaiser Family Foundation notes, the vast majority of those losing coverage are doing so because of reporting barriers and not ineligibility or failure to comply, following national trends that show Medicaid recipients who are able to work already do. Beginning January 1, the work requirements provision now also applies to Arkansas Medicaid enrollees aged 18-29, a group generally less burdened by online reporting requirements but even more likely to work unstable jobs that don’t allow them to meet the monthly hours-worked threshold.

AIDS United stands firmly against the implementation of Medicaid work requirements that only serve as barriers to care for those who need it most, including approximately 40% of people living with HIV currently in care. Check back to the AU Policy Update regularly for the latest info on the programs, funding, and legislation that support people living with HIV.

Posted By: AIDS United, Policy Department - Friday, January 11, 2019

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