Even if Medicaid expansion survives, states will likely seek waivers on enrollment

At the core of both the House and Senate Republicans’ proposals to replace the Affordable Care Act (ACA) is rolling back the law’s expansion of Medicaid. Whether or not the expanded eligibility stays in place, enrollment rules are likely to be changed by states, with encouragement from HHS and CMS.

NPR and ProPublica report these changes will involve beneficiaries having to verify their eligibility more frequently. Other proposed changes have included work requirements for “able-bodied” adults on Medicaid, drug testing and setting on caps on the number of enrollees and how long they can be covered by the program.

“All of the bells and whistles and hoops that people have to jump through create an enormous amount of red tape and that depresses enrollment,” said Joan Alker, executive director of the Center for Children and Families, a research center at Georgetown University. “That’s a proven strategy.”

Supporters of the changes say it would help clear programs of ineligible enrollees, like enrollees who had died years earlier or moved out of state but were still included on rolls. The checks don’t have to be intrusive, said Josh Archambault, senior fellow at the conservative-leaning Foundation for Government Accountability.

“If somebody gets a job, that’s great. They may no longer be able to qualify for the program,” he said. “If they still qualify, they can sign right back up.”

Read the full article at the link below:

""
John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

Around the web

CMS finalized a significant policy change when it increased the Medicare payments hospitals receive for performing CCTA exams. What, exactly, does the update mean for cardiologists, billing specialists and other hospital employees?

Stryker, a global medtech company based out of Michigan, has kicked off 2025 with a bit of excitement. The company says Inari’s peripheral vascular portfolio is highly complementary to its own neurovascular portfolio.

RBMA President Peter Moffatt discusses declining reimbursement rates, recruiting challenges and the role of artificial intelligence in transforming the industry.