Since efforts to repeal the ACA stalled out in Congress, the Trump Administration has used its administrative authority in an attempt to reshape Medicaid to be more in line with conservative arguments that employment is linked to better health outcomes and helps move people off Medicaid and out of poverty.
The Administration is giving the green light to states to condition Medicaid eligibility on meeting a work and/or community engagement requirement. Guidance from the Centers for Medicare & Medicaid Services has expressed a preference for following existing federal program work requirements found in programs like the Temporary Assistance for Needy Families (TANF), and the Supplemental Nutrition Assistance Program (SNAP). CMS has also indicated that they will allow states to account for local conditions such as high unemployment in certain areas and other factors such as “lack of viable transportation.”
To date, CMS has approved three state demonstration waivers – Arkansas, Kentucky and Indiana – incorporating work requirements; seven other states reportedly have waivers pending. Each carries a combination of additional provisions that may affect the eligibility or affordability of coverage. Approved waivers have exemptions for work requirements for “medically frail” adults, certain caregivers, students and pregnant women. Continue reading “Medicaid Work Requirements Will Create More Problems Than They Solve”
The President’s proposed budget is a wholesale shift of federal responsibilities onto states, with little to no support for those states to fulfill those responsibilities. It includes cuts to fundamental federal programs such as public housing, utilities, and food assistance programs. It also revives the President’s wish to repeal and replace the Affordable Care Act through the use of Medicaid block grants that would strip $250 billion from state Medicaid programs over the next ten years.
Smart Policy Works is most troubled by the efforts of this Administration and Congress to consistently undermine the Medicaid entitlement. A shift to block grants breaks the 50-year compact between the federal government and states to provide health care to the poor. A block grant – or flat funding – puts the onus on states to deliver the same quality of care without taking into account increases in medical costs, health care epidemics, or increased Medicaid enrollment in times of economic decline. Continue reading “The President’s Budget Doesn’t Reflect Smart Policy”
Smart Policy Works is pleased to see that an agreement in principle was reached that will re-open our government, fund the Children’s Health Insurance Program, and allow for the resumption of critical programs. We continue to stand with healthcare organizations, businesses, and leaders to express our grave concern about the effect of continued budget uncertainty will have on programs and services that support countless millions.
SPW has spent 25 years breaking down the barriers to healthcare access faced by millions with complex health conditions. Many of these barriers are created when policy is written and implemented in isolation, without consideration to its impact on the people it’s meant to support and how various health programs can work together to improve outcomes. Countless healthcare agencies and organizations rely on a stable policy framework to drive their operations and support the health of the people they serve. Addressing long-term budget issues with short-term continuations creates tremendous uncertainty, which then forces organizations to work in the short term as well.
We believe that a clear budget policy that seeks to broaden access to healthcare is the best solution for everyone. We will continue to evaluate actions in Washington and provide information that translates those actions into impacts at the federal, state, and local level.
On January 9, President Trump signed an executive order expanding access to mental health care for Veterans as they transition out of military service. The details of this move are not finalized, but it will include allowing access to Military OneSource for 12 months.
For those who think that transitioning Veterans are not eligible for mental health care currently – let me assure you that is not the case. However it can be confusing. Once a Veteran is discharged from the service they can apply for disability benefits at the VA, but most will wait an extended period of time before their applications are approved. Continue reading “The Executive Order and Veteran Suicide”
I’m really excited to share our news – on October 26th we are launching our new name and identity, Smart Policy Works.
The name Smart Policy Works signifies our commitment to making policy work smarter, not harder. It is the culmination of 25 years of working with communities, social services and health providers, and government to break down barriers to health and well-being.
Health & Disability Advocates stands in strong opposition to the steps President Trump has taken to undermine the vital consumer protections found in the Affordable Care Act. As a result of pushing federal agencies to expand the growth of association and short term insurance plans, coupled with his late night decision to end critical subsidy payments to insurers, people with complex conditions are now at greater risk than ever for higher premiums, lifetime caps, and losing coverage due to pre-existing conditions.
Health & Disability Advocates strongly objects to the provisions in the American Health Care Act (AHCA). Yesterday, the Congressional Budget Office (CBO) provided its analysis of AHCA and its impact on people, states, and the economy.
Health & Disability Advocates was disappointed that the House of Representatives passed HR 1628 – The American Health Care Act (AHCA). Despite assurances that the AHCA will ensure better coverage at less cost, the AHCA will instead:
- Cause an estimated 24 million people to lose coverage
- Give states the option to remove cost and coverage protections for people with pre-existing conditions
- Reduce Medicaid funding to all states by $880 billion over the next ten years
- Increase out-of-pocket costs for seniors
Every time Joe needs routine health care unrelated to his spinal cord injury (SCI), he ends up providing the doctors with a laundry list of things they should be asking him, but don’t. Even though he is in his 30s, Joe doesn’t have a primary care physician. He can’t find one with an accessible office for routine exams; he gets his routine care from the specialist who he’s been seeing for his SCI. He’s starting to give up on trying to find a primary care physician because every time he educates them about how his injury affects his health, he gets a new doctor and has to start all over again. He feels it’s a waste of time and demoralizing, so he’s just stopped looking for a primary care physician.
New leadership in the White House and in Congress always means different ideas and viewpoints for how we conduct the country’s business. But an election doesn’t change the needs that regular people have. We know from experience that the challenges people face today are the very same challenges we faced yesterday, and won’t change because of an election.
A new administration means changes, and we are ready to work with policymakers to mitigate the impact of change on our constituency. We will be using all of the tools at our disposal to make sure that people with complex health needs and disabilities have a voice – whatever systems of care we put in place.