Capitol Correspondence - 08.06.18

White House Opposes GOP State Efforts for Smaller-Scale Medicaid Expansion

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According to the New York Times:

“Hoping to head off a full expansion of Medicaid under the Affordable Care Act, some senior officials in the Trump administration and Republican governors have been pushing hard for a smaller expansion to satisfy a growing political demand in their states.

But President Trump decided on Friday to shut down the debate until after the midterm elections, administration officials said.


Several states would like to expand Medicaid in a more limited way, capping eligibility at the poverty level, or $12,140 for an individual. In states that have not expanded Medicaid, eligibility varies. Parents with incomes over half the poverty level are often ineligible, and most adults without dependent children are ineligible, no matter how poor they are.

The push touched off intense debate inside the Trump administration.

Supporting the option were Alex M. Azar II, the secretary of health and human services; Seema Verma, the administrator of the Centers for Medicare and Medicaid Services [CMS]; and Andrew Bremberg, the director of the Domestic Policy Council at the White House.

On the other side were Mick Mulvaney, the director of the White House Office of Management and Budget; Treasury Secretary Steven Mnuchin; Kevin Hassett, the chairman of the president’s Council of Economic Advisers; and Larry Kudlow, the director of the National Economic Council.


Paradoxically, Mr. Trump reached the same conclusion as President Barack Obama for a completely different reason. Mr. Obama refused to allow partial expansion of Medicaid because he wanted states to go for the full expansion envisioned in the Affordable Care Act.

Mr. Trump opposed any expansion of “Obamacare,” even a partial one.”

ANCOR has not taken an official position on Medicaid work requirements, given previous statements by CMS that work requirements do not apply to people with disabilities. However, we will be preparing a document explaining how people with disabilities and direct support professionals might get inadvertently affected by Medicaid work requirements and sharing it with CMS to inform their policy-making.