Congress has shut down the government. And this time, the Children's Health Insurance Program is caught in the crosshairs. Republicans are offering six years of funding for CHIP as an enticement for Democratic votes on the spending bill, but Democrats are still balking because they want the bill to include protections for undocumented individuals brought to the U.S. by their parents when they were children.
Meanwhile, with the help of the Trump administration, states are looking at other ways to change the Medicaid program besides work requirements.
And Tom Scully, former head of the Centers for Medicare & Medicaid Services under President George W. Bush, offers his predictions for what might happen this year in health policy. His short answer: not much.
This week's "What The Health?" panelists are Julie Rovner of Kaiser Health News, Stephanie Armour of The Wall Street Journal, Joanne Kenen of Politico, Sarah Kliff of Vox.com, Alice Ollstein of Talking Points Memo, Margot Sanger-Katz of The New York Times and Paige Winfield Cunningham of The Washington Post.
In the podcast's first live taping before an audience, the panelists discuss these topics as well as whether states will pass their own individual insurance requirements now that the penalty for the federal "individual mandate" has been repealed, how the loss of that penalty will change the individual marketplaces and whether anyone will address the high cost of prescription drugs.
Among the takeaways from this week's podcast:
Although CHIP has long enjoyed a reputation as having bipartisan support, it appears that House Republicans are less committed to the program than in past years. The addition of a work requirement gained many of the headlines in the Trump administration's Medicaid waiver for Kentucky, but other important changes were given a green light, too. They include jettisoning the long-standing practice of giving enrollees retroactive coverage if they were eligible for it at that time, charging premiums, and locking people out of coverage if they fail to provide required premiums or paperwork. Maryland officials are weighing the option of setting up a state-based requirement that people get insurance since the federal government has repealed the Affordable Care Act's penalties for not having insurance. If it passes, other states could follow suit. Scully says one of the biggest issues facing policymakers is trying to fix the gross inequities in Medicaid as different states use it for different populations and programs.
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