Dr. Tom Price is the new secretary of Health and Human Services and the future of Medicaid under Dr. Price will be revealed soon, as the HHS has to decide if Arizona and Kentucky can remodel their efforts to expand Medicaid. States like Indiana, Arizona, Montana, Michigan, Iowa, and New Hampshire currently operate their Medicaid expansions making use of federal waivers, which is a system offering them more flexibility to make healthcare policies that are designed with the idea of promoting financial responsibilities among the various enrollees.
The state of Kentucky is in need of an HHS waiver to impose some conservative changes to the policy, which includes work requirements for users of the program. The waiver request from Arizona seeks many of the same changes together with a 5-year limit on the benefits of the program. If HHS grants the requests, this will be the first time in the history of the program that the Medicaid eligibility would depend on work requirements and benefits would be capped.
It is to be noted HHS had rejected the waiver requests of states routinely under the Obama Administration. Leonardo Cuello, who is the director of health policy at the National Health Law Center, said that the department should do the same thing with the states of Kentucky and Arizona. He added that neither of the requests of the states met a basic requirement of waiver demonstrations and experiments, which is to further the objectives of the program. This includes improving the coverage, access to providers and health outcomes.
Cuello said that the current proposals from the states are “an attack on eligibility.” Together with the work requirements, the state of Kentucky also needs permission to impose enrollment waiting periods, premium contributions and “lockouts” to bar those users who have income above the poverty level from enrolling again in Medicaid for 6 months if they default their premium payments.
Officials of the state estimated that the waiver proposals from Kentucky would result in loss of coverage by more than fifty thousand Medicaid recipients over the waiver period of five years. The officials estimated that this would help the state to save more than 2.2 billion dollars.
“Kentucky cannot afford the cost of the Medicaid expansion program without this demonstration waiver,” the state’s waiver application said. The waiver request from Arizona would ban users from coverage for a year if the user offers false information to meet work requirements or failed to report changes in their family income.