Overnight Health Care: Officials move to allow Medicaid work requirements | GOP chairman eyes action on children's health funding next week | Sanders to host 'Medicare for all' town hall

Overnight Health Care: Officials move to allow Medicaid work requirements | GOP chairman eyes action on children's health funding next week | Sanders to host 'Medicare for all' town hall
© Victoria Sarno Jordan

Trump officials move to allow Medicaid work requirements

The Trump administration on Thursday unveiled guidance allowing states for the first time to impose work requirements in Medicaid, a major shift in the health insurance program for the poor.

The move opens the door for states to apply for waivers to allow them to require Medicaid enrollees to work in order to receive coverage, something that has never before happened in the 50-year history of the program.

Seema Verma, the administrator of the Centers for Medicare and Medicaid Services (CMS), says the move will help people get out of poverty.


"Our policy guidance was in response to states that asked us for the flexibility they need to improve their programs and to help people in achieving greater well-being and self-sufficiency," Verma said in a statement.

Democrats are sharply opposed to the changes, saying people will lose coverage if they can't meet the requirements or simply because new bureaucratic hurdles will discourage them from applying.

Democratic groups are expected to sue over the changes, arguing that the administration does not have the power to make them without action from Congress.

Read more here.


And groups responded quickly...

The National Health Law Program (NHeLP) is pressing the Centers for Medicare and Medicaid Services (CMS) to give the public more time to comment on state proposals to impose work requirements in the Medicaid program.

NHeLP sent a letter to the agency just hours after CMS unveiled guidance letting states apply for waivers requiring certain Medicaid enrollees work or participate in community engagement in order to get health coverage. The guidance marked a major policy shift in the joint federal-state health program for low-income and disabled Americans.

The state and federal comment periods have closed for at least seven states that have already asked CMS to allow them to institute work requirements, according to NHeLP. Though the public has already commented on those specific waivers, NHeLP argues that "as advocates, we had no opportunity to respond to the various, specific issues raised in CMS's letter."

Read more here.


GOP chairman eyes floor action for CHIP next week

House Energy and Commerce Committee Chairman Greg WaldenGregory (Greg) Paul WaldenVulnerable Republicans throw ‘Hail Mary’ on pre-existing conditions GOP senator wants Apple, Amazon to give briefing on reported Super Micro hack Overnight Health Care: Bill banning 'gag clauses' on drugs heads to Trump's desk | Romney opposes Utah Medicaid expansion | GOP candidate under fire over ad on pre-existing conditions MORE (R-Ore.) said on Thursday that he is aiming to bring a six-year reauthorization of the Children's Health Insurance Program (CHIP) to the floor next week.

Speaking to reporters, Walden pointed to new Congressional Budget Office estimates as the catalyst that broke the logjam over funding for the program, which covers 9 million children.

"If we go to six years, it may have no cost," Walden told reporters. "The good news is you can do six years and it costs you nothing."

Funding for CHIP has been stalled for months amid partisan fighting over how to pay for the program.

Its reauthorization could be attached to a short-term government funding bill that must pass before Jan. 19. Broader leadership negotiations, however, will determine whether the reauthorization is ultimately tied to the bill.

Read more here.


Sanders to host 'Medicare for all' town hall

Sen. Bernie SandersBernard (Bernie) SandersFive takeaways from Cruz, O'Rourke's debate showdown Live coverage: Cruz faces O'Rourke in Texas debate showdown Saudi mystery drives wedge between Trump, GOP MORE (I-Vt.) will host a town hall on his "Medicare for all" proposal, a 90-minute event that will be streamed online Jan. 23.

The event comes as some high-profile Democrats -- including potential 2020 candidates and thus potential rivals if Sanders decides to run again -- have gotten on board with Sanders's plan: expanding Medicare into a national health insurance program so every American would have health coverage.

Sanders will aim to answer a pressing question -- how exactly a "Medicare for all" system would work -- and will be joined by "leading health care experts," according to a news release. The Washington Post reports that the town hall will break out into three segments: the current state of health care in the country, the possible economic impacts of single-payer and the way universal health care works in other countries.

Read more here.


Lawsuit filed against ObamaCare insurer over coverage

The insurance carrier Centene misled enrollees about the benefits of its ObamaCare exchange plans and offered far skimpier coverage than promised, according to a class-action lawsuit filed Thursday.

The lawsuit, filed in federal court in Washington state, claims that customers who bought Centene's ObamaCare plans had trouble finding in-network doctors or hospitals, and often found that doctors who were advertised as in-network actually were not.

According to the lawsuit, Centene targets low-income customers who qualify for substantial government subsidies "while simultaneously providing coverage well below what is required by law and by its policies."

Read more here.


Officials defend canceling 'flawed' mental health, drug abuse database

The Trump administration ended a national database for evidence-based behavioral interventions and programs because it was "flawed" and potentially dangerous, officials said Thursday.

The administration announced earlier this month it would discontinue the database, which was created in 1997 to help people, agencies and organizations identify and implement evidence-based programs and practices in their communities.

But officials told reporters on a press call Thursday that the database, called the National Registry of Evidence-Based Programs and Practices (NREPP), virtually ignored serious mental illnesses and drug abuse disorders, and that its standards for being included in the registry were poor.

Read more here.


Trump admin moves to block abortion for fourth undocumented minor

The Trump administration has moved to block a fourth undocumented minor from receiving an abortion, according to the American Civil Liberties Union (ACLU).

The woman, known to the court as Jane Moe, has requested an abortion but has been prevented from getting one by the Office of Refugee Resettlement (ORR), an office within the Department of Health and Human Services.

A spokesperson said HHS does not believe it is required to facilitate the abortion.

Read more here.


Doctors group gets a new name as it pushes to change the health system

The doctors group formerly known as CAPG is renaming itself America's Physician Groups and stepping up its efforts to reform the health care system to make spending more efficient.

The group is pushing to move Medicare payments away from paying for the quantity of services provided, and towards a more efficient system of paying to reward healthy outcomes in patients.

"We like to think of ourselves as the tip of the spear in terms of the movement from volume to value," CEO Don Crane told The Hill.

He praised efforts by the Obama administration to change how Medicare pays for care, as well as comments by HHS nominee Alex Azar endorsing the same idea at his confirmation hearings.

He acknowledged that "change is hard" for some doctors, particularly older ones, but said once they come to understand the new system, they often like it better. For example, in the new system doctors can be paid for patients not showing up because they are healthy enough they don't need to make an appointment in the first place.


What we're reading

Estimated number of health plans on federal exchange plummets by two-thirds (Modern Healthcare)

What if CHIP funds run out? Here's what 6 families would do (The New York Times)

He was 21 and fit. He tried to push through the flu -- and it killed him. (The Washington Post)


State by state

Despite progress, ethnic health disparities persist in Minnesota (Star Tribune)

Video shows apparently incapacitated, half-naked woman put out in cold by Baltimore hospital (The Washington Post)

Sheriff criticizes mental health system as inmate found dead (Associated Press)