health care policy

The Hill: Congress Should Take a Cue from Arkansas

/ Nic Horton / Leave a comment

By a vote of 55 to 32, the Arkansas House voted yesterday to pass HB1465. The bill, sponsored by Republican State Rep. Josh Miller, would require the Department of Human Services to ask the Trump administration for an enrollment freeze in the state’s out-of-control Medicaid expansion program. No existing enrollees would be removed but no new applications would be accepted. The bill provides what could be a blueprint for lawmakers in D.C. who are looking for options to unwind ObamaCare.

HB1465 flew through the Arkansas House Public Health & Welfare committee earlier this week by a vote of 13-6, even garnering the support of some previous Medicaid expansion supporters, including Committee Chairman Rep. Jeff Wardlaw. Wardlaw, who voted for the initial expansion in 2013, was a Democrat at the time, but switched parties last November, just weeks after the election.

And Wardlaw is not alone. Yesterday, on the floor of the House, multiple members of both parties who have previously supported Medicaid expansion voted in favor of Miller’s commonsense proposal. Many of them voted for the original expansion proposal back in 2013.

The progression of HB1465 through the legislature is demonstrative of the political realignment happening not just in Arkansas but in expansion states across the country. Continue reading →

Advertisement

NRO: Welfare Reform Can Flourish In the Post-Obama Era

/ Nic Horton / Leave a comment

wi-state-capitol-1-848x0-c-defaultAs the dust of the Obama administration continues to settle, a trend is growing across the country: State leaders are stepping up to tackle big problems in their welfare systems. Specifically, states are moving away from policies that promote long-term dependency and towards reforms that are pro-work and pro-independence.

As recently as two years ago, for example, 42 states had a policy of partially or fully waiving work requirements for non-disabled, childless adults on food stamps. Today, however, just seven states are waiving these work requirements entirely and many states with partial waivers are moving to eliminate them. Now one governor is pushing the envelope even further. Continue reading →

The Hill: Unwinding ObamaCare Could Make Arkansas A Model for the Nation

/ Nic Horton / Leave a comment

ar-largemap

When Arkansas legislators and then-Governor Mike Beebe expanded Medicaid to able-bodied adults through ObamaCare, supporters claimed their plan was something other states were closely watching and, before it was even implemented, was serving as a national model. What unfolded, however, was a fiscal and moral disaster that no other state dares to fully replicate.

Recent reports indicate that Arkansas’ ObamaCare experiment is nearly twice as expensive per-person as a conventional Medicaid expansionwould have been. If that weren’t bad enough, more able-bodied adults signed up for this welfare expansion than state officials promised would ever even be eligible.

Now as state taxpayers begin feeling the brunt of budget shortfalls and skyrocketing enrollment, one Arkansas lawmaker is working to stop the bleeding. Continue reading →

IL Policy: How Illinois Can Turn Its Medicaid Program Into a True Safety Net

/ Nic Horton / Leave a comment

illinois medicaidPolicymakers in the Land of Lincoln have some important work to do this year to preserve limited state resources for the truly vulnerable. Stopping the enrollment of able-bodied adults in Illinois’ Medicaid expansion program, and instituting work requirements for able-bodied adults in Medicaid are necessary to safeguard the program for Illinoisans most in need of services.

A Medicaid enrollment freeze waiver can preserve resources for truly needy Illinoisans
To stop Medicaid expansion enrollment, Illinois policymakers should ask the Trump administration for an enrollment freeze waiver. The program is devouring state tax dollars that could go to help Illinois’ truly needy residents, including the 18,000-plus Illinoisans on Medicaid’s Prioritization for Urgency of Need for Services waiting list. An enrollment freeze waiver would allow state officials to stop the hemorrhaging of Medicaid dollars and begin to immediately prioritize truly vulnerable Illinoisans once again.

Medicaid work requirements can prevent the safety net from becoming a poverty trap
But that’s just the beginning of what Illinois officials must do to reform the state’s overgrown and unsustainable Medicaid system. The state should also request a waiver to institute work requirements for all able-bodied adults in Medicaid. Medicaid’s safety net has become a web that traps too many Illinoisans in dependency. But with the requirements in place, the truly vulnerable and taxpayers will find much-needed relief. Equally important, enrollees will be better able to transition to self-sufficiency.

Currently, Illinois’ Medicaid program is operating as a welfare trap – a system that encourages individuals to remain in dependency indefinitely and penalizes them if they try to leave. There’s perhaps no better proof of this phenomenon than the number of Illinoisans who are in the Medicaid program and not working at all.

According to the most recent data from the U.S. Census Bureau, less than one-third of all able-bodied, working-age Medicaid enrollees in Illinois work full time. By contrast, nearly 36 percent don’t work at all.

In addition, according to data from the Department of Healthcare and Family Services, nearly 54 percent of able-bodied adult enrollees in the Medicaid expansion reported no income at all in 2015. Continue reading →

IL Policy: How Illinois Can End Its Medicaid Nightmare

/ Nic Horton / Leave a comment

il-largemapIllinois’ Medicaid program has spiraled out of control. Since opting to expand Medicaid through Obamacare, the state has enrolled roughly 650,000 able-bodied adults – nearly twice as many as the state said would ever even qualify, much less enroll. Over that same period, 752 truly needy Illinoisans have died on a waiting list for medical treatment. And with a large Obamacare bill due in less than a month, policymakers should start working now to put the brakes on this nightmare.

Thankfully, simple, tested and effective policy solutions exist to the challenges facing the state. By freezing enrollment in its Medicaid expansion program, Illinois can immediately begin protecting resources for its truly vulnerable citizens and help Illinoisans currently trapped in welfare get back on the path to independence. In addition, lawmakers would immediately provide much-needed relief to overburdened state taxpayers.

Enrollment freezes are simple: Rather than pulling the plug on the expansion program overnight, the state would allow current enrollees to stay for the time being, but would stop enrolling new members. This allows lawmakers to gradually wind down the program over time, but immediately free up resources for the truly vulnerable.

Continue reading →

Forbes: The Next Big Thing In Health Care

/ Nic Horton / Leave a comment

By Josh Archambault and Nic Horton

Why should the exact same treatment for pneumonia cost $5,000 in one building and $124,000 in another? Or the exact same infusion drug for a chronically ill patient that requires them every six weeks cost $14,000 per shot in one setting, but $28,000 down the street? Why should patients have to pay so much more, simply based on where they park their cars? The answer is simple: they shouldn’t.

But the black box of pricing leaves patients in the dark. As a result, the financial futures of too many American families are in jeopardy as their paychecks fail to keep up with skyrocketing health care costs.

Continue reading →

Townhall: AR Wants To Give ObamaCare Welfare For People Who Already Have Insurance

/ Nic Horton / Leave a comment

Arkansas’ Obamacare expansion, commonly known as the “Private Option,” has been a nightmare. Costs have run significantly over budget and the truly needy are being pushed to the back of the line. The Government Accountability Office reported that Arkansas’ approach was simply a more expensive way to expand Obamacare. And, surprise, the promised economic stimulus from expansion never materialized.

The program has proven wildly unaffordable for taxpayers and has become a political landmine for state legislators. Facing mounting cost overruns and serious questions about long-term sustainability, the legislature and governor agreed last year to terminate the expansion at the end of 2016.

But now Governor Asa Hutchinson has decided that the state desperately needs to keep Obamacare expansion and has called a special session that will begin April 6th to extend it. Hutchinson’s plan will also make cosmetic tweaks to the expansion and give the program a new, Orwellian name: “Arkansas Works.”

One of the key bugs, errr, “features” of this new plan is to begin utilizing employer-sponsored health insurance plans for Medicaid expansion enrollees. But there are several elements of this proposal that are cause for serious concern. Continue reading →

FGA: The ObamaCare Expansion Enrollment Explosion

/ Nic Horton / Leave a comment

Last week, the Foundation for Government Accountability released a new report on the exploding enrollment in ObamaCare expansion across the country. The report, authored by Jonathan Ingram and Nic Horton, finds that all 17 expansion states with available data were over their Year 1 enrollment projections — by an average of 91 percent. In addition, 16 of the 17 states are already over their projected maximum total enrollment, by an average of 61 percent.

Screenshot 2015-04-27 13.51.56

From the report:

Across the country, states that opted into ObamaCare’s Medicaid expansion have seen the number of able-bodied adults on welfare skyrocket beyond expectations. In fact, after just one year of ObamaCare expansion, several states have already seen more adults sign up for Medicaid welfare than they thought would ever sign up or even be eligible.

Some politicians have cited these enrollment surges as signs of immense “success.” Taxpayers might disagree, as the economic consequences are sure to be severe. The Congressional Budget Office predicts that Medicaid expansion will discourage work and shrink the economy.1 Recent research suggests that as many as 2.6 million able-bodied adults could drop out of the labor force as a result.2 But the generational burden for future taxpayers to fund this welfare enrollment explosion is now mounting at a faster-than-expected rate, which means higher costs and even more truly needy Medicaid patients put on the chopping block.

The report was released on April 20, 2015. You can view it here.

Forbes: Is AR Violating Federal Law By Not Verifying Eligibility For Its Obamacare Expansion?

/ Nic Horton / Leave a comment

By Nic Horton, Jonathan Ingram, and Josh Archambault

Arkansas’ Obamacare expansion has been a policy disaster and a political landmine, but supporters may have to add violating federal law to their list of problems. Internal e-mails from the Arkansas Department of Human Services reveal that the state has not bothered to verify that individuals enrolled in Obamacare’s Medicaid expansion are still eligible for benefits. This revelation comes with several legal and policy implications and should serve as a wakeup call to state legislators across the country.

Arkansas Hasn’t Verified Eligibility Of Obamacare Expansion Enrollees

Internal e-mails from the Arkansas Department of Human Services reveal that Arkansas has yet to begin verifying whether individuals enrolled in Obamacare’s Medicaid expansion are still eligible for benefits.

Forbes King

Federal law requires states to verify Medicaid enrollees’ eligibility at least once per year, and more frequently if the state receives information indicating they may no longer be eligible. But John Selig, director of the Arkansas Department of Human Services, recently admitted that not a single redetermination had ever been done for those enrolled in the Medicaid expansion.

Selig explained that he hopes to begin eligibility verification later this month, but the state began enrolling individuals in the expansion in October 2013 – more than 18 months ago. Really, the state should have already begun checking eligibility. Continue reading →