Stateside Report: February 3, 2020

Medicaid, Medicaid expansion, MLTSS

New Mexico – (Navajo Times, 02/03/20) Last week delegates unanimously approved legislation to advance the “Naat’aanii – Molina Healthcare” (Naat’aanii Development Corp. is owned by Navajo Nation) and endorsed passive Medicaid enrollment for Navajo tribal members in New Mexico.  This organization is the first Indian Managed Care Entity (IMCE) among all tribal nations in the US and is expected to generate up to $470 million in annual Medicaid payments to Navajo Nation.  Delegate Mark Freeland said, “This not only brings economic benefits to the Nation but also opens the door for us to develop and tailor our healthcare programs to what Navajos need and want” and will allow the IMCE to focus on prevention, wellness, case management and care coordination. Delegate Paul Begay said that if the plan in New Mexico is successful, it will likely be expanded to Arizona and Utah.

New York – (City Limits, 01/31/20) Health care advocates, policy makers and government officials testified for nearly twelve hours last week in a hearing on the state’s Medicaid program and what is driving the cost overruns.  Key themes included questions of transparency; the governor’s failure to seat his Medicaid Redesign Team as was announced in his budget address; disagreements about how two programs (Managed Long Term Care and Consumer Directed Personal Assistance Program) are managed, the propensity for fraud and escalating enrollment; the need to revise or repeal the Medicaid Global Cap citing how the cap adjusts for inflation but not for increases in enrollment; and the need to address growth in the aging population.

Oklahoma – (US News & World Report, 02/01/20) Governor Kevin Stitt expressed support for the Trump administration’s Medicaid block grant proposal and House and Senate Republican leaders are excited to work with him on the details of the plan.  It is expected that the plan will include co-pays, premiums, and work requirements for the expansion population.  Regardless of what the administration’s plan looks like, it will have to compete with a full-scale Medicaid expansion initiative set to be on this year’s ballot.

Pennsylvania – (Connect FM, 02/01/20) Governor Wolf announced that his administration will not be applying for a Medicaid block grant as proposed by the Trump administration.  Instead, Pennsylvania is launching the “Medicaid Work Supports” program aimed at trying to link interested Medicaid enrollees to employment and training programs.  Department of Human Services Secretary Teresa Miller was quoted saying, “We want all people to be able to work, but we cannot do so in a way that is punitive or risks access to the health care people need to be able to get a job. The Medicaid Work Supports initiative will create that connection to employment and training.”

State Budget

Florida – (CBS 12 News, 01/28/20) Senate Health and Human Services Appropriations Chairman Aaron Bean is set to unveil a proposed budget that would provide $100 million in additional funding for community-based services for people with I/DD.  This comes following his committee’s approval of a bill to redesign the iBudget program.  The committee approved the bill with an amendment removing the original requirement that an outside organization conduct reviews when iBudget plans request an increase.  This function will remain with the Agency for Persons with Disabilities, but some additional parameters will be put in place and this office will be required to centralize the appeals process to “ensure consistent application of medical necessity criteria”.

Kentucky – (Courier Journal, 01/28/20) Governor Andy Beshear released his budget proposal which includes $31.5 million for 350 new social service workers in the state’s child protection agency which has been chronically understaffed and overwhelmed with abuse cases.  The budget also includes $10.5 million to address waiting lists in two Medicaid programs supporting adults with I/DD.  Five hundred slots would be added to the Michelle P. Waiver and another 100 slots to the Supports for Community Living Waiver.