Payer Roundup—Virginia House backs Medicaid expansion; Ohio set to apply for two new waivers

The Virginia House of Delegates has proposed a budget that would expand Medicaid but also require some beneficiaries to work. (Getty/juststock)

Virginia House backs Medicaid expansion with conservative twist

A key committee in the Virginia House of Delegates on Sunday proposed a two-year state budget that would expand Medicaid in the state.

But the draft budget backed by the Republican-controlled chamber would also add conservative provisions to the program, such as requiring certain beneficiaries to work and imposing cost-sharing requirements. In addition, it requires hospitals to pay for the state’s share of the cost of expanding Medicaid and includes a provision that would end the plan if the federal government ever backs out of its commitment to pay for its share.

“My longstanding concerns about the cost of expansion aren’t going away, but unfortunately the ACA is here to stay and the Trump administration is the best chance to secure conservative reforms,” said House of Delegates Speaker Kirk Cox, a Republican. (Release)

Ohio plans to seek Medicaid, ACA waivers

Officials in Ohio say they plan to file waiver applications with the federal government that would allow the state to stop requiring people to get insurance and to apply for work requirements to its Medicaid program.

The state estimates that the former proposal would have little to no effect, as the GOP tax legislation will end the penalty nationwide imposed on those who fail to comply with the Affordable Care Act’s individual mandate.

As for the latter waiver application, once filed it would add Ohio to a growing list of states that have requested permission to require certain Medicaid beneficiaries to work or complete other community-engagement activities as a condition of eligibility. The state estimates it would affect about 5% of the 700,000 people enrolled in the program as a result of Medicaid expansion (

Iowa’s ‘healthy behaviors’ Medicaid provision not very effective

If an experiment in Iowa is any indication, requiring Medicaid enrollees to engage in certain “healthy behaviors” isn’t an effective way to improve health outcomes.

That’s the conclusion of a new post from Georgetown University’s Center for Children and Families, which examines evaluations of Iowa’s 1115 waiver. The state’s demonstration project, which it implemented four years ago, charges premiums to certain individuals who do not complete one of two wellness exams and complete a health-risk assessment.

However, evaluations of the program show that few members of the Iowa Health and Wellness Plan who are subject to the requirement go on to complete their exam and assessment. One of the issues is general lack of awareness and understanding of the program, which has complicated rules. (Post)

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