Commentary: What to Watch for in Trump Administration Actions on Medicaid Waivers
End Notes
[1] Benjamin Sommers et al., “Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance,” JAMA Internal Medicine, October 2016.
[2] Letter from Secretary Price and CMS Administrator Verma to governors, March 14, 2017, https://www.hhs.gov/sites/default/files/sec-price-admin-verma-ltr.pdf.
[3] Casey Ross, “Trump health official Seema Verma has a plan to slash Medicaid rolls. Here’s how,” STAT News, October 26, 2017, https://www.statnews.com/2017/10/26/seema-verma-medicaid-plan/.
[4] For a full discussion of the requirements for approving an 1115 waiver, see Judith Solomon and Jessica Schubel, “Medicaid Waivers Should Further Program Objectives, Not Impose Barriers to Coverage and Care,” Center on Budget and Policy Priorities, August 29, 2017, https://www.cbpp.org/research/health/medicaid-waivers-should-further-program-objectives-not-impose-barriers-to-coverage.
[5] Maine, Wisconsin, and Utah have not expanded Medicaid. The changes these states would make would affect low-income parents and adults eligible under longstanding Medicaid waivers.
[6] Letter from HHS Secretary Sylvia Mathews Burwell to Arkansas Governor Asa Hutchinson, April 5, 2016, http://governor.arkansas.gov/images/uploads/Burwell_Letter_to_Governor.pdf; letter from CMS Director Vikki Wachino to New Hampshire Department of Health and Human Services Commissioner Jeffrey A. Meyers, November 1, 2016, https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/nh/health-protection-program/nh-health-protection-program-premium-assistance-cms-response-110116.pdf .
[7] Kentucky submitted its waiver proposal to the Obama Administration in September 2016. In February 2017 the state proposed modifications to its proposal, including a stricter work requirement and a lock-out penalty for failure to quickly report changes in employment or income.
[8] Section 1901 of the Social Security Act appropriates funds so states can “furnish (1) medical assistance on behalf of families with dependent children and of aged, blind, or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services, and (2) rehabilitation and other services to help such families and individuals attain or retain capability for independence or self-care.”
[9] Samantha Artiga, Petry Ubri, and Julia Zur, “The Effects of Premiums and Cost Sharing on Low-Income Populations: Updated Review of Research Findings,” Kaiser Family Foundation, June 21, 2017, http://www.kff.org/medicaid/issue-brief/the-effects-of-premiums-and-cost-sharing-on-low-income-populations-updated-review-of-research-findings/.
[10] “Arkansas Experience with Health Savings Accounts in a Medicaid Expansion Population,” Academy Health Annual Research Meeting, June 2017, https://academyhealth.confex.com/academyhealth/2017arm/meetingapp.cgi/Paper/18272.