CSG Midwest
Some Medicaid recipients in Wisconsin will have to submit to drug screenings and tests if federal officials give the OK to a demonstration waiver submitted by the state in April. This new requirement would apply to childless adults who are eligible for health insurance through the BadgerCare Plus program. As a condition of eligibility, individuals would have to complete a state-administered questionnaire. If the answers indicate possible abuse of a controlled substance, a drug test would be required. For anyone who tests positive, Medicaid eligibility would be contingent on completing a substance-abuse treatment program.

The American Health Care Act, or AHCA, the proposed legislation to repeal and replace the Affordable Care Act was passed by the U.S. House of Representatives on May 4. The bill contained several major changes to the Medicaid program that, if enacted, would directly impact states’ budgets. CSG estimates the annual state loss of federal Medicaid Funds from the high of $7,210.1 million in California to $16.8 million in Delaware. The median loss is $474.1 million for Connecticut, with half of the expansion states losing less federal funds annually and half of the expansion states losing more federal funds annually.

As plans to repeal and replace the Affordable Care Act, or ACA, are under construction, states face the possibility of losing significant federal funding for their Medicaid programs.

The implementation of the Medicaid expansion through the ACA, established access to healthcare for low-income adults who were not previously eligible. Specifically, nonelderly adults with an income at or below 138 percent of the federal poverty level— about $16,394 for an individual in 2016—gained access to coverage. As a result,...

The Kansas Legislature’s attempt to join the ranks of the 31 states and the District of Columbia that have already expanded their Medicaid programs came to a halt during the first week of April. The Kansas House voted narrowly to uphold Gov. Sam Brownback’s veto of a bill to expand Medicaid. The vote fell three votes short of the necessary super majority required to override the veto.

The Urban Institute released an analysis of the state-by-state impact of the AHCA, 2019 to 2028. The Urban Institute looked at the impact of the proposal on state funding (see Table 5). If states made up for the loss of federal funds with state funds, it would require a 16.1 percent increase in all states' Medicaid spending over the ten year period. 

Yesterday the Congressional Budget Office – or CBO – released its cost estimate for the House Republican plan to repeal and replace the Affordable Care Act. All told, the report says, the federal deficit would be reduced by $337 billion over the 2017-2026 decade. Reducing the federal deficit is welcome news to most federal policymakers.

On Monday, March 6, the House Republicans released the American Health Care Act, the measure intended to fulfill their campaign pledges to repeal and replace the Obama administration Affordable Care Act. Here is the summary provided by the House Republicans. 

Of primary interest to state policymakers, the House plan implements a per capita cap in Medicaid funding, beginning in 2020, based on FFY 2016 spending levels. The House Republican plan has not been scored by the Congressional Budget Office so there are no publicly available data on how much this change will cost states and save the federal government.

Kaiser Health News has created a special website to keep track of news about changes to the Affordable Care Act. KHN says it will provide analysis, explanation, investigation and data on its site called Repeal & Replace Watch. You can bookmark this on your browser.

A new study out of Michigan concludes that the state’s Medicaid expansion is to the state’s financial advantage.

When the legislature approved the expansion in 2013, it required that Michigan achieve other health care savings and revenue to offset the state match required starting Jan. 1, 2017 – or the state would reverse its expansion.

The Medicaid Policy Academy provided attendees an opportunity to meet with federal government officials and other Medicaid experts to develop a deeper understanding of program rules and requirements. With the upcoming change of administration in Washington, D.C., speakers and attendees discussed how policy changes might impact states' Medicaid programs. 

Presentation slides and audios from the session are posted, as well as speaker biographies. 

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