Budget Pressures, Health Law Expansions Trigger Medicaid Skirmishes

Policy proposals — such as turning the program into state block grants unencumbered by federal requirements, as well as the continuing push by some governors to relax maintenance of eligibility standards — are at the crux of these flare-ups.

The Fiscal Times: Obama Rejects Governors' Plan To Overhaul Medicaid
Turning federal Medicaid support into a block grant without national standards would run counter to the intent of Obama's Affordable Care Act, which relies on an expanded Medicaid program to cover about half the uninsured who obtain coverage under the health care reform law. The ACA also sets a fairly high standard for minimum coverage under the law. The federal government will pay for about 90 percent of the additional costs that come from adding about 16 million uninsured Americans to the Medicaid rolls after health care reform goes into effect in 2015. Cash-strapped states have seen their Medicaid rolls swell by six million people since the recession began in late 2007 (Goozner, 3/1).

CQ HealthBeat: Fight Over Medicaid Intensifies
As Republican governors continue to push President Obama and Congress to let them cut Medicaid, left-leaning groups and some medical providers Monday urged the administration not to give in to such calls, saying they could undermine the White House's goal of providing health coverage to more Americans. The fight over Medicaid is reaching a critical moment. On Tuesday, the House Energy and Commerce Committee will hear from three governors, including two Republicans who say that the federal government should give states more flexibility to drop people from the Medicaid rolls. The hearing comes after weeks of criticism from state officials challenging the administration to loosen requirements for Medicaid, the joint federal-state program for those with low incomes (Adams, 2/28).

Modern Healthcare: Some Expect Renewal Of '90s Medicaid Battle
A return of the 1990s battle to transform Medicaid from a federal-matching program into a block-grant approach is expected by liberal health care policy advocates. And the stakes have risen since then, they argue, because a block grant conversion now would undermine the Patient Protection and Affordable Care Act. "Converting Medicaid to a block grant is fundamentally inconsistent with the Affordable Care Act," Robert Greenstein, president of the Center on Budget and Policy Priorities, said during a Monday call with reporters. The Republican majority in the House of Representatives has yet to propose such a transformation of the federal-state low-income insurance program, which was an initiative over which the 1995 Republican-led Congress unsuccessfully fought President Bill Clinton (Daly, 2/28).

The Hill: Barbour: High-Risk Pools Make Case For Medicaid Flexibility
Mississippi Gov. Haley Barbour (R), a possible 2012 presidential candidate, said anemic enrollment in new federal high-risk insurance pools is proof that states need more flexibility to run their Medicaid programs. Enrollment in new federal insurance pools for individuals with preexisting conditions have fallen far short of original projections. Just more than 12,000 have enrolled as of February, far less than the 375,000 the Centers for Medicare and Medicaid Services actuary projected for the end of 2010. The pools were included in the health care reform law to provide temporary coverage until 2014, when insurance companies can no longer discriminate against individuals with preexisting conditions (Millman, 2/28).

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