She works hard for the money
And so do millions of Americans who rely on Medicaid to make their health care affordable. Cuts to the public health insurance program threaten to destabilize the workforce.
We’ve surpassed President Trump’s first 100 days in office and continue to eye budget reconciliation. We’re particularly interested in how Republicans will fund the president’s tax cuts — defunding Medicaid in the process. 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.
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.
ICYMI: Running the Numbers: The 50-State Impacts of Potential Medicaid Cuts
Over the last few months, we have dedicated several 80 Million articles to the $880 billion in Medicaid cuts under consideration in Congress, explaining the threat they pose to the program and the latest twists and turns in the budget reconciliation process. Today, we are all about the numbers. Drawing on Manatt Health’s 50-State Medicaid Financing Model and a new toolkit that we recently prepared for states in partnership with the Robert Wood Johnson Foundation funded State Health Value Strategies program, we explore what several key proposals to cut Medicaid would mean nationally and for each of the 50 states and D.C.
Before we dive into the results, here is what you should know about Manatt’s 50-State Medicaid Financing Model. The model uses publicly available data sources supplemented by Manatt research and Congressional Budget Office (CBO) projections to establish a “baseline” of how we expect Medicaid expenditures and enrollment to change over time under current law (that is, if Congress made no changes to Medicaid). We develop this baseline for each of the 50 states and D.C., and for each of five key Medicaid eligibility groups: seniors, people with disabilities, children, expansion adults and other adults. (For a detailed explanation of methodology, see Section 3, page 2 of the toolkit). We then assess what happens to expenditures and enrollment if any one of several proposals under consideration in Congress is adopted. Since we do not know how states will respond to any given proposal, we model a number of different scenarios for state responses, allowing states and stakeholders to determine what they think is most likely.
For the purposes of running the numbers, we look at four of the major proposals that seem most likely to advance through budget reconciliation, at least based on the latest news articles plus a touch of tea leaf reading.
Keep reading at The 80 Million.
Thirty-five states have agreed to participate in the CMS Innovation Center’s Cell and Gene Therapy Access Model, HHS Secretary Robert F. Kennedy Jr. said April 25. Under the 11-year model, CMS has negotiated and will administer value-based contracts with manufacturers of the only two FDA-approved sickle cell disease (SCD) gene therapies. The companies will provide states with additional Medicaid rebates if the therapies don’t perform as expected. The participating states represent about 84% of Medicaid enrollees with SCD, per Kennedy.
Manatt is hosting a webinar on May 6 to discuss the impact of Medicaid cuts on children. Register here.
Colorado lawmakers brace for special session over potential Medicaid cuts – The Colorado Sun
Republican Medicaid cuts could mean ‘Armageddon’ in D.C., official says – The Washington Post
Don Bacon sets $500B red line on Medicaid – Politico
Working on an interesting Medicaid project? Making moves at your agency? Shoot us an email at 80million@manatt.com to be featured in The 80 Million.