Earlier this week, the head of the U.S. Centers for Medicare and Medicaid, Seema Verma, travelled to Arkansas and signed a waiver request to require Medicaid enrollees to work or prepare for a job. The work requirement will only impact the expansion population, specifically childless adults 19 to 49 years old. They will be required to work or participate in activities such as volunteering or vocational training for 20 hours per week. The requirement will be phased in between June and September 2018.

Both chambers in Wisconsin have passed a $200 million reinsurance plan that would provide funds to insurers for high-cost patients’ expenses to prevent ACA marketplace premium increases in 2019. The Governor has come out in support of the program and is expected to sign the bill, according to the Journal Sentinel.

CSG Midwest
The idea of requiring able-bodied adults to work or be actively seeking it as a condition for government assistance is certainly not new, but its application to Medicaid is as of January, when the Trump administration began approving some states’ applications to impose work rules as a condition of eligibility for this public health insurance program.

Open enrollment for health insurance policies sold under the Affordable Care Act marketplaces ran for 6 weeks the end of 2017. Enrollment was down from 2017 – by 3.7 percent – but nonetheless 11,760,533 Americans selected a health insurance plan for 2018.

Read about top health issues facing states in 2018. Medicaid expenditures are 30 percent of states general fund budgets and states are looking for ways to cut costs. The opioid epidemic shows no signs of letting up, increasing the need for treatment, harm reduction programs and prevention. Questions of how to provide health service to the growing aging population and rural populations are top-of-mind in many states. Finally, state policymakers are beginning to look at the social determinants of health, searching for strategies that are more preventive in nature.

CSG Midwest
A trip to the doctor, and treatment, without a co-pay?

According to The Hill, the Senate measure approved earlier today, Jan. 22, included six years funding for the Children's Health Insurance Program, also know as CHIP.

The Children’s Health Insurance Program – also known as CHIP – has figured prominently in the deliberations on keeping the federal government open. Reporting today by Governing magazine says that the details of the vote later today have not been made public, so the fate of the six-year funding appropriation for CHIP that was included in the House continuing resolution is unclear.

Yesterday, federal officials issued new guidance that will support “state efforts to improve Medicaid enrollee health outcomes by incentivizing community engagement among able-bodied, working-age Medicaid beneficiaries.” A number of Section 1115 waiver applications currently before the Department for Health and Human Services would impose work requirements in one way or another are expected to be approved under the new policy.

WHEREAS, it is in states’ best interests to stabilize health insurance markets, increase consumer choices, reduce health insurance premiums and stem health care cost growth; and

WHEREAS, regulation of health insurance markets has been a traditional area of state responsibility; and