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Yahoo
05-03-2025
- Health
- Yahoo
Medicaid goes by many names. Will Americans realize if it gets cut?
Apple Health, KanCare, ARHOME, Med-QUEST, and Medi-Cal: What do these have in common? They're all Medicaid programs. States, which administer Medicaid after receiving federal funds, often change the name of the program, sometimes even branding it to reflect state pride, such as Husky Health in Connecticut or SoonerCare in Oklahoma. They also change the name of the federally funded CHIP healthcare program for children, at times with cutesy names like PeachCare for Kids in Georgia and CubCare in Maine. Some Medicaid programs even have a private insurer's name attached to it because many states farm out contracts to managed care organizations, or MCOs, to administer the programs. Those changes, though, can cause confusion. A pair of recent studies noted that state-specific names and MCO plan designs can prevent people from realizing they are receiving a public benefit. That disconnect adds to the larger confusion over Medicaid itself, who it covers, and why. It simply isn't a poor people's program, a stigma that motivates states to change the name in the first place. It covers our children, grandparents, and Americans with disabilities. As cuts to government healthcare programs become a real possibility, experts say it's crucial for Americans to understand the scope and necessity of the Medicaid program. "It's one of those situations where our best intentions can backfire," said Jessica Calarco, a sociologist and professor at the University of Wisconsin-Madison. "When we change the way these programs operate, when we refuse to use words like welfare, it makes it more difficult for people to understand who is and who isn't benefiting from these programs and to see the benefits that they themselves are getting as well." While Medicaid is a joint federal-state program, "states administer Medicaid programs fairly independently," Melissa Hafner, a health policy researcher at the American Institutes for Research, told Yahoo Finance. Certain groups must be eligible for the program, and specific core benefits must be included under Title XIX of the Social Security Act, which established Medicaid. "But beyond that, states have a lot of flexibility in the scope of their Medicaid program," she said. That includes who's eligible, what services enrollees can receive, what states will pay for Medicaid services, and how states pay — either directly to healthcare providers or through MCOs, which are often private health insurers. The federal government provides a portion of the funding to a state's Medicaid program. States with higher rates of poverty receive a higher federal match. Nationally, 1 in 5 people are on Medicaid, according to KFF. That includes nearly 2 in 5 children, 1 in 6 adults, over 1 in 4 adults with disabilities, almost 1 in 2 children with special healthcare needs, and 5 in 8 nursing home residents. In fact, Medicaid is the only federal program that offers Americans long-term care insurance. Medicare does not, and the need for this type of care is only becoming more acute as the baby boomers age and can no longer care for themselves. Medicaid also covers 41% of all births in the US, 29% of non-elderly adults with mental illness, and 40% of non-elderly adults with HIV. One in 5 people on Medicare also receive extra coverage from Medicaid. And yes, it covers our most financially vulnerable Americans — over 8 in 10 children in poverty, and almost half of adults in poverty are on Medicaid. "This is likely something that helps someone you know or love actually make ends meet," said Lauren Rivera, a sociology professor at the Kellogg School of Management at Northwestern University who started a discussion over Medicaid names on social media. "I would say that every person in this country — if they're not already receiving Medicaid — is one step away from needing it." By subscribing, you are agreeing to Yahoo's Terms and Privacy Policy Most experts I spoke to think the reason many states drop the "Medicaid" from their program names is to reduce a stigma and encourage more people who are eligible for the assistance to sign up. While surveys show high support for Medicaid funding overall, enrolling in the program itself on a personal level can bring up mixed feelings. Consider this account from Calarco, who interviewed 250 women from pregnancy through their first couple of years postpartum for her recent book "Holding it Together: How Women Became America's Safety Net." One mother, Erin, and her husband were struggling to afford childcare, both working split shifts to watch their children. Exhausted by that arrangement, Erin dropped out of the workforce to stay at home with their kids, but the couple was going broke trying to afford health insurance at the same time. When Medicaid was expanded in her state, Erin was reluctant to sign up. "She felt like 'it's not for people like us,'" Calarco recounted, saying that they weren't poor enough to need it. There's also an othering factor around Medicaid, said Rivera. It's a program for this group or that group, one "that is different from me. Attempts to rename the programs try to make them more friendly, more appealing, more palatable." Signing up for TennCare or Healthy Connections in South Carolina may not sting as much, and that's exactly the point. The drawback, according to a 2024 study, is the effort "may muddle understanding of the program as a government-provided benefit." "The inner workings of how programs like Medicaid are funded is far too complex for the average person to understand," Calarco said. "It's hard for people to parse out that when we talk about your state Medicaid program, that's connected to and deeply dependent on federal Medicaid funding." There's a similar concern among the 75% of Medicaid enrollees who sign up for a plan managed by an MCO. For example in Georgia, those eligible for Medicaid register for the Georgia Families program, which then provides members a choice of three health plans managed by an MCO for adults. The three health plans are provided by Amerigroup Community Care, CareSource, or Peach State Health Plan. Absent from these plan names? Medicaid. Another study published in 2018 found that Medicaid recipients are less likely to self-report that they are on the program when MCO plans are designed to obscure government involvement. Enrollees are less able to recognize how they personally benefit from Medicaid, the study found, making it more difficult for them "to engage in the civic sphere as informed advocates for their self-interest." And that there is the rub. Senate lawmakers are set later this month to vote on which parts of the government should be slashed to reach the $880 billion in spending reductions the House GOP advanced in its budget resolution last week. The resolution itself didn't state those cuts must come from Medicaid, but the reductions must come from the House Energy and Commerce Committee, which oversees the program and the Children's Health Insurance Program. "When it comes to mobilizing for this much-needed part of our social safety net, it complicates things if people don't necessarily know that they're on it," Rivera said. 'It is really important for people to have a clear understanding that programs like Medicaid are essential for a functioning society." No matter what it's called. Janna Herron is a Senior Columnist at Yahoo Finance. Follow her on X @JannaHerron. Sign in to access your portfolio
Yahoo
31-01-2025
- Health
- Yahoo
Five takeaways from the third week of the Arkansas 95th General Assembly
LITTLE ROCK, Ark. – It was a busy week for the Arkansas legislature as lawmakers dug into a range of matters impacting Arkansans. Five of the larger issues for the week were a counter to the governor's prison plan, a planned Medicaid work requirement, no cell phones in school legislation, an end to DEI in Arkansas and watershed protections. Prison plan: Sen. Bryan King (R-Green Forest) introduced a public safety plan to renew the focus on the safety of Arkansans. King cited what he called the 'three-headed monster' facing the state as a high incarceration rate, a high crime rate and high prison overcrowding. He proposed working with the Arkansas State Police and county sheriff's offices to add public-safety-focused hires, additional beds in county detention centers, and ramped-up assistance for probation and patrol officers. Funding would come from medical marijuana and casino revenue, King said, adding that unlike the 3,000-bed prison proposal, his plan is funded. Medicaid work requirement: Gov. Sarah Huckabee announced her plan to create a work requirement for anyone receiving Medicaid in the state. The update to the ARHOME program would require what she called 'able-bodied individuals' to either work, go to school or stay home and take care of their children to continue receiving Medicaid. Clients will receive support in meeting work requirement goals, including education and coaching, Deputy Secretary for Programs and State Medicaid Director Janet Mann said. Those who refuse to comply will have their Medicaid suspended, which will be restored when they comply with the requirements. This is a slight retweaking of the state's previous effort at a Medicaid work requirement. If the Center for Medicare and Medicaid accepts it, Arkansas will be the first state in the nation with a work requirement. No cell phones in schools: On Wednesday, the governor made a second announcement about the Bell to Bell, No Cell Act. This would end student's using cell phones while school is in session. Sanders said the bill was a necessity in light of a growing mental health need among young people with 'unrestricted access to smartphones and social media.' The plan had been tested in some schools during the previous school year where it was judged a success. End to DEI in Arkansas: A bill has cleared the Senate and is now before the House that would 'prohibit discrimination by public entities on the basis of race, sex, color, ethnicity or national origin,' according to the legislation's language. It would drop the requirement to state higher education from maintaining programs to encourage minority student, faculty and staff participation, as well as any hiring programs by state entities aiming to increase the number of minority employees. Several people spoke against the bill in its Senate committee hearing. It is now scheduled to be heard in the House State Agencies and Governmental Affairs Committee. Watershed protection: A bill was introduced in the Senate to end the moratorium on issuing permits to confined animal feeding operations along any Arkansas waterway, including the Buffalo River. The state currently maintains a temporary moratorium on issuing new permits for medium and large CAFOs along the Buffalo. The Department of Environmental Quality initiated the moratorium in 2014 after environmental concerns about the waste generated by a large-scale hog farm near the river. The farm closed in late 2019 when the state purchased its assets. The bill was due for a Senate Agriculture, Forestry & Economic Development committee hearing, but that meeting was canceled and, as of Friday, had not been rescheduled. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
28-01-2025
- Health
- Yahoo
Arkansas again seeks Medicaid work requirement waiver
Arkansas Department of Human Services Sec. Kristi Putnam discusses the state's waiver request for Medicaid work requirements on Jan. 28, 2025 as State Medicaid Director Janet Mann (left) and Gov. Sarah Huckabee Sanders listen. (Antoinette Grajeda/Arkansas Advocate) Arkansas is again seeking a Medicaid work requirement that state officials say incorporates lessons learned from previous attempts. Republican Gov. Sarah Huckabee Sanders on Tuesday shared a letter to U.S. Department of Health and Human Services Secretary-Designate, Robert F. Kennedy Jr. and a waiver request to the Centers for Medicare and Medicaid Services (CMS) requesting the implementation of a work requirement for 'able-bodied, working-age recipients' of the state's Medicaid expansion program — Arkansas Health and Opportunity for Me (ARHOME). The waiver will be submitted to CMS following a 30-day public comment period, State Medicaid Director Janet Mann said. Arkansas became the first state to implement a work requirement for some Medicaid recipients in 2018, but a federal judge halted the policy the following year. Arkansas was one of 13 states to receive permission to impose work rules on some Medicaid recipients during Donald Trump's first administration. With his return to the White House, more states might again apply for work requirements from an administration that's demonstrated it's amenable to them, according to Stateline. It costs Arkansas more than $2.2 billion annually to support the roughly 220,000 'able-bodied, working-age adults' on ARHOME, an estimated 90,000 of whom are unemployed, according to the letter. If the waiver is approved, the work requirement would apply to Arkansans ages 19-64 who are eligible through the new adult expansion group, have an income at or below 138% of the federal poverty level and are covered by a qualified health plan, according to the waiver request. 'The requirement is simple — you want to receive free health care paid for by your fellow taxpayer, able-bodied working-aged adults have to work, go to school, volunteer or be home to take care of their kids,' Sanders said at a press conference at the Capitol. Learning from past issues with the program, state officials said the new waiver differs from previous work-requirement attempts in that it removes the burden of reporting requirements from recipients through the use of data matching. Data matching refers to the practice of comparing different sets of data to identify similarities and relationships. Additionally, state agencies will use multiple forms of communication to connect with recipients, and when beneficiaries fall out of compliance, they will be suspended from the program instead of disenrolled, state officials said. Medicaid eligibility was expanded during the COVID-19 pandemic, but when the public health emergency ended last year, the Arkansas Department of Human Services began 'unwinding' the extension by disenrolling clients the agency considered ineligible. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Between April and September 2024, more than 184,500 Arkansans lost coverage because they did not provide necessary eligibility information. In some cases, beneficiaries likely declined to submit renewal paperwork because they no longer qualified for coverage, state officials have said. But advocates have argued that some still-eligible beneficiaries likely lost coverage because they never received proper notification or encountered problems when trying to return renewal information. Arkansas Advocates for Children and Families said it was unable to comment on the details of the requested CMS waiver because DHS did not provide a copy prior to Tuesday's announcement, but the nonprofit organization did have concerns about the waiver's effect on Arkansas. 'Although the state is looking at the various problems that occurred during the last round of work-reporting requirements, the bottom line is that Medicaid is not a workforce or a work-incentive program,' AACF said in a statement. 'It is an insurance program for low-income adults and children.' Noting that 130,000 of the 220,000 able-bodied individuals on the program are currently working, AACF said this highlights that despite common messaging about Medicaid recipients, the majority have a desire to work and provide for their families. During the state's first attempt at a Medicaid work requirement, more than 18,000 Arkansans lost health insurance coverage between Sept. 1 and Dec. 31, 2018, for failing to meet those work-reporting requirements, according to AACF. Of those removed, 97% were compliant or had exemptions, but still lost coverage. Proposed Medicaid cuts would hurt rural areas, including Arkansas kids, researchers say The loss of health care coverage can lead to higher health care costs for all Arkansans because of increased emergency room usage, hospitalizations and unreimbursed medical care, according to AACF. 'Hospitals could be impacted, and people will lose their jobs when they become too sick to work,' AACF's statement reads. 'At a time when families are living paycheck to paycheck and struggling with the high cost of living, now is not the time to take away people's health insurance while forcing taxpayers to foot the bill for more unwanted bureaucracy.' Work requirements are already part of other federal assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) program, DHS Secretary Kristi Putnam said Tuesday. The 'Pathway to Prosperity' waiver is about helping Arkansans learn about new opportunities, seek new skills and pursue new careers, she said. 'The goal should be for Medicaid to be a safety net, and we should routinely see healthy adults moving from government dependence to economic independence, improving their health in the process,' Putnam said. 'It is not punitive. It is about purpose.' Individuals who are suspended from the program can become active again and have their full benefits restored by notifying DHS of their intention to cooperate with personal development plan requirements, according to the waiver request. DHS also plans to use data matching to identify ARHOME beneficiaries who are 'not on track towards meeting their personal health and economic goals,' according to the state's waiver request. Those individuals will then be contacted by a 'Success Coaching resource.' DHS is assessing public and private options to fulfill Success Coaching roles, but intends to leverage resources and community partnerships, according to the waiver request. Details about the nuances of the program's implementation will be determined during negotiations with CMS, Putnam said. SUPPORT: YOU MAKE OUR WORK POSSIBLE
