Friday Five - May 19, 2017

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May 19, 2017
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It’s Friday and this week in our Friday Five series, MAXIMUS is sharing how the AHCA would impact states’ Medicaid financing; early roadblocks in the Senate’s GOP health care working group; and, Maine’s move to increase Medicaid beneficiary responsibility with a Section 1115 waiver.

1. Can States Survive the Per Capita Medicaid Caps in the AHCA?

The American Health Care Act (AHCA), passed earlier this month by the House, would significantly change Medicaid financing, cutting federal support for state programs. Some states could be advantaged, though certainly almost all will suffer financially. According to the Health Affairs Blog, how individual states will be affected will depend on many factors, from actual cost growth for specific eligibility categories to opportunities for new Medicaid reforms or cost cuts in the future.

2. GOP Health Care Working Group Runs Into Early Obstacles

Republican senators have been grappling this week with how to find consensus between their moderate and conservative factions on health care while still managing to get the 50 votes they need to reform the Affordable Care Act (ACA). The 13-senator working group is just the beginning of the process. CNN explains the current status of the bill and how Republicans will need widespread buy-in to move forward.

3. CMS Gives States Until 2022 to Meet Medicaid Standards of Care

The Trump administration granted states three additional years to execute plans for helping elderly and disabled people receive Medicaid services without being forced to go into nursing homes. Now, federal standards requiring states to find ways to deliver care to Medicaid enrollees in home- and community-based settings will take effect in 2022 instead of 2019, and will also require states to provide opportunities for enrollees to engage in community life and control their own finances. Kaiser Health News explores what the extension means for consumers and how state Medicaid programs will have to adapt.

4. Maine Medicaid Waiver Would Increase Patient Responsibility

In an effort to reform its Medicaid program, Maine will apply for a Section 1115 waiver from the Centers for Medicare and Medicaid Services (CMS) to increase beneficiary responsibility and implement a work requirement, among other changes. “These initiatives are designed to preserve limited financial resources for Maine's neediest individuals,” said the state’s Department of Health and Human Services. HealthPayer Intelligence details what’s in the waiver and how it would affect Maine’s Medicaid population.

5. CMS Checklist for State 1332 Waivers Focuses on High-Risk Pools, Reinsurance

CMS and the Treasury Department released last week a checklist for states’ Section 1332 innovation waiver applications, which they hope would “lower premiums for consumers, improve market stability and increase customer choice.” The checklist also requires that states specify the ACA provisions they wish to waive and provide supporting economic analyses demonstrating the potential effect on coverage and affordability. Health Affairs Blog takes an in-depth look at the checklist.

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