The care and keeping of you
With H.R.1 enacted, states need to move quickly to capture funding and mitigate enrollee churn. We’re here for you.
It’s a stressful time to run a Medicaid agency. There are preprints to submit, budgets holes to fill and applications to file. And yet, it’s hard to parse the provisions in H.R.1, from grandfathered state-directed payments to how immigrants will receive care now that the administration is limiting their access to health and social service programs. Understanding this, Manatt Health has been developing resources like The 80 Million to make these transitions smoother. What else are you struggling with? Reach out to us at 80million@manatt.com.
Medicaid Impacts of H.R.1 – You Asked, We Answered
The Congressional Budget Office estimates that H.R.1, which President Trump enacted on July 4, will reduce federal Medicaid funding over the next decade by more than a trillion dollars. Some of the largest changes in direct federal funding include:
-$325.6 billion in federal funding reductions for coverage terminations due to work requirements
-$225.7 billion in federal funding reductions related to provider taxes and waiver of uniform tax requirement provisions
-$149.4 billion in federal funding reductions attached to state-directed payment changes that will reduce payment to hospitals and other providers
-$121.9 billion in federal funding reductions for the delay of select Biden-era eligibility and enrollment final rule provisions
-$62.5 billion in federal funding reductions due to coverage terminations related to more frequent eligibility redeterminations
-$104.5 billion in federal cuts attached to all other Medicaid provisions
An increase in federal funding of $50 billion for a new rural health transformation fund
80 Million readers wanted to know how we think states will approach the new work requirement mandate. Will most states seek approval to delay implementation? Or, conversely, to accelerate implementation?
Keep reading at The 80 Million.
ICYMI: Trump Administration Restricts Noncitizens’ Access to Federal Benefits, Including Major Health Programs
On July 10, the Trump administration announced it is expanding restrictions on immigrants’ access to federal programs under the Departments of Health and Human Services (HHS), Agriculture, and Education.
These changes do not directly affect Medicaid, the Children’s Health Insurance Program (CHIP), Medicare or the Marketplaces. However, by restricting access to other health care and social services, these policies are likely to broadly impact the health care system and have downstream effects on these health programs.
For years, many federal programs (including Medicaid) have been subject to eligibility restrictions for immigrants under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA). HHS’ announcement expands these restrictions to more than a dozen additional health programs, effective July 14, including funding for community health centers, mental health and substance use disorder services, early childhood education and development, family planning, and other programs. (See the table below for a list of affected programs.)
There are limited exceptions to these restrictions that protect immigrant access to programs related to immunizations, testing, and treatment for communicable diseases; short-term disaster relief; and, under certain circumstances, services delivered by nonprofits. However, effective Aug. 15, the administration has repealed a longstanding exemption for services “necessary for life or safety”— including crisis services and mental health care — pursuant to a recent Department of Justice (DOJ) policy update.
Keep reading at The 80 Million.
Colorado’s insurance division announced that the statewide average for submitted premium increases is 28%, and insurance companies estimate that nearly 100,000 Coloradans will lose their health coverage.
Connecticut will boost Medicaid reimbursement rates for 17 community health centers, which serve 440,000 people across the state annually. The agreement will phase in rate increases over three years totaling approximately $80 million by June 30, 2028.
Utah submitted a request to amend its 1115 demonstration, which would implement a work requirement for eligible individuals ages 19-59 in the Medicaid expansion population.
Medicaid cuts could cause more challenges for expectant mothers – Axios
Why Josh Hawley Is Trying to Reverse Medicaid Cuts He Voted For – The Atlantic
Disabled Americans Fear What Medicaid Cuts Could Do to Them – Axios
Medicaid Cuts Will Be a Disaster for ERs – The Atlantic
Working on an interesting Medicaid project? Making moves at your agency? Shoot us an email at 80million@manatt.com to be featured or fill out this survey.