WASHINGTON (AP) — President Donald Trump's pick to run the government's major health insurance programs said Thursday that Medicaid needs a full overhaul but she doesn't support turning Medicare into a "voucher" plan.
Medicaid already spends about 25 percent less than private insurance on a per-person basis, and generally reimburses providers much less than Medicare and private insurers do. So while proponents of block grants argue that the shift will give states greater flexibility to spend Medicaid dollars wisely, critics of the approach say that the only realistic way for states to cope with less federal money would be to cut coverage and benefits for low-income people.
This brief explains key components of Michigan and Indiana's Medicaid expansions under Section 1115 demonstration waivers and presents insights from stakeholder interviews and focus groups about early implementation experience.
This new fact sheet examines key questions around the potential changes President-elect Donald Trump and the next Congress may seek to make in Medicaid, a program that covers 73 million people nationally.
In states that do not implement the Medicaid expansion under the Affordable Care Act (ACA), many adults will fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits. Nationwide, 2.6 million poor uninsured adults are in this situation. This brief presents estimates of the number of people in non-expansion states who could have been reached by Medicaid but instead fall into the coverage gap, describes who they are, and discusses the implications of them being left out of ACA coverage expansions.
This fact sheet discusses CMS's denial of Ohio's proposed changes to its existing Medicaid expansion . It also provides an overview of the proposed changes as included in the state's Section 1115 demonstration waiver application.
AUSTIN – The privatization of a state program that transports poor Texans to medical appointments has cost the state hundreds of millions of dollars more while serving fewer than half as many people, according to a Legislative Budget Board report that some officials tried to withhold from the public. In the five years since Texas began privatizing the management of the Medical Transportation Program, the number of Medicaid recipients using the program has dropped from 350,000 to 150,000, the number of substantiated complaints has doubled, administrative costs have quadruped and the overall per-ride cost to the public has nearly tripled, the report authors found. Despite the problems, and in spite of a promise to put the program out for bid again, the Texas Health and Human Services Commission recently renewed all of the contracts until 2018, the budget board report noted. The Health and Human Services Commission solicited applications from companies to manage different regions of the state, but it picked several firms that its own evaluators had determined were not the best options, according to the report's authors. "Cost and quality issues have been due in part to procurement and contract management failures," the budget board wrote in the report, which urged the state to re-do the procurement and enact safeguards to save money. "The lieutenant governor directed the LBB to focus on their principle mission, which is developing the budget, and to leave policy-making to elected officials," said the spokesman, Alejandro Garcia, who declined to answer questions on the Medical Transportation Program. In the past, when the state used a fee-for-service model that paid transportation entities directly for each person transported, there were concerns the program did not serve enough Medicaid recipients and that there was fraud. According to the budget board, the commission also promised last April to re-procureall of the Medical Transportation Program contracts using a more competitive system as soon as possible.
This fact sheet provides insight into how a repeal of the Affordable Care Act (ACA) and changes in the financing structure would affect Medicaid, including the Medicaid expansion, and how a Trump administration could change Medicaid through administrative actions.
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