After allowing states to impose work requirements for Medicaid enrollees, the Trump administration is now pondering lifetime limits on adults’ access to coverage.
Capping health care benefits — like federal welfare benefits — would be a first for Medicaid, the joint state-and-federal health plan for low-income and disabled Americans.
If approved, the dramatic policy change would recast government-subsidized health coverage as temporary assistance by placing a limit on the number of months adults have access to Medicaid benefits.
The move would continue the Trump administration’s push to inject conservative policies into the Medicaid program through the use of federal waivers, which allow states more flexibility to create policies designed to promote personal and financial responsibility among enrollees.
However, advocates say capping Medicaid benefits would amount to a massive breach of the nation’s social safety net designed to protect children, the elderly and the impoverished.
At least five states — Arizona, Kansas, Utah, Maine and Wisconsin — are seeking waivers from the Trump administration to impose lifetime Medicaid coverage limits.
Critics say Medicaid time limits will pose an enormous administrative burden by requiring states to track recipients’ employment, eligibility and disability status. It could also shave valuable coverage months from people with health problems that impede their ability to work.
In addition, low-wage workers who may not get health coverage through their jobs could also reach their Medicaid coverage limit “as if it’s their fault that their job isn’t offering insurance,” said Leonardo Cuello, director of health policy at the National Health Law Center. “And this would happen to thousands upon thousands of people across the country,” if the policy catches on nationwide.
Others argue that attaching time limits and work requirements to Medicaid coverage does not meet a basic requirement of HHS waiver experiments and demonstration projects: to further the objectives of the Medicaid program, such as improving coverage, health outcomes and access to providers.
“All of these policies that we are seeing are inconsistent with the objectives of Medicaid. They don’t seem to seem to have a legal basis and, as such, our stance is that they should not be approved. And we will work very hard with our partners to make that opinion well known,” said Suzanne Wikle, a senior policy analyst at the Center for Law and Social Policy.
But unlike capping cash welfare assistance or food stamp benefits, time-limiting health coverage runs the risk of pushing sick people into costly emergency rooms where they’ll receive indigent care paid for by taxpayers.
essica Schubel, a senior policy analyst at the Center on Budget and Policy Priorities, said there’s a “50-50 chance” that the Trump administration approves the time limits.
“I feel like the Trump administration is hell-bent on trying to keep people out of coverage … So, I don’t know. I hope not, but I’m not holding my breath. And I guess I wouldn’t be too terribly surprised to see it approved,” said Schubel, a former senior policy advisor at HHS’ Center for Medicare and Medicaid Services during the Obama administration.
(Excerpted from Lexington Hearld Leader 2/5/18)