Sara Rosenbaum Outlines Concerns Over Waivers in Medicaid Programs

Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy and founding chair of the Department of Health Policy at the Milken Institute School of Public Health, George Washington University, mentions her concerns about states’ decision to include waivers in Medicaid programs.

Do you have concerns about what states may try and include in waivers for their Medicaid programs?
My concern is we’ve yet to see the generation of states, and I’m sure we will actually. Virginia where I live may be one of them may be the first, which tries to couple Medicaid expansion with some steps to make it easier to get in hold a job. I don’t think anybody who worked on that kind of expansion would be under any illusions that somehow that would mean these people wouldn’t need Medicaid anymore.

The point is they are likely to end up at jobs that don’t have benefits. Some will gain a foothold and get jobs with benefits but the issue of how the Medicaid portal can be a way into a lot more social support is a great idea and that is a discussion worth having. There’s been a lot of thinking about that. I think when you start seeing things like penalties for not paying your premiums on time, for not reporting your work-hour changes, if you read the plaintiffs profile in the complaint against the Kentucky case that was recently filed these are people whose pay changes from day to day, they don’t know how many hours they are going to be given on Tuesday when they are done on Monday.

So, to have these repetitive reporting rules and lockout periods and time limits, if you look at the state zone estimates it’s only a calling of the roles they are estimating they are not going to bring more people in.
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