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On the Hill: Funding Deadline, Medicaid Work Requirements

As Congress focuses this week on Friday’s deadline to continue funding the federal government, America’s Essential Hospitals continues to aggressively pursue a delay of Medicaid disproportionate share hospital (DSH) cuts as part of the next funding measure.

Congress failed to include the DSH cuts delay in the short-term continuing resolution it passed before the holiday recess and that expires Friday. The CR also did not include long-term funding for the Children’s Health Insurance Plan (CHIP) or funding for several health care extenders. 

America’s Essential Hospitals last week sent a letter to lawmakers signed by its board of directors and launched an advocacy and media campaign urging Congress to include a two-year DSH cut delay as part of the next funding measure. The association also sent an Action Alert urging members to ask their lawmakers to support a two-year DSH cut delay that was part of the House-passed CHAMPIONING HEALTHY KIDS Act.

Last week, the Congressional Budget Office (CBO) released a report that found extending CHIP for five years would cost $800 million instead of the originally estimated $8 billion. The agency attributed this change to the recent repeal of the individual mandate. CBO also estimated that extending CHIP funding for 10 years would save $6 billion in federal spending. The agency added that failing to secure CHIP would result in many children transitioning into coverage offered through the Affordable Care Act insurance marketplaces. The government would have to subsidize such coverage and would spend more on tax credits than it does for current CHIP coverage, CBO said.

Medicaid Work Requirements

Meanwhile, the Trump administration last week released guidance for states to impose work requirements for Medicaid recipients.

The guidance permits states to apply for waivers that would require Medicaid enrollees to be employed to receive coverage — a first in the 52-year history of the program. The Centers for Medicare & Medicaid Services (CMS) has emphasized that the requirements will apply only to “able-bodied adults” and will exempt children, elderly individuals, and disabled individuals. It is unclear how the administration will define “able-bodied adults” under the new policy.

Republicans argue that such a requirement will lead to better health outcomes for Medicaid beneficiaries, because of a link between employment and improved health. But Democrats counter that many Medicaid recipients already work or live in working families and that those who don’t likely are elderly, disabled, retired, sick, or caring for a family member.

Committee Activity

The Senate Committee on Health, Education, Labor, and Pensions will hold a Jan. 17 hearing on the nation’s preparedness and response to public health threats. The House Committee on Ways and Means will hold a Jan. 17 hearing on the opioid crisis and CMS efforts to prevent opioid misuse.

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About the Author

Erin Delaney is the legislative affairs associate at America's Essential Hospitals.

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