Medicaid

Blake Farmer | WPLN

Tennessee lawmakers rarely debate consequential legislation in the first few days of a session. But the General Assembly is forgoing precedent to alter how the state’s Medicaid program receives federal funding, and in the process will be altering roughly a third of the state budget before the Biden administration takes over.

Passage is a given. The same Republican majority told TennCare to seek this so-called “block grant” for Medicaid, which has been a dream of conservatives. Now that dream is nearly reality.

But in less than a week, the country will have a Democrat in the White House, leading a party that has opposed block grants for Medicaid and argued that they only lead to cutting benefits and beneficiaries from programs.

With less than a dozen days left in power, the Trump administration on Friday approved a radically different Medicaid financing system in Tennessee. With this move, the federal government is for the first time granting a state broader authority in the operation of its health insurance program for the poor without interference from Washington, allowing Tennessee to make decisions on such issues as whether to add new benefits or eligibility categories or spend Medicaid dollars outside of health care, if it thinks that would help enrollees.

Rebecca Kiger

A report from a federal oversight agency shows that over 4,000 patients in the Ohio Valley received high amounts of opioids in 2018 through Medicaid, potentially putting hundreds at risk of addiction and overdose. 

 

The Office of Inspector General for the Department of Health and Human Services focused the report on six Appalachian states in support of their partnership with law enforcement agencies who are in the Appalachian Regional Prescription Opioid Strike Force.

 

The IG’s Office found through claims data from Kentucky, Ohio, and West Virginia that nearly 400 Medicaid patients in the Ohio Valley who received high amounts of opioids are at serious risk of opioid misuse or overdose.

 

Flickr/Creative Commons/401(K) 2012

A new Pew Charitable Trusts report shows Kentucky’s spending on Medicaid has increased since the recession, but remains below the national average. The study looked at how much Medicaid spending takes up of each state’s revenue.

 

Pew found Medicaid consumed a greater portion of state revenue across the country from 2000 to 2017. Justin Theal, with Pew, said the organization studies the issue for a couple of reasons.


J. Tyler Franklin

Passport Health Plan and Anthem Kentucky, the Medicaid providers whose contracts were not renewed by outgoing Gov. Matt Bevin last month, have another shot at continuing to serve Kentuckians.

Gov. Andy Beshear said his administration would cancel the five Medicaid contracts awarded by Bevin in his last days in office. He plans to redo the bid process early next year, with the goal of awarding new contracts by the spring. Beshear said anyone is welcome to bid, including those who were denied contracts by Bevin.

During a press conference Monday, Beshear said he wants to create a system the public can trust that is free of perceived bias. Beshear pointed to Bevin’s attitude toward Passport, whose enrollees are mostly in Louisville and which suffered when the state changed reimbursement rates last year.

Screenshot from Gov. Andy Beshear Facebook

Governor Andy Beshear will not move forward with former Governor Matt Bevin’s controversial changes to Kentucky’s Medicaid program. Beshear made the announcement Monday, within his first week in office.

Beshear said he’s sending a letter to federal officials to rescind the 1115 waiver that Bevin first submitted back in 2016. He also signed an executive order repealing Bevin’s signature health policy.

“Let me be clear, this Medicaid waiver would have cost Kentucky money, lives and jobs: I believe it would have saved us nothing,” Beshear said. “By every measure, Kentucky’s decision to expand Medicaid in 2014 has been a huge success.”


NPR

A little under a half a million Medicaid enrollees in Kentucky may be confused about what recent news about the state’s Medicaid contracts means for their health benefits. About 435,130 Kentuckians currently have Medicaid health insurance through Passport and Anthem, both of which recently lost out on contract renewals.

The companies are still offering coverage now, and people are able to sign up for a plan from either during open enrollment, which ends December 13. But as the situation stands, these two plans won’t offer Medicaid benefits starting July 1; Molina and United Healthcare will take their places. And all that could change depending on decisions by new Gov. Andy Beshear’s administration or the success of the companies’ appeals. 

Flickr/Creative Commons

Anthem Kentucky has submitted its appeal to the state protesting its exclusion from the Medicaid contracts issued two weeks ago by former Governor Matt Bevin’s administration. Anthem is asking for Governor Andy Beshear’s new administration to halt the new contracts and reconsider.

About two weeks ago, former Gov. Matt Bevin’s administration issued contracts to five insurance companies that will administer Medicaid benefits in the state starting in July; Anthem Kentucky and Passport Health weren’t among them. Meanwhile, United Healthcare and Molina were granted contracts to offer the benefits starting in July.


U.S. Air Force photo illustration

In his inaugural address Tuesday, Kentucky Gov. Andy Beshear addressed two of the core issues he campaigned on: health care insurance and the cost of drugs.

“These are our brothers and our sisters; after the expansion, these neighbors could go see a doctor without the fear of bankruptcy. And the expansion ensured that almost all of Kentucky’s children had access to health care,” Beshear said. “I will honor and strengthen our commitment to these families.”

Beshear’s father, former Gov. Steve Beshear, expanded Medicaid in 2014 to adults without children and to people making up to 138 percent of the poverty limit, or about 400,000 people.

Lawmakers Vote Against Kentucky Medicaid Contracts

Dec 9, 2019
Ryland Barton

A panel of state lawmakers has unanimously disapproved and voted against $8 billion worth of Medicaid contracts issued by Gov. Matt Bevin’s administration.

In the last hours of Bevin’s term as governor, the outgoing Finance Cabinet Secretary could override that disapproval, but any override may be moot as Gov.-elect Andy Beshear’s incoming Finance Secretary could also nullify the contracts.

Bevin’s Finance Cabinet awarded contracts to five insurance companies to administer Medicaid benefits for Kentucky enrollees two weeks ago. Two of the contracts to companies that had previously provided the service in Kentucky — Anthem of Kentucky and Passport Health — were not renewed.

Creative Commons

Passport Health Plan and Anthem Kentucky will no longer offer Medicaid coverage to Kentuckians starting next summer. State officials announced Wednesday that it did not award those providers contracts following the expiration of their current contracts at the end of June 2020.

This year, there are five Medicaid providers who cover 1.3 million enrollees in Kentucky. The state will renew contracts with Aetna, Humana and WellCare. The latter of which — in a change — will be dedicated to children in the foster care system and those in the juvenile justice system.

Molina and UnitedHealthcare will receive fresh contracts for next year.

TN photo services

Now the block grant ball is in the federal government’s court.

Tennessee’s Medicaid agency has spent months redesigning TennCare, after the Trump administration asked for so-called block grant requests. The 50-page proposal, which could reshape a program that serves more than 1.4 million Tennesseans, was officially submitted Wednesday afternoon, though with some last-minute changes.

State officials acknowledged that nearly all of the roughly 1,800 comments received in recent weeks were from people concerned about cuts to existing benefits. That’s because the block grant concept has historically been intended to save money, and Gov. Bill Lee calls the negative response “completely understandable.”


Ryland Barton

For the past four years, Kentucky officials have been trying to institute a policy requiring some Medicaid recipients work or do community service to keep their health coverage. It’s been a pillar of Republican Gov. Matt Bevin’s policy priorities, but with Bevin soon leaving office and Democratic Governor-Elect Andy Beshear opposed to the requirement, it would be up to the legislature to continue that effort. 

However, it appears there’s little appetite among Republican legislators who would have to lead that legislative fight. 

Carter Barrett/Side Effects Public Media

Indiana’s Medicaid program won’t cut off enrollees’ coverage for not meeting work requirements for the time being, state officials announced Thursday.

Indiana was set to suspend Medicaid benefits in January for some enrollees not working, volunteering or taking classes, sometimes known as work requirements. Seventeen other states have similar programs, but none are in effect, in large part because of court challenges. 

The state said it is temporarily suspending the requirements because of a lawsuit by Indiana Medicaid enrollees that is pending in federal court against the federal government for approving the requirements.

TN photo services

Tennessee’s Medicaid program is preparing to finalize the country’s first block grant application within days. The plan would reimagine the way the federal government funds health care for low-income Tennesseans, and according to TennCare officials, it envisions expansion of service rather than cuts.

The block grant proposal is not just a request for a lump sum, as critics feared. TennCare has come up with a formula that gives the state even more incentive and flexibility to keep medical costs down. That’s something TennCare has already done better than most state Medicaid programs.


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