CMS’ Verma says no to Medicaid lifetime limits

Brief:

  •  CMS Administrator Seema Verma on Tuesday said the agency will not approve any state requests to put lifetime coverage limits on Medicaid beneficiaries.
  •  Earlier this month, CMS rejected Kansas’ request to place a three-year lifetime limit on Medicaid benefits. Still, four other states have requested similar Medicaid waivers: Utah, Arizona, Maine and Wisconsin.
  •  Despite the opposition to lifetime limits, CMS is still closely working with states on other types of waivers, Verma said at The Washington Post’s “American Health Future” forum.

Insight:

Verma’s remarks show that although the administration is willing to make big changes to Medicaid, including approving state work requirements, it still sees the program as a safety net for the poor.

“We’ve indicated we would not approve lifetime limits, and we’ve made that pretty clear to states,” she said at the Post event.

She warned that while CMS wants to give states more flexibility to decide how to administer their programs, Medicaid must remain remain available for those who need it, saying there must be a pathway back into the program.

Health policy experts and patient advocates have slammed Medicaid lifetime limit proposals, saying they would hurt those who need Medicaid the most.

A number of them signed on to a letter to HHS Secretary Alex Azar opposing the Kansas wavier.

“The work requirement is misguided, will not achieve the state’s goals and does not further the objectives of the Medicaid program,” they wrote. “Time limits have never been permitted in the Medicaid program and are not compatible with the goals of Medicaid.”

Verma reiterated Tuesday that the Trump administration isn’t shying away from giving states more control over their healthcare programs in general, however. “I hope to get to a new era where states are driving their programs, and they are deciding what is going to work best in their communities, because they are closest to the people they serve,” she said. “And we can hold states accountable for shaping outcomes so we can measure what they are doing.”

CMS has moved forward on state requests to impose work requirements for Medicaid, which require eligible enrollees much have a job, be in job training or engage with the community through volunteer work. But the practice has been criticized by those who say those able bodied already do work, it will put several million at risk of losing coverage and add to administrative burden.

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