THE MEDICAID SCRAMBLE — States are racing to have their Medicaid requests approved before the Trump administration takes power.
The new administration is expected to have a very different view of Medicaid than the Biden administration, and GOP lawmakers in Congress are eyeing major changes. Some states want waivers that will impact their states’ budgets, but others seek to allow Medicaid to pay for social services, a Biden administration innovation that links health to social well-being, POLITICO’s Rachel Bluth, Maya Kaufman, Kelly Hooper and Robert King report.
For example, Hawaii and California want waivers to use federal money to help low-income people with rent, and Pennsylvania and Rhode Island want to use their Medicaid dollars to help with access to nutritious foods.
Democratic-controlled states expect that whoever President-elect Donald Trump chooses to lead CMS will support less government spending.
“There’s always the nagging concern,” said Judy Mohr Peterson, Hawaii’s Medicaid director, who was in Washington last week for a fall conference of Medicaid agency staffers. “Our governor is very anxious also to get this through.”
CMS doesn’t discuss pending waiver requests.
Among the states with pending requests:
California: The state has five requests pending, including one meant to improve its mental health infrastructure outside of institutionalized settings that Gov. Gavin Newsom pushed for while in Washington last week. Another would explicitly protect the state’s reproductive health infrastructure from funding cuts by a hostile federal administration.
New York: Gov. Kathy Hochul is working with CMS to approve a managed-care organization tax — a levy on some health plans used to draw down more federal dollars. The state’s goal is to secure billions of dollars in additional federal revenue for higher Medicaid reimbursement rates for hospitals and other health care providers. The concept is widely viewed as a temporary gimmick, given its reliance on an obscure loophole that CMS said it plans to close.
Hawaii: The state wants a five-year extension for one of its Medicaid waivers, including new expansions of prerelease coverage for incarcerated people, nutrition support and “continuous coverage” for young children so they don’t fall off Medicaid rolls for bureaucratic reasons.