Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.
By Sara Hansard
March 7 — The HHS won't try to push states to expand Medicaid under the ACA by using waivers as a lever, a top agency official said March 7.
“We're not going to use this as a lever. We've got no interest in making the residents of a state the pawns,” Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services, said in a webcast interview with the Association of Health Care Journalists.
As the presidential election looms in November, a question being raised is what the Department of Health and Human Services will do strengthen the Affordable Care Act. Slavitt was asked whether the CMS—part of the HHS—will use Section 1115 waivers as a way to push states to expand Medicaid under the ACA. The waivers, for which states may apply to use federal Medicaid funds in ways that are not otherwise allowed under federal rules, apply to the traditional Medicaid program in existence before the Affordable Care Act was enacted.
Under the ACA and a subsequent U.S. Supreme Court decision, states have the option of expanding Medicaid to cover people with incomes up to 138 percent of the federal poverty level.
“I really believe that Medicaid expansion is a state's decision,” Slavitt answered. “That's the way the Supreme Court decided.”
He said HHS is having “a lot of promising conversations with a lot of states” about expanding Medicaid under the ACA.
According to the Kaiser Family Foundation, 31 states and the District of Columbia had expanded Medicaid under the ACA.
Slavitt said proposals that require Medicaid beneficiaries to work wouldn't be acceptable. “A work requirement is not what the Medicaid program is about, and it's not part of what we would do,” he said.
However, he added, “We're flexible. If people want to use Medicaid to help get people into job training programs or other things that could help them with employment, we think those are ideas that could work.”
Arkansas Gov. Asa Hutchinson (R), whose state had expanded Medicaid under the ACA during a previous Democratic governor, has proposed changing the program to include a work requirement .
Slavitt also said that going into their third year in 2016, the “$40 billion” ACA marketplaces are “moving out of the start-up stage into a sort of more stable and more predictable stage.” The marketplaces have characteristics attractive to consumers, such as choice, affordability and a good consumer experience, he said.
Health insurers are experimenting with the marketplaces, which have seen a lot of pent-up, new demand from consumers, Slavitt said. “I really see this market turning into very much the way we operate the Medicare Part D market and the Medicare Advantage market,” he said. Part D is the outpatient drug benefit, and MA is Medicare's managed care benefit.
However, Slavitt said rural areas continue to lack competition and plans covering those areas are less affordable than those for more populated areas. The smaller markets need access to “the things that are going to make them healthier over the longer term,” he said.
To contact the reporter on this story: Sara Hansard in Washington at email@example.com
To contact the editor responsible for this story: Brian Broderick at firstname.lastname@example.org
More information from the Kaiser Family Foundation on Medicaid expansion is at http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/.
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to email@example.com.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to firstname.lastname@example.org.
Put me on standing order
Notify me when new releases are available (no standing order will be created)