Clay’s Weekly Medicaid RoundUp: Week of March 26th 2018

Soundtrack for today’s RoundUp pessimist readers-

For optimist readers-

OPPOSING MEDICAID EXPANSION BECOMING GOOD IDEA IN OH GUVNR RACE- Now that the Good Guvnr Kasich has had his 15 minutes of fame, competition is piling on in the local race for the top seat in the Buckeye State. Two contenders – LT Guv Mary Taylor and AG Mike DeWine are now arguing over who was against Medicaid expansion first. The old I-was-for-it-before-I-was-against-it-because-it-used-to-be-popular line.

HURRY AND WAIT IN THE BEEHIVE STATE- The Good Guvn’r Herbert signed a Medicaid expansion bill in Utah this week. Now its time to see if CMS approves it. Predictions, anyone?

STATES CONTINUE TO FIND SUPPORT FOR REQUESTED FLEXIBILITY WAIVERS- I can’t even keep count of how many flexibility waivers have been filed now. While our wonderfully not-no-way-no-how-biased 3rd estate use a broad-brush to paint all the waivers as evil “work requirements” schemes (imagine the Darth Vader march song right now), these requests include all types of things related to volunteer hours, reducing NET, changing how rx is paid for, et cet era (see the recording of our AZ state spotlight a few months back for a great example). Newer entrants this week include the Centennial State, where Colorado lawmakers are trying (currently stumbling) to get a bill through committee to modify its program. Minnesota lawmakers debated a possible flexibility waiver this week, too.

DEMS CARE ABOUT THE COSTS OF IMPLEMENTING A MEDICAID PROGRAM. HELL FREEZES OVER- In an unprecedented move, lefties now want to consider how much it will cost to implement new Medicaid program requirements. While this has never been an issue before, it seems the new flexibility waivers have clued them in to caring about implementation costs. Go figure.

OPIOIDS NEWS: IT JUST KEEPS GETTING WORSE- New research out in Pediatrics this month shows that Medicaid spent $2B on neonatal abstinence syndrome from 2004 to 2014. That’s babies born with opioid withdrawal, people. Not that I have any idea how much of the $2B is effective, waste, etc – all I know is it signifies how big and awful and evil this opioid thing is. Even before birth.

GOLD RUSH IN THE GOLDEN STATE: $740M IN MEDICAID SPENDING FOR INELIGIBLES (BUT DON’T WORRY THAT WAS 90% FEDERAL MONEY, SO NO HARM NO FOUL, RIGHT? CLASS- WHERE DOES FEDERAL MONEY COME FROM?)- CA enrolled 450k people that may have not been eligible, spending $738M on those who were definitely not eligible (and another $416M on those who were potentially not eligible). Check out the HHS OIG report here – 

CONGRATS ERHARDT!- Erhardt Preitauer (currently of BCBS NJ) will be taking the helm at CareSource as CEO on May 1. Congratulations, Erhardt!

WEBINARS! WEBINARS! WEBINARS! We have had so many lately its hard to keep up. In addition to our regularly scheduled programming of News Roundtables, we also recently had Governor Matt Bevin of Kentucky. We have about a million shows coming up in the next few months, too. With everything from innovations in community engagement to ACOs in Massachusetts. Check the newsletter for schedules and times. And get there early if possible. We are in the process of upping our seat count, but until then only the first 100 people get in.


ON THIS DAY IN HISTORY- A little more than 2,000 years ago a first century Jew (who also happened to be God) was brutally tortured and murdered. He did this willingly so you can be with him (if you choose to). This is why today is GOOD Friday.

FARRIS’S FANTASTIC FRAUD FOLLIES– And now for everybody’s favorite paragraph. No time this week, folks – but I am cooking up a quarterly fraud show. Would you attend? Let me know in the comments or via email..

That’s it for this week. As always, please send me a note with your thoughts to or give me a buzz at 919.727.9231. Get outside (plant a fruit tree) and keep running the race (you know who you are).


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