CSG Midwest
Starting in January, states that chose to expand their Medicaid programs under the Affordable Care Act will have to begin paying part of the associated costs, and three of the Midwest’s expansion states say they will rely at least in part on revenue from their taxes on health care providers.

Seema Verma, a health policy consultant from Indiana, has been picked by President-elect Donald J. Trump to direct the Centers for Medicare and Medicaid within the U.S. Department of Health and Human Services according to Politico.

Health policies and programs in the states face an uncertain future with the election of Donald J. Trump. During his campaign he vowed to repeal the Affordable Care Act.

Currently 73 million Americans are enrolled in the Medicaid program, a federal-state partnership program for which the federal government pays 62 percent of total expenditures. A Medicaid block grant, one proposal under discussion, might provide the states more flexibility but also might transfer more financial responsibility, especially in the long term, to the states. 

Today's Stateline article by Christine Vestal highlights three states--California, Maryland and New York--that are moving to use Medicaid reimbursement policies to facilitate more counseling for substance use addicts who are in medication-assisted treatment. 

An article in today's Kaiser Health News suggests that a President Trump could dismantle much of the Affordable Care Act without Congressional action. For instance, just a stroke of his presidential pen could eliminate subsidies to persons between 100 and 250 percent of the poverty level. On the other hand, Clinton's proposals to support and build on the ACA would seem to require Congressional action. 

Voters in Colorado will head to the polls this November not only to cast their ballots for the next president of the United States, but also to determine whether they will become the only state in the nation to adopt single-payer health care.

More than 20 legislators from 16 states--many of them in key leadership positions on health or budget committees that deal with Medicaid in their home states--attended a CSG policy academy in Washington D.C. on September 21-23, 2016, to learn how states are making reforms in their Medicaid program that pursue the health "triple aim": improving the quality of care for individuals, improving the health of populations, and reducing per capita costs of health care.

States are increasingly turning to community paramedicine to help fill the gap in the health care workforce. States have been experimenting with community paramedicine programs for the last five years or more. Expanding the role of licensed or certified emergency medical technicians—or EMTs—and paramedics to provide non-emergency preventive health care services directly to patients in their communities can be cost-effective and make up for health care work force shortages. 

Voters in Colorado will face a choice on the ballot this November regarding medical aid in dying for the terminally ill. The “Colorado End of Life Options Act,” or Initiative 145, is a proposal that would allow physicians to prescribe life-ending medications to adult Colorado residents who have a terminal illness with a prognosis of six months to live or less.

On August 16, the insurance giant Aetna announced that it will be withdrawing from insurance exchanges in 11 states beginning in 2017.  This move comes on the heels of the decision by Humana and United Healthcare to substantially reduce the number of states in which they offer coverage.

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