Two states seek Medicaid waivers to impose welfare-like provisions – Healthcare Finance News

Wisconsin and Maine are seeking Medicaid waivers to impose work requirements and time limits in both states, according to Kaiser Family Foundation report.

Wisconsin also wants drug screenings for some beneficiaries.

Neither state adopted Medicaid expansion. If approved, this is the first time the waivers would be used in the traditional Medicaid program. Previous waiver requests by states were about provisions in the Affordable Care Act‘s Medicaid expansion.

[Also: Hospital wait times longer for Medicaid patients than privately insured, Health Affairs study finds]

President Trump opened the door to waiver requests that go to the U.S. Department of Health and Human Services.

Waivers could, for instance, restrict funds if a beneficiary fails to pay premiums.

Both states’  waiver proposals estimate less coverage and higher costs to beneficiaries, according to the Kaiser Family Foundation report.

Maine’s changes would affect traditional Medicaid adults, such as parents with incomes up to 105 percent of the federal poverty level. In 2017, this is $20,420 a year for a family of three. It also includes former foster care youth, those receiving transitional medical assistance, and people with breast cancer, cervical cancer or HIV up to 250 percent of the federal poverty level, or $30,050 a year.

[Also: Medicaid expansion a middle ground as experts debate repeal and replace options]

Maine anticipates that its proposed waiver would cover 56,000 fewer eligible member months, but with an increase in per member, per month costs from $790 to $815, comparing the cost by the fifth year of the waiver.

Wisconsin’s changes would affect childless adults who make up to 100 percent of the federal poverty level, or $12,060 a year for an individual in 2017, who are covered under an existing waiver.

Under its waiver proposal, Wisconsin projects that enrollment would decrease from 150,050 beneficiaries in 2016 to 146,407 in 2018, while costs would increase from $825 million to over $1 billion.

Twitter: @SusanJMorse


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