Different states, different attitudes to paying the tab for children’s coverage
Lawmakers in Arizona and Florida saw trouble ahead for children in 2023, as states planned — as the Covid-19 outbreak subsided — to resume disenrolling ineligible people from Medicaid.
So, lawmakers in both states voted to expand a safety net known as the Children’s Health Insurance Program, or CHIP, which covers those 18 and younger in families who earn too much for Medicaid.
Governor of Florida Ron DeSantis (R) and Arizona Gov. Katie Hobbs (D) signed the bills into law last year, giving state Medicaid agencies the green light to seek federal regulators to raise family income limits for CHIP eligibility.
But while Arizona’s plan bucked the Biden administration’s policies, such as keeping eligible children enrolled in CHIP even with unpaid premiums, Florida’s proposal ignored those protections; the state has removed at least 22,000 children from CHIP for unpaid premiums since the rule banning such disenrollments went into effect on Jan. 1.
Obviously there is a division, said Jennifer Tolbert, deputy director of the KFF program on Medicaid and the uninsured. “It could simply be between the policies of the Trump administration and the Biden administration.”
This difference is also evident in relation to the presidential elections of 2024. Former president Donald Trump has suggested he is open to cutting federal aid programs if elected to a second term, while the Biden administration has taken steps to make it easier for low-income people to keep their health coverage.
States’ flexibility to design different CHIP programs is a big reason Republicans and Democrats have supported the federal initiative since 1997, when it was signed into law, Tolbert said.
But how Arizona and Florida have handled CHIP premiums highlights a key ideological conflict over the government’s role in subsidizing health insurance for children.
The Sunshine State eventually sued the Biden administration over the unpaid premium policy, but a U.S. District Judge William Jung dismissed the case on May 31, saying it was up to the federal regulator to decide.
Sarah Lonardofederal spokesman Department of Health and Human Servicessaid in an email that the Biden administration says the law requires states to give children in CHIP the same insurance coverage as children in Medicaid — continuous enrollment for 12 months, even if the premium is not paid.
“No eligible child should face barriers to enrolling in CHIP or risk losing the coverage they rely on to stay healthy,” Lonardo said.
However, Florida officials have said on social media and in legal filings that the state’s CHIP program is a “bridge from Medicaid to private insurance,” intended to acclimate families to premiums, cost-sharing and the risk of losing coverage when they miss a payment. .
Research shows that the cost of premiums can prevent many families from obtaining and maintaining CHIP coverage even when the cost is low.
“Premiums are more about an ideological belief that families need to have skin in the game, rather than any practical way to pay money to support the program,” said Matt Jewettdirector of health policy for the Arizona Children’s Action Coalitiona non-profit organization that promotes health insurance for children.
DeSantis’ office, the Florida Medicaid Agency and the Florida Attorney General Ashley MoodyThe office did not respond to questions about CHIP — or whether Florida will appeal the court ruling.
KFF health news is a national news agency that produces in-depth journalism on health issues and is one of the main operating programs at KFF — an independent source of health policy research, polling and journalism.
Democrats try to repeal Comstock’s abortion rules
This is new: Democrats are pushing to overhaul an 1873 federal law that bans abortion-related materials from being sent through the mail, fearing that a future Trump administration could use the Comstock Act to limit access to the procedure nationwide, The Post reports. And Diamond and Caroline Kitchener the scoop
“There is a very clear, well-orchestrated plan underway by MAGA Republicans to use Comstock as a tool to ban medication abortions and possibly all abortions,” Sen said. Tina Smith (D-Minn.), who plans to introduce legislation today to repeal the 151-year abortion provision. “My job is to take that tool away.
Chance. Elizabeth Warren (mass) and Catherine Cortez Masto (Nev.) and other Democrats have signed on to the legislation, which was drafted in consultation with the Ministry of Justice, according to Smith’s office. Rep. Becca Balint (D-Vt.) will introduce companion legislation in the House, and she said in an interview that she has support from House Democratic leaders.
Yes, but: Not all Democrats agree that repealing the Comstock Act should be an election-year priority, fearing it could distract voters from current efforts to protect access to abortion. Some advocates also question its chances in a divided Congress.
Trump’s stance on invoking the Comstock Act remains unclear. Asked about the law in April, Trump said it was a “very important issue” and promised a “major statement” within two weeks. Almost two months later we are still waiting.
Becerra begins restorative justice journey with support from senators
When he hits the road this week, the Minister of Health and Human Resources Xavier Becerra plans to highlight Biden administration’s efforts to protect access to abortion and other reproductive health care after Supreme Court overturn Roe v. Wade two years ago this month, writes Dan.
“Everyone in America should have access to the health care they need. Period,” Becerra told reporters Tuesday, surrounded by five Democratic senators at HHS headquarters.
One implicit message: the opposite of Trump. While Becerra, as a federal official, could only say so much about GOP challenger Biden, Democratic senators took up the slack.
“One in three women now live under Trump’s extreme or dangerous abortion bans,” Sen said. Debbie Stabenow (D-Mich.), referring to Trump’s appointment of three Supreme Court justices who voted to overturn Roe. “It’s an all-hands-on-deck moment.
Second Goal: Democrats want their message to be broader than abortion.
“We are in this fight to ensure that women everywhere in the United States have access to abortion, access to contraception, and access to IVF,” Warren said.
Next: Becerra plans to visit Nevada, Arizona and Colorado this week and California, New Mexico and Idaho next week. In particular, the Supreme Court is expected to rule this week or next in a case involving Idaho’s strict abortion ban and whether federal law requires hospitals to perform emergency abortions.
Medicaid changes gain momentum after pandemic
This is new: The repeal of pandemic enrollment protections in Medicaid helped prompt states to implement policy changes aimed at simplifying the renewal process for beneficiaries and increasing eligibility for key groups, according to a KFF survey of state Medicaid officials.
Why it matters: Most states have committed to maintaining at least some of these changes beyond the relaxation period and reshaping “business as usual” operations going forward. Here’s a snapshot:
- All but four states are interested in maintaining the waiver flexibility that streamlined the redetermination processsuch as automatic renewal for those without income and longer response times for renewal notices.
- Forty-one countries plan to continue using increased outreachincluding involving health plans and community organizations in the renewal process.
- Thirteen states have adopted or are pursuing continuous eligibility for young children in Medicaid. Nine other states also cover or plan to cover certain adult groups continuously.
The Health Committee encourages interventions for children and adolescents with obesity
A leading panel of independent U.S. health experts urges doctors to refer young people with obesity to programs that offer guidance on healthy eating, safe exercise and understanding food labels, The Post’s Sabrina Malhi reports.
The US Preventive Services Task ForceThe updated guidelines apply to those age 6 or older with a body mass index (BMI) in the 95th percentile. BMI assesses body fat based on weight and height.
The recommendations are in line with the guidelines from 2017, but now the working group recommends going beyond screening and intervention. Some doctors and obesity experts praised the initiative, but others said the panel’s advice should include prescribing weight-loss drugs like Wegovy when warranted.
- This is new: More than half of Democratic women in states with abortion-related ballots say they are more interested in voting in November than in previous presidential elections, according to a KFF survey.
- New York Court of Appeals paved the way for a proposal to amend the state constitution which would ban discrimination based on pregnancy outcomes and protect against government measures that could restrict reproduction from appearing on voters’ ballots in November.
- The Congressional Budget Office estimates the US uninsured rate increases to 8.9 percent for the year 2034a shift that the nonpartisan accountant attributed largely to increased immigration, the expiration of the American Care Act’s expanded subsidies and the rollback of Medicaid protections since the pandemic.
- Nursing homes must conduct a facility assessment to determine the staff and resources needed to meet the needs of residents in accordance with the minimum staffing rule that will come into effect in August, according to revised guidelines from Centers for Medicare and Medicaid Services.
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