CBO knows the budget woes I’ve seen
The Congressional Budget Office estimates that upward of 8.6 million Americans will lose health coverage if the GOP moves forward with budget cuts.
Surprising no one — especially us at Manatt Health and our Medicaid modeling team — the Congressional Budget Office (CBO) released an analysis that various actions, such as establishing federal spending caps for Medicaid expansion, will result in massive health coverage losses. To better prepare for potential impacts of budget reconciliation proposals on Medicaid funding and program enrollment, join Manatt Health’s Medicaid team for the inaugural ‘Ask Manatt Anything’ session at 1:30 p.m. ET on May 14. Register now.
DOJ and HHS Signal Future Actions to Block Access to Treatment for Trans Youth
Federal agencies are continuing to take action to implement President Trump’s January 28 EO aimed at blocking access to care for transgender individuals under the age of 19. U.S. Attorney General Pam Bondi, on April 22, circulated an internal memo calling on the Department of Justice (DOJ) to enforce existing federal laws — including regarding off-label promotion of drugs like hormones and puberty blockers — and advance new legislation restricting gender-affirming care for youth. On May 1, the Department of Health and Human Services (HHS) released a report presenting the Trump administration’s conclusions on the clinical evidence and ethics of health care for transgender youth.
It appears the federal government is building an administrative record to cite when taking future action to shut down coverage of gender-affirming care for young people or penalize the providers who offer it. The American Academy of Pediatrics (AAP) has already weighed in on the HHS report, stating that it “misrepresents the current medical consensus and fails to reflect the realities of pediatric care” and that “patients, their families, and their physicians — not politicians or government officials — should be the ones to make decisions together about what care is best for them based on evidence-based, age-appropriate care.”
These steps follow prior federal actions, including HHS signaling funding risks for providers who serve transgender youth and suggesting limits on Medicaid coverage for youth gender-affirming care. The common themes are that none of these actions change existing legal requirements regarding treatment for transgender youth and that all appear to be crafted to promote hesitancy and fear among impacted patients, families, providers and payors, including state Medicaid programs.
Keep reading at The 80 Million.
ICYMI: The Reality of Work Requirements: Designed to Cut, Not to Put People to Work
Congressional Republicans seem poised to impose a national, statutory Medicaid work requirement through budget reconciliation. Lawmakers are exploring what such a mandate might look like, drawing on the Limit, Save Grow Act of 2023 and more recent legislative proposals being advanced by Congressional Republicans (e.g., H.R. 1059, S. 447, H.R. 1452) as potential blueprints. The precise way in which such a policy would be structured remains unclear, including the populations that would be subject to the requirement and the level of flexibility that states would have to implement it.
Drawing on Manatt Health’s 50-State Medicaid Financing Model and a toolkit that we recently prepared for states in partnership with the Robert Wood Johnson Foundation funded State Health Value Strategies program, we explore what making work requirements a condition of Medicaid eligibility would mean nationally and for each of the 50 states and D.C. Since we do not yet know the exact parameters that would be established for the federal work requirements proposal if adopted, we estimate the impact of two different policy approaches, drawing on bills that have been introduced in Congress: one that requires all adults ages 18 to 65 eligible through non-disability pathways to comply with work requirements, and another that applies work requirements to adults 19 to 55 in the Medicaid expansion adult group only.
For each policy approach, we model three potential state responses based on the degree to which a state can automate data matching to identify individuals complying with or exempt from work requirements. We selected these scenarios because previous and current state experiences with work requirements make one thing very clear: the less able states are to automate implementation of work requirements the more people have their coverage terminated.
Keep reading at The 80 Million.
Washington, D.C., Mayor Muriel Bowser called on Congress to preserve the District’s federal medical assistance percentage (FMAP). Congress is considering a proposal to reduce D.C.’s FMAP from 70% to 50%, a change that would result in a $2.1 billion funding loss and would be cataclysmic.
Georgia’s public comment period opened for the application to extend the state’s Pathways to Coverage demonstration, which provides Medicaid benefits to low-income adults ages 19 through 64 who aren’t otherwise eligible for Medicaid coverage. Georgia is proposing to reduce its work reporting requirement from monthly to annual and update copayments, among other changes.
The Wisconsin Department of Health Services published an analytic report modeling the impact of congressional budget cuts on Wisconsin Medicaid. The policies examined include work requirements, per capita caps on federal spending and a reduction to the administrative and technology federal match.
Manatt Health is hosting a webinar on May 12 that reimagines primary care, diving into AI and policy. Register here.
Why the Lehigh Valley is ground zero for a new effort to stop potential Medicaid, SNAP cuts – The Morning Call
G.O.P. targets a Medicaid loophole used by 49 states to grab federal money – The New York Times
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