Medicaid Waiver News (Washington Update July 25, 2018)

Kentucky Waiver

As reported in the July 3 Washington Update (under “Courts”), a federal court vacated the Department of Health and Human Services (HHS) approval of a Kentucky Medicaid waiver proposal to impose work requirements on Medicaid beneficiaries. The ruling does not affect the status of other state work-requirement waivers. See Verma: Court Ruling Won’t Close Door on Other Medicaid Work Requests (Politico, 7/17/18). The basis of the court’s decision was the failure of the Centers for Medicare and Medicaid Services (CMS) to consider a “salient factor” in deciding to grant a waiver – the waiver’s impact on furnishing medical assistance.

On July 18 CMS announced that it would provide another 30-day public comment period for the Kentucky waiver. The comment period ends on August 18. See Trump Administration to Give Kentucky Medicaid Work Requirement a Second Chance (Washington Post, 7/20/18).

Mississippi Waiver

Mississippi has also requested a waiver to establish work or community engagement requirements for Medicaid beneficiaries. Under that proposal, those who are employed the required number of hours and get paid minimum wage will then make too much to qualify for Medicaid. (Those who meet non-paying community engagement requirements would still be eligible.) In light of an amendment to the waiver proposal, CMS is providing another comment period for the Mississippi proposal as well. Comments are due on August 18.

Other States’ Waiver Proposals

Waiver proposals from several other states are also open for public comment: Rhode Island’s global waiver renewal (due August 17); Maine’s Demonstration for Individuals with HIV/AIDS (due August 18); Maryland’s Health Choice (due August 18); Utah’s Primary Care Network (due August 11); Delaware’ Diamond State Health Plan SUD Amendment (due August 12); and Delaware’s Diamond State Health Plan Extension (due August 12).

Kentucky Will Re-Establish Medicaid Vision and Dental Benefits

After the court ruling vacating approval of Kentucky’s Medicaid work-requirement waiver, Governor Matt Bevin (R), announced that the state would no longer provide vision or dental benefits for the adults in the Medicaid expansion population. On July 19, the state announced that these benefits would be restored, retroactive to July 1. See Reversal: Kentucky Restoring Medicaid Benefits for Thousands (Associated Press, 7/20/18).