Kansas was one of five states that requested lifetime limits, the others are Arizona, Maine, Utah and Wisconsin.
As President Donald Trump took office, his administration announced a willingness to give states more flexibility in how they run their Medicaid programs, funded through a combination of state and federal dollars. The Kansas proposal is the first the administration has rejected.
Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, told the American Hospital Association that her agency is open to many new ideas about reforming Medicaid but is determined to make sure it “remains a safety net for those that need it most.”
To this end, we have determined that we will not approve Kansas’ recent request to place a lifetime limit on Medicaid benefits for some beneficiaries. We seek to create a pathway out of poverty, but we also understand that people’s circumstances change, and we must ensure that our programs are sustainable and available to them when they need and qualify for them.
The Kansas proposal would have applied the three-year limit only to Medicaid recipients deemed able to work. It would have applied to about 12,000 extremely low-income parents who make up a small fraction of the 400,000-plus total Kansans who receive Medicaid.
The Kansas City Star reports Sheldon Weisgrau, interim executive director of the Alliance for Healthy Kansans, said the Trump administration was right to reject lifetime limits on Medicaid coverage. The alliance is a group of health care providers and disability organizations advocating for expanding Medicaid eligibility to more low-income Kansans.
Patients can now be assured that an arbitrary, bureaucratic time limit would not end their health care coverage in the middle of a critical course of treatment. Patients’ needs change throughout their lives and the programs they depend on should have the flexibility to meet these changing needs.
However, Verma didn’t rule out approving other “community engagement” requirements, including work requirements. Quoted in Fierce Healthcare she said:
We will continue to be supportive of state efforts to help able-bodied, working-age adults rise out of poverty, so they can gain the skills they need to fill the jobs that are available.
Eliot Fishman, a former Medicaid official in the Obama administration now at the liberal advocacy group Families USA, said the decision to reject the request is a positive development. Quoted in The Hill, he said:
“I think it’s major both on its own terms and because it shows that CMS is not just closing its eyes and letting everything through,” noting that there are other major decisions the administration will face on Medicaid as well.