Biden Admin starts dismantling #DanceSpiderDance Medicaid policies


Nearly six years ago:

In other words, only about 10% (at most) of those still in the Medicaid Gap could remotely match the GOP's cliche of a "lazy, good-for-nothing layabout" type who's able-bodied, has no serious extenuating circumstances and so forth. The "get off your ass and work!" requirements appear to be nearly as big a waste of time and resources as the infamous "drug testing for welfare recipients" bandwagon which a bunch of states jumped on board over the past few years.

As for the other requirements (co-pays/premiums), this is kind of the same sort of logic which recently led a GOP state Senator to come to the brilliant conclusion that slashing the Medicaid budget in half would free up money for other stuff! Why yes, of course it would. Just as requiring people on Medicaid to pay a chunk of the cost of their treatment would, as demonstrated by the Montana example above, save money as well...because 36% of those eligible would never enroll in the program in the first place! BRILLIANT!!

For that matter, guess what else would "save money" for the state? Killing all of the people in the Medicaid Gap! Then you wouldn't have to deal with them at all!

Basically, Republicans have gone from saying "screw the poor" to "OK, you can see a doctor but only if you dance for me first."

Sure enough, starting in 2018, the Trump Administration opened up the floodgates for Medicaid work requirements...and sure enough, the thing every healthcare expert predicted happened:

Last week, the state of Arkansas released its latest round of data on implementation of its Medicaid work reporting requirement – the first in the country to be implemented. As readers of SayAhhh! know, over 18,000 lost coverage in 2018 as a result of not complying with the new reporting rules. And the policy is clearly failing to achieve its purported goal – incentivizing work – with less than 1% of those subject to the new policy newly reporting work or community engagement activities.

...As it races to revamp Medicaid by allowing work requirements for the first time, the Trump administration is failing to enforce federal rules directing states to assess the impact of the change on low-income patients who rely on the half-century-old safety net program, a Times analysis shows.

None of the eight states that the administration has cleared to implement a Medicaid work requirement has in place a plan to track whether Medicaid enrollees find jobs or improve their health, two goals often touted by administration health officials.

...Critics say the administration and the states appear to be systematically ignoring or weakening the requirement for independent analysis, perhaps because they fear the results.

...New work requirements for people in Michigan's Medicaid expansion group could cause as many as 183,000 people to lose their coverage.

Anywhere between 9 and 27 percent of the approximately 680,000 people enrolled in the Michigan Healthy Plan - or 61,000 to 183,000 recipients - could be kicked of the rolls.

That's up to three times what was estimated by the House Fiscal Agency when the work requirement bill was passed last year. The work requirements are scheduled to take effect on January 1, 2020.

And so on...and so on...and so on...

Cut to today: This just in from Adam Cancryn of Politico:

The Biden administration on Friday will notify states it plans to revoke Medicaid work requirements, starting the process of dismantling one of the Trump administration's signature health policies.

The move is one of several steps that Biden’s health department is expected to take this week to unravel the contentious work rules long criticized by Democrats, according to internal documents obtained by POLITICO.

The documents — which were labeled “close hold” — do not make clear how quickly Biden will cut off work rules the previous administration approved in a number of states, which for the first time were allowed to mandate that some people work or volunteer as a condition of enrollment in the low-income health care program.

Health officials are also preparing to withdraw the Trump administration’s 2018 letter that first announced the work requirements policy, and rescind a separate letter from earlier this year aimed at making it more difficult for the incoming Biden administration to quickly overturn the policy.

“CMS has serious concerns that now is not the appropriate time to test policies that risk a substantial loss of health care coverage or benefits in the near term,” according to a health department draft rollout plan entitled “Medicaid Work Requirement Rescission.”

Obviously I'm glad to see this being done as soon as possible (though I imagine it'll take some time for the full process to complete), but the timing is interesting for another reason:

The move also comes as the Supreme Court is slated to consider the validity of the work rules on March 29. Lower courts have so far blocked attempts to institute the work rules, which led most states with the requirements to halt their enforcement. Biden's plan to withdraw the work rules could render the Supreme Court case moot.