Alliance Alert: New York and other state governments are moving quickly to get Medicaid requests approved ahead of the federal government’s transition to the new administration to ensure needed funding is secured before unknown changes to approach occur. We are encouraged by New York’s proactive approach to ensure that state-led healthcare initiatives, including the recent NYHER 1115 Medicaid Waiver and the expansion of our Medicaid buy-in program to support more people with disabilities as they look to work without losing essential health coverage, are safeguarded against potential policy shifts that may delay or impede implementation.
A change in administration often brings new policy priorities, regulatory interpretations, and procedural reviews. These shifts can lead to prolonged approval timelines or even a reconsideration of previously submitted proposals, delaying critical healthcare innovations. By securing approvals now, New York and other states can preserve the continuity of their Medicaid programs, protect vulnerable groups, and maintain momentum in addressing pressing healthcare challenges, such as expanding coverage, enhancing community-based mental health and substance use services, or addressing social determinants of health.
The Alliance will continue to advocate for advances in our Medicaid program as we transition and after the new Administration begins their work. Continue to monitor this E-news for updates, including ways you can join our advocacy efforts like attending our Annual Legislative day on March 5th. Sign up for Legislative day here and see below for more information.
New York Presses for Medicaid Approvals before Trump’s Inauguration
By Maya Kaufman | Politico Pro | November 18, 2024
The clock is ticking as New York awaits word from the Centers for Medicare & Medicaid Services on the fate of a lucrative tax meant to fund Medicaid reimbursement rate increases for health care institutions.
And it’s not the only policy proposalthat state officials hope the Biden administration will green-light in the weeks before handing over the reins to President-elect Donald Trump, whose administration is certain to have a very different view of Medicaid spending.
The state Department of Health just kicked off the 30-day public comment period for a new application to significantly expand the eligibility threshold for a Medicaid buy-in program geared to disabled working people, starting Jan. 1, POLITICO’s Maya Kaufman reports.
If approved, the program’s income limit would increase from 250 percent of the federal poverty line to 2,250 percent, the resource limit would expand by nearly 10 times to $300,000, and the upper age limit of 65 years would be removed.
The program currently covers approximately 12,500 working New Yorkers with disabilities who might not otherwise be Medicaid-eligible.
The changes are expected to yield nearly 2,200 more program participants annually, at a cost of $57 million per year, according to the state’s application.
But the state’s timing gives the Biden administration an exceedingly short window to approve the request before the upcoming change in the White House.
As far as the tax proposal, Gov. Kathy Hochul said she has raised the issue with CMS, remarking at a press conference earlier this month: “They know we have a timetable. We know we have a timetable to get them done.”
In the words of one person familiar with the state’s request, who was granted anonymity to speak candidly about the negotiations, it’s “now or never.”
“There’s no way a Trump administration would approve it,” the person said.
Another open question is the fate of the state’s ongoing Medicaid redesign effort, the $7.5 billion New York Health Equity Reform project, which is authorized under a federal waiver that expires in early 2027.
IN OTHER NEWS:
— State legislation signed into law Saturday will expand children’s access to fluoride treatments, Hochul’s office announced. The bill authorizes registered dental assistants and licensed practical nurses to administer fluoride treatment in dental offices.
“Fluoride is scientifically proven to prevent cavities and protect our kids’ teeth,” Hochul said in a statement. “As a mom, I know how difficult it can be to get an appointment at the dentist’s office and how critical it is for our kids to maintain good oral hygiene. That’s why I’m signing this legislation to expand access to fluoride treatments, keeping our kids healthy and strong.”
— The federal government on Thursday approved New York’s continuous coverage proposal for Medicaid and Child Health Plus enrollees up to the age of six.
The change, which is effective immediately, is meant to reduce churn rates among the insurance programs’ youngest members. More than 66,000 children annually are expected to benefit from the new enrollment policy, according to state estimates.
States Rush Medicaid Requests before Trump Return
By Ben Leonard and Chelsea Cirruzzo | Politico Pro | November 18, 2024
THE MEDICAID SCRAMBLE — States are racing to have their Medicaid requests approved before the Trump administration takes power.
The new administration is expected to have a very different view of Medicaid than the Biden administration, and GOP lawmakers in Congress are eyeing major changes. Some states want waivers that will impact their states’ budgets, but others seek to allow Medicaid to pay for social services, a Biden administration innovation that links health to social well-being, POLITICO’s Rachel Bluth, Maya Kaufman, Kelly Hooper and Robert King report.
For example, Hawaii and California want waivers to use federal money to help low-income people with rent, and Pennsylvania and Rhode Island want to use their Medicaid dollars to help with access to nutritious foods.
Democratic-controlled states expect that whoever President-elect Donald Trump chooses to lead CMS will support less government spending.
“There’s always the nagging concern,” said Judy Mohr Peterson, Hawaii’s Medicaid director, who was in Washington last week for a fall conference of Medicaid agency staffers. “Our governor is very anxious also to get this through.”
CMS doesn’t discuss pending waiver requests.
Among the states with pending requests:
California: The state has five requests pending, including one meant to improve its mental health infrastructure outside of institutionalized settings that Gov. Gavin Newsom pushed for while in Washington last week. Another would explicitly protect the state’s reproductive health infrastructure from funding cuts by a hostile federal administration.
New York: Gov. Kathy Hochul is working with CMS to approve a managed-care organization tax — a levy on some health plans used to draw down more federal dollars. The state’s goal is to secure billions of dollars in additional federal revenue for higher Medicaid reimbursement rates for hospitals and other health care providers. The concept is widely viewed as a temporary gimmick, given its reliance on an obscure loophole that CMS said it plans to close.
Hawaii: The state wants a five-year extension for one of its Medicaid waivers, including new expansions of prerelease coverage for incarcerated people, nutrition support and “continuous coverage” for young children so they don’t fall off Medicaid rolls for bureaucratic reasons.