As legislators leave Washington for the August recess with no clear plans to repeal, replace or even repair the Affordable Care Act, states are taking matters into their own hands, proposing Medicaid eligibility changes that include mandatory drug testing and work requirements.
Even in the face of uncertainty, some states are still looking to further expand Medicaid. In North Carolina, Democratic Gov. Roy Cooper is pushing for Medicaid expansion despite opposition from the state’s GOP-controlled legislature. In Maine, a ballot initiative will take up the issue in November.
Meanwhile, some states with Republican governors—including Arkansas, Kentucky, Arizona, Maine, Wisconsin and Vice President Mike Pence’s old stomping grounds, Indiana—are drafting plans that would place restrictions on Medicaid eligibility.
Wisconsin Gov. Scott Walker wants to screen childless, able-bodied recipients of BadgerCare Medicaid coverage for drugs in a bid to get more of them off Medicaid and into the workforce.
Any such plans would have to be approved by the Trump administration. Centers for Medicare & Medicaid Services Administrator Seema Verma and Department of Health and Human Services Secretary Tom Price both support giving states flexibility to redesign their Medicaid programs through waivers.
And if the Trump administration starts approving the waivers, most experts think other states will get similar requirements approved quickly, the publication noted.
“If and when Kentucky and Arizona get approval ... you’ll see a bunch of other Republican states copycat,” said Josh Archambault, a senior fellow at the conservative Foundation for Government Accountability.
“There are limits on what's allowable, and tying eligibility to work or drug testing or some of these other things is not consistent with what should be allowed,” Judith Solomon, vice president for health policy at the liberal-leaning Centers on Budget and Policy Priorities, told The Hill. “That said, we know we now have an administration that likely thinks differently, and we could see some changes in that regard,” she said.
'Nobody gets high marks on healthcare'
Whether reform comes from the federal government, the states or some combination of the two, American voters aren’t happy with the way both Republicans and Democrats have handled healthcare reform.
In a Quinnipiac University poll released on Thursday, 60% of Republicans disapprove of the way their party has handled healthcare in Congress; just 15% approve. Democrats aren’t happy with their party’s efforts by a margin of 59% to 34%.
"Nobody gets high marks on healthcare, but Republicans take a crushing blow,” said Tim Malloy, assistant director of the poll. “The message: Start over and do it right."
Only 22% of American voters say President Donald Trump and Republicans in Congress should repeal the ACA. Another 40% say repeal parts of Obamacare and 33% say don't repeal it at all.
And a whopping 81% of voters, including 76% of Republicans, say there should be bipartisan hearings on any new healthcare law to replace Obamacare.