Late last night, the U.S. Senate finally voted to approve a massive $2 TRILLION bailout/recovery bill in response to the Coronavirus pandemic. After a lot of haggling and drama, the final bill ended up passing unanimously, 96 - 0 (four Republican Senators weren't able to vote at all...due to being in self-isolation because of Coronavirus). It's expected to be quickly passed by unanimous consent in the House today and will presumably be signed by Donald Trump before nightfall.
And like that, the largest emergency economic influx bill in history is done.
There's a lot of explainers and thinkpieces being written about the bill as a whole...which elements are good, which are bad, which are flat-out offensive (especially the ~$500 billion in corporate giveaways, which still ended up in the final bill although they supposedly have some sort of oversight over which companies receive them and under what conditions), but my focus is of course on the healthcare aspects, and especially what it means for enrollment in ACA exchange plans and Medicaid via ACA expansion.
For nearly three years now, the Trump Administration and Republican politicians across dozens of states have been claiming that expanding Medicaid to "able-bodied adults" encourages them to be lazy couch potatoes, lying around on their butts just soaking up all that sweet, sweet free healthcare coverage. That's the main excuse they've used to tack on draconian work requirements for Medicaid expansion enrollees: Supposedly doing so goads them into getting off their rumps, pulling themselves up by their bootstraps and becoming a Productive Member of Society, etc etc.
Of course, the reality is that most Medicaid expansion enrollees already work, and of those who don't most are already either in school, caring for a child or a medically frail relative, etc etc...meaning that work requirements impose a mountain of burdensome paperwork and reporting requirements in order to "catch" a tiny handful of people who supposedly match the "lazy bum" stereotype...but instead end up kicking thousands of people who are working/in school/etc. off of their coverage because they aren't able to keep up with the reporting requirements.
The number of Idaho residents who have signed up for Medicaid under the state’s voter-approved expanded coverage has passed 60,000.
The Idaho Department of Health and Welfare posted updated numbers Thursday. The agency estimates 91,000 residents meet requirements.
Coverage started January 1, but enrollment is year-round. Those who sign up for Medicaid will be covered for doctor visits that occurred earlier in the same month.
Voters authorized Medicaid expansion in 2018 with an initiative that passed with 61% of the vote after years of inaction by state lawmakers. In 2019, lawmakers added restrictions requiring five waivers from the U.S. Department of Health and Human Services.
Waivers are required when states want to deviate from Medicaid rules. Federal officials have yet to approve any of Idaho’s requested waivers.
If the anticipated 91,000 people do eventually sign up, it would cost Idaho about $400 million, with the federal government paying 90%.
TOPEKA, Kan. (KWCH) Gov. Laura Kelly and Republican leadership announce an agreement on Medicaid expansion in Kansas.
During a press conference on Thursday, the governor said the program would be funded by the hospital administrative fee. At this time, it's unknown if that fee would be passed on to patients.
Kelly said the hospitals have endorsed the program.
Kansas Senate GOP Majority Leader Jim Denning said the bill would be pre-filed on Thursday with 22 co-sponsors.
If passed in the Kansas Senate and House, the full expansion would go into effect no later than Jan. 1.
(Obviously that's January 1st of 2021 at this point, of course)
Here's some live tweeting of the event by a Kansas-based political reporter:
Your Health Idaho enrolls 89,000 Idahoans for 2020 health insurance coverage
Idaho exchange sees increase in new customers as overall enrollments decline amid Medicaid expansion
BOISE, Idaho – More than 89,000 Idahoans signed up for 2020 health insurance coverage through the state insurance exchange, Your Health Idaho, during open enrollment which ended Dec. 16, 2019.
Enrollments are down approximately 14,000 from the same time last year. This decline is largely due to Medicaid expansion and was expected by the exchange. Your Health Idaho originally estimated that around 18,000 individuals would move from the exchange to Medicaid under the newly expanded program.
A brief recap of ACA Medicaid expansion in the great state of Utah:
November 2018: Utah voters pass Proposition 3, a "clean" Medicaid expansion ballot initiative, by a solid margin, 53-47. "Clean" expansion means just that: The program would be expanded to every legally documented Utah resident earning up to 138% of the Federal Poverty level, without requiring additional barriers like work requirements, etc.
February 2019: The Utah state legislature, blatantly defying the clear will of the people, votes to effectively ignore Prop 3 by replacing it with Senate Bill 96, which would only partially expand Medicaid to those earning just 100% FPL (around 50,000 fewer low-income residents) while also tacking on work requirements to boot.
Adding insult to injury, while you might think this would at least save the state a few bucks (under ACA Medicaid expansion, the federal government pays 90% of the bill for the expanded population while the state has to pay the other 10%), this would actually cost the state around $50 million more, because the partial expansion, if approved by the federal government, would mean the state would instead pay the 32% portion they already pay for other Medicaid populations. The state put in a separate waiver request asking for the feds to agree to the 90% match rate anyway.
Former Republican Gov. Matt Bevin’s controversial plan to impose work requirements and monthly premiums for many Kentucky Medicaid recipients is no more, Democratic Gov. Andy Beshear announced Monday.
(Monday = Last Monday; this is from a week ago)
In one of his first major moves as the 63rd governor of Kentucky, Beshear signed an executive order Monday rescinding Bevin’s Kentucky HEALTH plan, which sought to impose strict work requirements for able-bodied, working-age adults. It would have ended health coverage for an estimated 95,000 Kentuckians.
Your Health Idaho, the states' ACA exchange, reminds residents who completed their enrollment applications that they still have until midnight tonight to actually select a policy:
Last chance to #GetCovered!
For those Idahoans who submitted an application for 2020 health insurance coverage by December 16, you have one more day to pick a plan! Do not wait! Find your perfect plan today at YourHealthIdaho.org!
Yes, that's right: Not only did they lop 50,000 people out of the loop entirely, the other 90 - 100K enrollees will also be subject to...wait for it...work requirements. Well...sort of; keep reading.
First, it looks like they'll have to apply to at least 48 employers as well. So...what, if they get hired by the first one they still have to apply with 47 more?
Note that it says "and" before the fourth item, not "or"...which means all of them will have to register online, complete a training assessment, apply to at least 48 companies and complete an online training course.
...Oh by the way, one more thing: The minimum wage in Utah is $7.25/hour.
Open Enrollment for Idaho is coming to a close, don’t miss out on enrolling in an affordable health insurance plan! You can set up an account, shop for plans, and apply for coverage online. Visit Apply and Enroll for more information. No computer? No problem. To apply over the phone or to request a paper application, call Your Health Idaho at 1-855-944-3246.
We’re Here to Help!
Your Health Idaho will have extended hours throughout December*:
December 1 – 6: 7am – 7pm
December 9 – 13: 7am – 8pm
December 14 (Saturday): 10am – 4pm
December 16 – 20: 7am – 8pm
December 21 (Saturday): 10am – 4pm
This is the perfect opportunity for those Idahoans who were unable to reach us during the busy work week.
*All times are in Mountain Time Zone.
Gov. Gretchen Whitmer said delaying implementation of work requirements for enrollees in Michigan's Medicaid expansion program would prevent the state from potentially wasting at least $1 million.
The Democrat issued a special message to legislative leaders Tuesday, a day after saying the Republican-controlled Legislature should pause the rules taking effect in January.
Whitmer said the state has spent $28 million to implement the workforce engagement requirements and is on track to spend an additional $40 million this fiscal year — an unnecessary expense if a federal judge blocks the rules.
Coming on top of not one, not two, but three other states either scrapping or "delaying" implementation of Medicaid expansion work requirements (Arizona, Indiana and Montana), this one isn't particularly surprising given that Democrats hold the governor's seat and just flipped both the state House and Senate. Still welcome, though!
Gov. Ralph Northam has directed Virginia's Medicaid program to "pause" negotiations with the federal government on approval of a work requirement that was central to a political deal that allowed the state to expand eligibility for the program's health care benefits to hundreds of thousands of uninsured Virginians.
Northam cited the Democratic takeover of both chambers of the General Assembly in legislative elections last month. He also referred to litigation that has faced other states that have tried to link Medicaid health benefits to requirements that program participants seek work, training, education or other forms of civic engagement.
But the plans were on display…”
“On display? I eventually had to go down to the cellar to find them.”
“That’s the display department.”
“With a flashlight.”
“Ah, well, the lights had probably gone.”
“So had the stairs.”
“But look, you found the notice, didn’t you?”
“Yes,” said Arthur, “yes I did. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard.”
Under the Arkansas law, targeted enrollees were notified by the state via mail and informational flyers that they were required to work 80 hours a month, participate in another qualifying activity such as job training or community service, or meet criteria for an exemption such as pregnancy, a disability or parenting a child.
BREAKING -- Poverty rights group files suit in federal court against work requirements MI has enacted for those on expanded Medicaid program Healthy Michigan.
A lawsuit has been filed challenging Michigan's new Medicaid work requirements that take effect Jan. 1. Plaintiffs are 4 people enrolled in the Medicaid expansion program known as Healthy Michigan #MiLeg
The recent elections in Virginia, Kentucky and Louisiana had two things in common: The first is that all three were huge victories for Democrats (they took control of both the state House and Senate in Virginia, flipped the Governor's seat in Kentucky and held onto it in deep red Louisiana).
The second is that all three elections were won in large part based on...Medicaid expansion.
Yet Edwards won, in large part, by also stressing his implementation of the Affordable Care Act’s Medicaid expansion in the state during his first term. Indeed, Edwards’s lead pollster, Zac McCrary, told me during an interview that no single issue was more important in driving the governor’s victory.
