A major coronavirus response law could undermine the Trump administration’s initiatives to give states more cost and quality control over their Medicaid programs.
The Families First Coronavirus Response Act, signed into law by President Donald Trump on March 18, restricts states from controlling improper enrollments in order to preserve the funds for the neediest (see related story, page 16).
Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma had unveiled the “Healthy Adult Opportunity” policy on January 30, describing it as “a vital backstop” for Americans when “life can be turned upside down.”
The policy would give states more flexibility to administer and design their programs as they see fit, Verma told the press at the time.
“It provides rigorous protections for all Medicaid beneficiaries, and for the first time, it aligns financial incentives to improve quality of care and health outcomes,” Verma said.
In exchange for flexibility, states would have more accountability for managing their programs, Verma stated.
“I’ve come to appreciate that it’s not enough to enroll individuals in our programs and call it a day; instead, we must strive to provide high-value, high quality care to our beneficiaries,” Verma said. “That care must help beneficiaries achieve the best quality of life as possible and realize their fullest potential.”
Since 2014, Medicaid has added 15 million working-age adults to the program, according to Verma.
“The program was not originally designed for this group,” Verma said.
State practices for verifying eligibility “are far too lax,” and “we shouldn’t have to tell someone with a disability to get on a waitlist for services because we’re diverting precious resources to cover someone who potentially doesn’t qualify,” Verma stated.
Ashley Bateman (bateman.ae@googlemail.com) writes from Alexandria, Virginia.