What We're Reading: Medicaid Work Rules; Suicide Risk in Managed Care; Eradicating TB

April 1, 2019

CMS approves Utah Medicaid work requirements after a federal judge overturns rules for Arkansas and Kentucky; youth suicide risk in Missouri grows with the shift to managed care; CDC says a goal of eliminating tuberculosis by end of 21st century unlikely.

CMS Approves Medicaid Work Requirements in Utah in Wake of Federal Rulings for Arkansas and Kentucky

Shift from Medicaid to Managed Care Associated With Increased Suicide Risk Among Missouri Youth With Mental Illness

CDC: Goal of Eliminating Tuberculosis Unlikely as Pace of Decline Slows

CMS gave Utah permission to impose work requirements on Medicaid beneficiaries less than 48 hours after a federal judge struck down requirements in Arkansas and Kentucky, reported Kaiser Health News. In her approval letter, CMS Administrator Seema Verma said that Utah's program is structured differently from other states and that requiring Medicaid recipients to work will help make them healthier. CMS' approval also allowed Utah to cap Medicaid enrollment if spending exceeds what the state budget allocates for the program. On Wednesday, Judge James Boasberg of the US District Court for the District of Columbia remanded Medicaid work requirements for Arkansas and Kentucky back to CMS for more review, saying waivers for the 2 states did not achieve the 1965 law's primary objective of providing healthcare. Arkansas Governor Asa Hutchinson said last Thursday he will ask the Trump administration to appeal the ruling. Following the ruling, Arkansas legislators failed to reauthorize funding for the Medicaid program, according to The Hill. The Arkansas House voted 52-28 in favor of allocating more than $8 billion for the state Division of Medical Services, which didn’t secure the three-quarters majority needed to pass the budget.The percentage of suicide attempts or suicidal thoughts nearly doubled among 2000 Missouri children diagnosed with mental illness after shifts from traditional Medicaid to 3 for-profit managed care companies, according to Kaiser Health News. The average length of stay at psychiatric hospitals fell from 10 to 7 days following the change in May 2017. The hospital association called on state Medicaid officials to investigate the findings concerning youths covered by the state-federal program for low-income families. Other factors, such as lack of access to specialized mental health care, cyber-bullying, and use of social media were thought to contribute to the increase. The hospital association said that Missouri’s suicide rate increased from 2.8 per 100,000 children in 2003 to 6.4 per 100,000 children in 2017, and 735 Missouri youths died by suicide during that time period. Nationwide, CDC data show teen suicide rates have increased more than 30% since 2007.The CDC says that while cases of tuberculosis (TB) have been falling, the pace of its decline falls short towards the goal of eradicating the disease in the United States by the end of the 21st century, The Washington Post reported. The pace of its decline slowed by 1.3% between 2017 and 2018, compared to the 4.7% overall decline between 2010 and 2014. TB has been most prevalent in Alaska while 4 states, including California, New York, Florida, and Texas, have accounted for nearly half of all reported cases in 2018. The disease is caused by bacteria that attack the lungs and can affect other parts of the body. While the majority of cases can be treated or cured with medication, some strains of the virus are drug-resistant. The disease can be deadly if left untreated.