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10 States move to impose Medicaid work requirements; Kentucky HEALTH becomes first to implement

Earlier this week, we examined a major shift involving states’ proposals to impose work requirements for Medicaid recipients through Section 1115 waivers. The move, which was announced by the Trump Administration on January 11, would affect nearly 70 million low-income people receiving benefits.

According to CMS, ten states – Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah, and Wisconsin – have already sent in proposals to add work requirements for Medicaid. On January 12, Kentucky became the first to gain CMS approval. Mississippi has also submitted a waiver proposal to CMS, but it has not yet been certified as complete.

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Trump Administration releases guidance on Medicaid work requirements

What happened?  

In a major shift that could affect millions of low-income people receiving benefits, The Trump Administration announced Thursday, January 11, that it will open the door for states to require work requirements for Medicaid recipients.  

The guidance was published in a letter from CMS Deputy Administrator Brian Neale to State Medicaid Directors Thursday morning. In the letter, Deputy Administrator Neale stated that the move would help “improve Medicaid enrollee health and well-being through incentivizing work and community engagement.” 

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Alex Azar on track to become next HHS Secretary

Following yesterday’s Senate Finance Committee hearing, it appears Alex Azar, the former head of Pharmaceutical company Eli Lilly’s U.S. operation, is on track to be confirmed as the Head of the Department of Health and Human Services (HHS). If confirmed, Azar will replace Thomas Price M.D., a former congressman who served as the HHS secretary for seven months before resigning. 

Despite a probe by Democrats, including that from Sen. Ron Wyden (D-Oregon), on his drug industry ties, Republicans have focused on the fact that Azar would come to the job with greater working knowledge of the sprawling agency, with its budget of more than $1.1 trillion and far-flung staff of nearly 80,000, than many of his predecessors, according to the Washington Post 

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What’s new for SHOP in 2018

The Small Business Health Options Program (SHOP) will remain open for small businesses with 1-50 employees in 2018, and will boast new features that’ll impact how small employers and their employees enroll in and manage their coverage for SHOP plans starting on or after January 1, 2018.

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CMS signals support for Medicaid work requirements

Earlier this month, the head of the Centers for Medicare and Medicaid Services (CMS), Seema Verma, made an announcement conveying that CMS would approve waiver applications from states that would require Medicaid enrollees to participate in “community engagement” activities, otherwise known as work requirements. This follows a letter co-authored by Verma that encouraged state Medicaid directors to use these waivers to modify their Medicaid programs to empower consumers. To advocates, work requirements are a way to empower Medicaid enrollees by encouraging them to be independent, self-sufficient consumers of healthcare.

Here’s what you should know about the proposed work requirements for Medicaid:

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What can healthcare payers learn from consumer retail?

The Commerce Department announced last week that U.S. retail sales have surged 0.8% for the month of November, which was more than double the rate economists had predicted. As consumers flock to retailers like Amazon and Walmart this holiday season, here are 5 takeaways healthcare Payers can learn from them:

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Major changes to 1332 waivers could be coming

1332 waivers, or state innovation waivers, allow states to apply to the federal government to waive certain provisions of the Affordable Care Act (ACA) and pursue innovative strategies for providing residents with access to quality, affordable insurance while retaining the law’s basic protections. However, there are two developments currently in motion that could make significant changes to these waivers.

One is the Alexander-Murray bill, which is indirectly connected to the Congressional tax bill currently in the process of reconciliation between the Senate and the House. The other is a bill currently being drafted by Senators Orrin Hatch (R-UT) and Mike Crapo (R-ID) that would overhaul the 1332 process, altering many of the original stipulations laid out by the ACA.

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Repealing individual mandate: not as bad as once feared?

Background

On Wednesday, December 13th, leaders from both the House and Senate will meet in Washington to finalize the Tax Cuts and Jobs Bill. If they decide to include removing the individual mandate, this will undoubtedly have an impact on healthcare in America – but it may be not as extreme as originally thought.

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Tax bill takes toll on individual mandate

Background

On Saturday, December 2nd, the U.S. Senate passed The Tax Cuts and Jobs Act, which was drafted in a Republican effort to reform the U.S. tax code. This follows the passage of Congress’ version of the bill, which took place on November 16th. One of the key differences between the two bills is that the Senate’s version includes a provision that effectively removes the Affordable Care Act’s individual mandate, which requires all individuals to purchase health insurance.

As leaders from the Senate and Congress meet to discuss how to reconcile the two versions of the bill, the healthcare industry is waiting to see if the mandate will be removed and what some of the ramifications could be.

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Hidden benefits of medicaid expansion

Although there is still an ongoing debate in many states over whether or not to expand Medicaid, in the 33 states that have, unexpected benefits are starting to surface.

When the Patient Protection and Affordable Care Act (ACA) laid the framework for Medicaid Expansion, it allowed states to expand the income level needed to qualify for Medicaid. This gave a large number of Americans access to coverage. But it turns out this wasn’t the only benefit.

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