Are Section 1115 Waivers A Panacea For Draconian Medicaid Funding Reductions?

From a structural perspective, what makes the pending Medicaid legislation so extraordinary is that, without changing any of the program’s fundamental contours, both the House and Senate bills would simply superimpose arbitrary spending caps onto the statute’s federal funding contribution formula. In the near term, the loss of enhanced federal funding for the optional ACA adult expansion group would cause the most financial damage. But over the long term the true injury to Medicaid would come from holding back federal funding otherwise due under the financing agreement that has been the program’s statutory hallmark for more than a half century. A Hobson’s Choice Under the legislation as written, even as federal funding declines, Medicaid would retain its basic structure: certain eligibility groups would be mandatory, while others would be optional; any individual wishing to apply for medical assistance would have the right to do so, and, if found eligible, would have a right to medical assistance with reasonable promptness; and coverage of certain services with limited cost sharing would remain a requirement. As the Medicaid and CHIP Payment and Access Commission (MACPAC) recently has documented, slightly less than half of total Medicaid spending goes to mandatory services furnished to mandatory populations — poor children; poor pregnant women; impoverished Medicare beneficiaries; children and adults with disabilities who receive Supplemental Security Income; an...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Medicaid and CHIP Section 1115 Waivers Source Type: blogs