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ML Strategies Health Care Preview Week of July 9th

This week, Congress returns from recess to another four-week work period that will immediately become contentious. Tonight, President Trump is expected to make his Supreme Court pick this week. This could change the dynamics in Congress. With the Senate now able to move a Supreme Court nominee free from the consensus-driving role of the filibuster, will Democrats want to be seen as working with Senate Republicans on any issue? Before Justice Kennedy’s retirement, an opioids package passing Congress seemed plausible bordering on likely. After tonight and the reaction that follows, opioids may be pushed off the table through the election.

Over the weekend, the Trump Administration announced that it would suspend risk adjustment payments. CMS stated the decision to halt payments came after a New Mexico district court decided the payments were based on flawed rules. CMS is seeking a “quick resolution to the legal issues” due to a conflicting ruling in a Massachusetts court which upheld the payments. The decision to freeze risk adjustment payments, however temporary, could negatively impact premiums for plan year 2019 as uncertainly mounts. The impact will vary down to the state and even county level.

Future of Work Requirements 

Late last month, a court blocked Medicaid work requirements from going into effect in Kentucky. The court held that HHS did not adequately consider “whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid.” Should the requirement have gone into effect, over 90,000 people could have lost coverage under the plan.

CMS has approved work requirements for Arkansas, Indiana, and New Hampshire with more states looking at utilizing the requirement in their Medicaid programs. However, this court ruling could slow the momentum toward work requirements as states may have to consider potential legal challenges to their programs. Mississippi, a state with a pending 1115 waiver application with a work requirement provision, has already revamped its application after this ruling.

Arizona, Kansas, Maine, Mississippi, Ohio, Utah, and Wisconsin have work requirement proposals awaiting approval from CMS with more states heading in that direction. You can read more about our coverage of work requirements and Medicaid 1115 Waivers by clicking here.

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About this Author

Rodney L. Whitlock, Mintz Levin, ML Startegies, Health Policy Advisor, Washington DC
ML Strategies - Vice President

Rodney is a veteran health care policy professional with more than 20 years of experience working with the US Congress, where he served as health policy advisor and as Acting Health Policy Director for Finance Committee Chairman Chuck Grassley of Iowa and, earlier, on the staff of former US Representative Charlie Norwood of Georgia.

During his years with Representative Norwood, Rodney managed the Patients’ Bill of Rights, which passed the House in 1999 and 2001. In February 2005, Rodney left the office of Congressman Norwood to join the Finance...

Manager of Government Relations

Prior to joining ML Strategies, Eli was a legislative correspondent for US Senator Martin Heinrich (D-NM), where his experience included health care, education, child welfare, social security, food assistance, and poverty issues specifically as they relate to the Affordable Care Act, Medicare, and Social Security. Previously, Eli served as a legislative intern with Senator Heinrich. He also served as a legislative intern with Senator Dick Durbin (D-IL), where he worked on issues related to education, health, and commerce. Eli has also served as an intern at a political fundraising and strategy firm in Chicago.

Outside of politics, Eli was the founder of MLB Daily Dish, a blog devoted to Major League Baseball. He also was the lead sports writer for ChicagoNow’s Down on the Farm, where he covered the Cubs and White Sox minor league teams.

Katie Weider, Mintz Levin Law Firm, New York, Health Care Policy Director
Director of Health Policy

Katie provides advice and guidance on issues relating to Medicaid, Medicare, and the Marketplace.

Prior to joining ML Strategies, Katie was a senior analyst with the Medicaid and CHIP Payment and Access Commission (MACPAC), a nonpartisan agency that provides Congress, the Secretary of the U.S. Department of Health and Human Services, and states with analysis and recommendations on issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP). There Katie researched, developed, and prepared Medicaid policy recommendations;...