Weekly Medicaid RoundUp: Week of April 17th, 2017

Soundtrack for today’s RoundUp pessimist readers- http://bit.ly/2owUh57

For optimist readers – http://bit.ly/2ox20jq



MY KIND OF TOWN- Had a GREAT time at the HEA-RISE MMC Leadership conference this week in Chicago. Looking forward to next year. And to Balto next month with the MMC Congress. Will I see you there?



THE (EGADS!) CONSERVATIVE FEATURES IN EMERGING MEDICAID TRENDS (DOES ANYONE HAVE ANY HOLY WATER?) I have been around this Medicaid game long enough to know the war over Medicaid spending is a war of attrition and anything that even smells slightly conservative loses in the end because of lack of sustained interest on the conservatives’ part and vehement “resistance” on the liberals’ part. That being said, there are many signs if you care to read the bones: Every week a new state announces waiver plans with job requirements. Wisconsin was the latest- and it added drug testing and premiums. Maine announced similar plans (they linked food stamps to work already). Arizona is considering a 5-year lifetime enrollment max for the “able-bodied” (super slippery word all around) as well as work requirements.



OREGON MAY BE THROWING IN THE TOWEL ON EXPANSION- Dems – I repeat Dems – in OR are proposing Medicaid be un-expanded. Why? you ask? Because the state is short $1.6B.


BUT ON THE OTHER HAND, NC MAY BE GETTING CLOSER TO EXPANDING- Republicans – I repeat Republicans – introed HB 662 this week to start the process of funding expansion using federal dollars. GOP leadership in both the NC House and Senate remain opposed, but hey – these Repub Resisters deserve some props, right?


CMS WILL “REVIEW” MONTANA’S EXPANSION- This situation is sort of like when you see the cops at the precinct get a visit from Internal Audit. CMS approved MT’s expansion in 2015 and had high hopes for adding 70k under the spreading wings of Mother CMS. What is the crime that brought in Internal Audit? MT charges 2% for premiums to bennies above 50% FPL. And copays. So, CMS is sending in sleuths to “evaluate” the program (take a gander at how many other waivers ever get evaluated, vs just renewing the “demos” for decades on autopilot). The real goal is to get a ton of negative public comment to pile on to the program and insist a mandate for change has been discovered. Keep in mind the same thing happened to IN last year (a post-CMS approval PR campaign ala a surprise round of public comment-y evaluation against the “conservative” model once they saw other states following IN’s lead).


MISSOURI SAYS NO TO EXPANSION- While some had high hopes for the Show Me State this year, and a proposal was introduced, sources say no dice.


SO DOES NEBRASKA- The committee that reviewed the expansion proposal in the NE legislature politely declined this week. Would have added about 90k to the rolls.


CLAY GETS TIRED OF WRITING EXPANSION HEADLINES- Aren’t you tired of reading them? How about a video about Atlantic Mole Crabs instead http://bit.ly/2oxf9sL ?


LOW CAP RATES MAY SCARE OFF MCOS? Says the headline. What are they gonna do – go back to the exchanges? Ha! (imagine that Ha! being said by A.L.F.)


FARRIS’S FANTASTIC FRAUD FOLLIES– And now for everybody’s favorite paragraph… but not enough space this week, Dear Readers. Had to catch you up on a ton of news. I put lots of Follies in the twitter feed for you this morning, though. My favorite is the former NY state legislator who was charged with running a Medicaid pill mill scam. Check them out and tell me your favorite.



That’s it for this week. As always, please send me a note with your thoughts to clay@mostlymedicaid.com or give me a buzz at 919.727.9231. Get outside (don’t forget mulch for your baby plants!) and keep running the race (you know who you are).


FULL, FREE newsletter: http://eepurl.com/ep81Y . News that didn’t make it and sources for those that did: twitter @mostlymedicaid . Trystero: Leej Txiv tau xa Leej Tub kom txuag lub ntiaj teb no