Last Friday, a single judge in the U.S. District Court for Washington, DC struck down Kentucky’s recently approved Medicaid reform package. A group of current Medicaid enrollees challenged the state’s Medicaid overhaul, called Kentucky HEALTH, which was set to take effect July 1. The plaintiffs argued Kentucky HEALTH was contrary to Medicaid’s mission of providing medical insurance and other related benefits to individuals with insufficient income.
In a last-minute decision, Judge James Boasberg ruled in favor of the plaintiffs, determining the secretary of the U.S. Department for Health and Human Services (HHS) did not satisfactorily evaluate the relevant data and objectives of Kentucky HEALTH before approving it. Specifically, Boasberg referred to the estimate suggesting 95,000 persons will leave the state’s Medicaid rolls over a five-year period as evidence the reform would be antithetical to the objective of the 53-year-old federal health insurance program. The Bluegrass State is expected to appeal the ruling.
These reforms would have saved the state approximately $331 million over the course of five years. More importantly, the reforms would have paved a pathway for low-income individuals to become self-sufficient and financially independent, eliminating their reliance on government handouts. Similar reforms have already been implemented in Arkansas. HHS has also approved Medicaid reforms for Indiana and New Hampshire, which will be enacted in 2019.
The now-halted reforms would have applied solely to those able-bodied recipients enrolled in Medicaid under the expansion program created by the Affordable Care Act. The reforms included monthly premium payments, annual eligibility reporting, and an 80-hours-per-month work or volunteer requirement. If individuals failed to meet these requirements, their benefits would have been suspended for six months, after which they would have become eligible to reenroll.
In 2013, Kentucky expanded its Medicaid population to include able-bodied adults without dependents (ABAWDs) with incomes up to 138 percent of the Federal Poverty Level ($16,643 a year for an individual). More than 420,000 Kentuckians enrolled in the expanded program. The new enrollees exceeded state projections by a whopping 134 percent, and they will cost Kentucky taxpayers an estimated $1.2 billion over the next five years.
Medicaid expansion’s financial instability and lack of improved health outcomes for recipients prompted HHS to contact state Medicaid directors, encouraging them to institute necessary reforms to help people escape government dependency. HHS is dedicated to granting innovative state waivers that boost consumer-directed health care, efficient care use, and other options to make Medicaid more akin to the private insurance market.
The Kentucky ruling should not deter state officials from seeking Medicaid reforms that include work requirements for able-bodied adults, which 70 percent of Americans support, according to a recent Kaiser Family Foundation poll. Legislators should also campaign to roll back Medicaid expansion so that only the truly needy—low-income families and disabled people—receive state medical assistance.
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Energy & Environment
Podcast: The End of Secret Science and Carbon Colonialism
In this episode of the Heartland Daily Podcast, David Wojick, former consultant with the Office of Scientific and Technical Information at the U.S. Department of Energy, explains the flawed methodology utilized by the Obama-era Environmental Protection Agency (EPA). Obama’s EPA produced scientific studies that formed the basis of numerous public policies, many of which are still in place.
Popularity of New York Charters Shows the Need for Expansion
In this Research & Commentary, Policy Analyst Tim Benson discusses results from an annual survey by the New York City Charter School Center. The study reveals Gotham charters received an estimated 79,600 applications for only 26,900 seat openings for the 2018–19 school year. That is a 9 percent increase compared to 2017–18 and a 47 percent increase compared to 2010–11. Ninety-seven percent of charters that responded to the survey said they have a waiting list for seats, while 91 percent responded they have a waiting list that was at least twice the number of available seats. The number of applicants outnumbered the number of available seats in all five boroughs.
Budget & Tax
Pennsylvania Should Strengthen Budget Transparency Tools
In this Research & Commentary, Senior Policy Analyst Matthew Glans discusses Pennsylvania’s existing online budget transparency portal and examines a new proposal that would improve transparency in the state’s budget and spending process. “House Bill 1843 would direct the state Treasury Department to expand the portal’s data to include a detailed list of annual state budget expenditures, grouped by agency. Importantly, the bill would require state agencies to place on the portal the same unedited budget documents used to craft the governor’s budget proposal,” wrote Glans.
Reversing Obamacare’s Medicaid Expansion Would Benefit Everyone
In this opinion article, State Government Relations Manager Charlie Katebi examines the sweeping reforms recently passed by Michigan legislators that will help sick and able-bodied Medicaid recipients obtain quality health care. “There is no question that all Americans deserve high quality health care. Thankfully, Michigan’s work requirements will help able-bodied adults obtain employer-based insurance and ensure Medicaid cares for the truly needy,” wrote Katebi.
From Our Free-Market Friends
Two Ways to Build on the Success of the Special Needs Scholarship Program
In this paper, the Georgia Center for Opportunity examines the existing Georgia Special Needs Scholarship Program, as well as the updates to these programs that are currently being considered in House Bill 801. House Bill 801 contains two major amendments to the existing Special Needs Scholarship Programs, both of which intend to give parents more autonomy in deciding how to spend education funds. The first amendment would allow parents to use the scholarship funds for therapies, tutoring, and specialized educational equipment. The second amendment to the existing program would allow homeschooled children to access these funds. Given the unique educational demands of special-needs children, it makes sense that the people who know these students best—their parents—should be empowered with the ability to decide the best ways to allocate these scholarship funds.
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