Trump Reining In Medicaid Waivers, Further Complicating State Medicaid Budgets
The Centers for Medicare and Medicaid Services (CMS) is paring back on 1115 research and demonstration waivers. Critics say this could increase enrollee churn, undercut finances for providers, and impact innovation. States are already grappling with work requirements as well as reductions to provider taxes used to fund the state share or contribution.
The administration argues that the Medicaid footprint has grown considerably over the years, funded inappropriate areas, and has not lived up to budget neutrality. The administration has defunded social needs waivers and will not renew continuous coverage enrollment.
CMS has informally notified Arkansas that its private option Medicaid expansion under the Affordable Care Act of 2010 will not be renewed. Arkansas is seeking a two-year extension after CMS rejected its five-year renewal. It impacts 200,000 enrollees.
In other news, California’s Medicaid program, Medi-Cal, will reduce its asset limits 84% in July 2027. In 2022, California moved the asset limit from $2,000 to a ridiculous $130,000 for individuals and wanted to drop the asset test altogether at one time, which was approved by the Biden administration. But due to budget difficulties, the asset limit now will drop to $21,000 for singles.
Additional article: https://www.beckerspayer.com/payer/medicaid/medi-cal-plans-brace-for-devastating-asset-limit-crunch/
#medicaid #waivers #coverage
https://www.modernhealthcare.com/politics-regulation/mh-cms-medicaid-1115-waiver-states
Aetna To Withhold Some MA Commissions
Since 2024, major Medicare Advantage (MA) plans have cut or withheld commissions for many enrollments and the trend will continue in 2027. Aetna, the third-largest player, said it will not pay commissions to agents and brokers for selling 123 Medicare Advantage plans in 33 states. The freeze impacts policies in nearly 780 counties, about one-fifth of which are located in Georgia.
Aetna also will not compensate agents and brokers for new enrollments into standalone Medicare Part D prescription drug plans.
#medicareadvantage #enrollment
https://www.modernhealthcare.com/insurance/mh-aetna-medicare-advantage-commissions-2027
— Marc S. Ryan
