Swordsmyth
08-18-2018, 10:58 PM
The high-stakes changes, involving work requirements and questions about illegal drug use, have been the subject of intense behind-the-scenes lobbying in recent months by federal and state lawmakers in the latest chapter of the GOP’s long-running efforts to reshape Medicaid — a policy priority extending back to the Reagan era.
And they are moving forward even after a federal judge blocked Kentucky’s work requirement in June, saying the Trump administration failed to consider how the plan would affect coverage, and new evidence (https://www.politico.com/newsletters/politico-pulse/2018/08/16/thousands-of-medicaid-enrollees-could-lose-coverage-in-arkansas-319038) that thousands of Arkansans will lose benefits because of the state's work requirement. Advocacy groups have sued to stop Medicaid work requirements in both states and threaten further litigation if more changes are OK'd.
Nonetheless, the administration is expected to sign off soon on work requirements in three more states — Arizona, Wisconsin and Maine — while approving limited drug testing questions sought by Wisconsin’s GOP Gov. Scott Walker, according to four individuals with knowledge of the process.
Administration officials say that Medicaid beneficiaries should be encouraged to seek jobs to ensure they move off the program eventually.
An attempt by Arizona to protect Native Americans from work requirements is also expected to be denied as part of the review — a move that effectively reiterates (https://www.politico.com/story/2018/04/22/trump-native-americans-historical-standing-492794) the administration's position that members of tribes might need to get jobs to keep their health care.
HHS and Justice Department officials are additionally finalizing the Medicaid work requirements sought by Maine, amid broader legal uncertainty about the state’s health program under Republican Gov. Paul LePage, who has refused to implement a voter-approved Medicaid expansion.
“Everything’s being steered through the Justice Department right now,” said one official. “They’re trying to make it bulletproof.”
The goal is to make the latest Medicaid changes withstand simultaneous legal challenges, similar to those targeting early versions of President Donald Trump’s travel ban, according to officials familiar with the process.
One of the most controversial changes sought by the states is Wisconsin's attempt to drug test its Medicaid applicants — an effort that advocates and lawyers say (https://familiesusa.org/blog/2017/12/drug-testing-medicaid-illegal-and-hurts-people-who-need-help-most) is illegal and that also drew objection from the Trump administration. Drug testing has never been allowed as a condition of Medicaid, in any state.
Instead, Wisconsin is expected to win approval to ask applicants to disclose on their Medicaid applications whether they've used drugs or are in recovery, but won't make coverage decisions based on the answers provided, according to three officials with knowledge of the plan.
"It's a political give to Walker," said an administration official briefed on the plan, noting the Wisconsin governor has sought drug testing across multiple social programs, including food stamps.
More at: https://www.politico.com/story/2018/08/16/medicaid-changes-trump-work-drug-use-741890
And they are moving forward even after a federal judge blocked Kentucky’s work requirement in June, saying the Trump administration failed to consider how the plan would affect coverage, and new evidence (https://www.politico.com/newsletters/politico-pulse/2018/08/16/thousands-of-medicaid-enrollees-could-lose-coverage-in-arkansas-319038) that thousands of Arkansans will lose benefits because of the state's work requirement. Advocacy groups have sued to stop Medicaid work requirements in both states and threaten further litigation if more changes are OK'd.
Nonetheless, the administration is expected to sign off soon on work requirements in three more states — Arizona, Wisconsin and Maine — while approving limited drug testing questions sought by Wisconsin’s GOP Gov. Scott Walker, according to four individuals with knowledge of the process.
Administration officials say that Medicaid beneficiaries should be encouraged to seek jobs to ensure they move off the program eventually.
An attempt by Arizona to protect Native Americans from work requirements is also expected to be denied as part of the review — a move that effectively reiterates (https://www.politico.com/story/2018/04/22/trump-native-americans-historical-standing-492794) the administration's position that members of tribes might need to get jobs to keep their health care.
HHS and Justice Department officials are additionally finalizing the Medicaid work requirements sought by Maine, amid broader legal uncertainty about the state’s health program under Republican Gov. Paul LePage, who has refused to implement a voter-approved Medicaid expansion.
“Everything’s being steered through the Justice Department right now,” said one official. “They’re trying to make it bulletproof.”
The goal is to make the latest Medicaid changes withstand simultaneous legal challenges, similar to those targeting early versions of President Donald Trump’s travel ban, according to officials familiar with the process.
One of the most controversial changes sought by the states is Wisconsin's attempt to drug test its Medicaid applicants — an effort that advocates and lawyers say (https://familiesusa.org/blog/2017/12/drug-testing-medicaid-illegal-and-hurts-people-who-need-help-most) is illegal and that also drew objection from the Trump administration. Drug testing has never been allowed as a condition of Medicaid, in any state.
Instead, Wisconsin is expected to win approval to ask applicants to disclose on their Medicaid applications whether they've used drugs or are in recovery, but won't make coverage decisions based on the answers provided, according to three officials with knowledge of the plan.
"It's a political give to Walker," said an administration official briefed on the plan, noting the Wisconsin governor has sought drug testing across multiple social programs, including food stamps.
More at: https://www.politico.com/story/2018/08/16/medicaid-changes-trump-work-drug-use-741890