HHS negotiating Medicaid wavers state-by-state
Negotiating Medicaid waivers state by state is a key aspect of the Trump administration's efforts to shore up the markets, according to Jane Norton, director of intergovernmental and external affairs for the U.S. Office of Health and Human Services.
"We are working diligently," Norton told reporters after a discussion hosted by the National Conference of State Legislatures. She said the Centers for Medicare and Medicaid Services is "doing everything it can to ensure that they're doing a quick review, a thorough review of all the waiver requests before them."
Gov. Charlie Baker is also seeking federal approval for changes to Massachusetts health insurance programs, moving roughly 140,000 adults off of Medicaid and onto subsidized health plans offered by the Health Connector.
Norton said she did not know details of the Massachusetts waiver, which Baker plans to pursue in tandem with companion reforms at the state level.
The political and policy effects of Obamacare have roiled the country since the law was enacted in 2010, ushering in Republican control of Congress, threatening President Barack Obama's re-election in 2012 and now confounding the Republican-controlled Congress, which has yet to settle on an alternative.
Rising Medicaid expenses in Massachusetts have burdened the state budget and this month led to the adoption of new temporary costs on employers.
President Donald Trump, who has pushed for congressional action on health reforms, has predicted that Obamacare will "implode."
Asked if she agreed with that assessment, Norton said, "If you listen to the statistics about how premiums are increasing, many counties are going bare. It's having a very difficult time right now. It's unsustainable, and it's just unacceptable to put people through what they're going through so we're doing everything we can to shore up the market."
Norton, who is the former lieutenant governor of Colorado, said one example of federal efforts to preserve health care access is the granting of a waiver to Alaska, which she said would "help ensure that more Alaskans are covered and that their premiums will come down."
In Iowa, federal approval for the state's proposal, known as a 1332 waiver, would mean an additional insurer or two might enter the individual exchange market, Heaton told the News Service. Without it, the last remaining insurer, Medica, will leave, he said.
"If we do not get our 1332 accepted, they will be forced to leave," Heaton said after the discussion held at the Boston Convention and Exhibition Center. He said that after Iowa officials submitted their proposal to the federal government, they are now awaiting a response.
Governors around the country have also expressed concerns about Republican-backed proposals in Congress to reduce Medicaid funding in future years.
Sara Rosenbaum, a health policy professor at George Washington University, offered a defense of Medicaid, calling it a "workhorse of the first order" that she said has adapted to meet the changing demands of the populace and provides coverage to roughly 75 million people nationwide
Likening Medicaid to a "hearty perennial," Rosenbaum said the individual markets established by Obamacare are more like a "hothouse flower" in need of a lot of tending.
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