Medicaid remains a hotly contested battleground topic in the US government, both federally and in individual states. As a government-sponsored healthcare program, Medicaid now services almost ten percent of American citizens, two in five of whom are children. But it undergoes changes often, especially when administrations change and new lawmakers get elected. Beyond that, states individually choose which parts of Medicaid to adopt and how to adopt them. Legislative movements to determine Medicaid functionality take time, however. It can be hard to keep track of all of the policy changes that affect this program. So let’s get into some of what’s been going on recently in the ever-evolving world of Medicaid.
What is Medicaid?
First, what is Medicaid? Medicaid is a joint federal-state healthcare program for uninsured or underinsured Americans to help them pay their medical bills. The federal government determines the standards that are to be followed in the program, and the states interpret them and decide how to manage them within their individual territories and based on the overall needs of the internal population. To help manage Medicaid policies, states apply for Section 1115 waivers so that they can be allowed to be flexible in their specific healthcare programming.
Some of the most significant changes in Medicaid in recent years have been due to the policies of the Affordable Care Act (ACA), the healthcare program that the Obama Administration pioneered. For instance, under the ACA, states have been allowed to expand healthcare coverage to those making up to 133% of the federal poverty level. The ACA continues to be a powerful contributor to the policy changes that we are seeing develop now.
What’s New With Medicaid
Around this time last year, 33 states (including DC) had expanded their coverage, whereas 18 had not. That number has since changed to 37 states that have expanded their coverage and 14 that have not. Also, the ACA has expanded coverage to those who make up to 138% of the federal poverty level (as opposed to the previous 133%). And since the Trump Administration called for states to experiment with Medicaid in 2017, Section 1115 waivers have swamped the Capitol, many of which involve flexibility with regulations that require proof of work or other activity for those covered by Medicaid.
Furthermore, federal lawmakers are moving new legislation through to assist with and compensate for the opioid epidemic occurring nationwide. Medicaid covers 4 in 10 people suffering from and undergoing treatment for opioid addiction. States are currently working to integrate into their individual programs coverage for inpatient and outpatient recovery procedures and for the medicine prescribed for medication-assisted treatment (MAT). Last October President Trump signed the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, which addresses the growing concern about nationwide addiction and the need to support options for treatment. It will be helpful to watch the more detailed legislation of the SUPPORT Act as states continue to discuss it.
The Trump Administration also announced in October 2018 a proposed change to Medicaid’s “public charge” policies, which could limit the number of immigrants who have access to healthcare coverage through Medicaid.
Conclusion: 2019 Medicaid Changes
Medicaid and the ACA will continue to evolve as new standards and models are introduced and as states continue to decide whether or not to expand their healthcare coverage options. Will more states expand their Medicaid policies? Will the Trump Administration make more suggestions or roll back benefits? It’s easy to get lost in the midst of all of the changes. But we’re here to help. Does your hospital need to reduce its bad debt from uncompensated care costs? Do you need help determining your patients’ eligibility for government assistance? Contact us today for more information. We’d love to help you.