National Review: The Biggest Welfare Crisis You’ve Never Heard Of

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Medicaid is out of control and unsustainable. Work requirements could help.

It’s not the lead story on the nightly news, and it’s not generating millions of clicks online. It may be one of the most underreported, underappreciated public-policy crises of our time. That’s a terrifying reality because, left unaddressed, this crisis will come at great cost to America’s most vulnerable.

The Medicaid program is at its breaking point. Even before Obamacare lured some states into expanding the program to non-disabled, working-age adults, Medicaid was growing at an alarming rate. Now, in the Obamacare era, the program is growing even faster, siphoning more and more resources away from folks who truly depend on Medicaid for survival.

A new report, released this week by the Foundation for Government Accountability, gives a glimpse of just how serious the problem is.

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The Hill: Congress Should Take a Cue from Arkansas

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

The Oklahoman: Declining Medicaid Expansion a “Wise Decision”

ok-largemapEarlier this week, The Oklahoman editorial board published an editorial praising Oklahoma policymakers for rejecting ObamaCare’s Medicaid expansion. As evidence, they cited FGA’s new enrollment explosion report.

From The Oklahoman:

During the 2016 legislative session, there was a strong push to expand Oklahoma’s Medicaid program to obtain funding from the Affordable Care Act. Ultimately, lawmakers declined to take that step. It’s proving to be a wise decision…

A recent report by the Foundation for Government Accountability notes that expansion enrollment exceeded projections by 322 percent in California, 276 percent in New York, 134 percent in Kentucky, 90 percent in Illinois, 60 percent in Ohio and 51 percent in Arkansas.

That means the cost of the 10 percent state share for Medicaid expansion will be commensurately higher as well. And federal data shows that Medicaid expansion spending was 49 percent higher per enrollee in 2015 than what was predicted when the law passed in 2010.

At the same time, Medicaid expansion isn’t generating the savings supporters promised, such as lowering the use of emergency rooms for routine care.

You can read the full editorial here.

Forbes: AR DHS Director Misled Lawmakers On Obamacare Waiver

By Jonathan IngramNic Horton and Josh Archambault Mr. Ingram is Research Director, Mr. Horton is Policy Impact Specialist, and Mr. Archambault is a Senior Fellow at the Foundation for Government Accountability.

Arkansas bureaucrats are wasting millions of dollars providing Medicaid benefits to people no longer eligible for the state’s Obamacare expansion. But is that just the tip of the iceberg?

Last month, internal e-mails from the Arkansas Department of Human Services surfaced, revealing that the state had never bothered to verify that individuals enrolled in Obamacare’s Medicaid expansion were still eligible for benefits. According to data provided by state officials, this is costing taxpayers up to $20 million each and every month.

We previously questioned why the state hadn’t started the redetermination process yet – which should have begun months ago. After all, federal law requires states to verify Medicaid enrollees’ eligibility at least once per year.

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Department of Human Services Director John Selig (Photo: Log Cabin Democrat)

As we reported at the time, state officials contended that they had received a temporary waiver from the Obama administration, allowing them extra time to perform the eligibility checks. But it turns out that no formal waiver ever existed. Worse yet, a recent follow-up letter from the Obama administration may generate more questions than answers.

No Waiver Existed

After news broke that the state wasn’t performing the required eligibility checks, a number of reporters and lawmakers reached out for a copy of that waiver. Such a waiver would be pretty important – without it, Arkansas would be violating federal law.

But according to internal e-mails and other communications, no such waiver actually existed. Questions about the redetermination process sent state officials scrambling for cover.

That cover came on April 27, 2015, when the Obama administration retroactively approved Arkansas’ delay for all redeterminations that should have been conducted in 2014. The letter states:

[The Centers for Medicare and Medicaid Services] is now providing Arkansas with authority under section 1902(e)(14)(A) of the [Social Security Act] to delay eligibility renewals scheduled for January 1, 2014 through December 31, 2014 for 9 months, until October 1, 2014 through September 30, 2015. The state will continue to act on changes in circumstances, including changes in income.

Obama’s Letter Provides More Questions Than Answers

Unfortunately, this letter provides more questions than answers. First, it says that the Obama administration is now providing Arkansas the authority to delay its eligibility redeterminations. Does that mean that Arkansas was operating without that authority prior to April 27th? It certainly seems that way.

The Department of Human Services also contends that this letter allows them to delay all redeterminations until September 2015. But that is not, in fact, what the letter says. The letter allows them to delay redeterminations due in 2014 “for 9 months.” While a redetermination due on December 31, 2014 would not be due until September 2015 under this letter, one originally due on January 1, 2014 was actually due back in October 2014. This means that all redeterminations originally scheduled between January and August of last year should already have been conducted.

But even more worrisome is that the letter limits the delay exclusively to “eligibility renewals scheduled for January 1, 2014 through December 31, 2014.”It provides zero authority to delay redeterminations that should have been scheduled in 2015. So why hasn’t the state conducted the mandatory redeterminations that were due in January, February, March and April?

The Redetermination Process Should Have Begun Months Ago

Regardless of whether or not Arkansas’ actions are approved by Obama, they should be worrisome to taxpayers everywhere. The state has yet to redetermine eligibility for a single Medicaid expansion enrollee. By now, the state should have re-checked eligibility for more than 170,000 enrollees. Another 70,000 should be due for verification later this year or early next year.

To make matters worse, the Department of Human Services expects that up to 40,000 enrollees are still receiving benefits even though they’re no longer eligible. If those estimates are correct, taxpayers could be on the hook for up to $20 million per month to provide Medicaid expansion benefits to people no longer eligible.

Worst of all, state officials have facilitated this fraud by asking for waivers and continuing to kick the can further down the road. Meanwhile, nearly 3,000 children and adults with developmental disabilities are sitting on Medicaid waiting lists. Some of them have been waiting eight years or more for their needed home- and community-based services. They continue to wait, while Arkansas bureaucrats provide Obamacare welfare to 40,000 able-bodied adults who aren’t even eligible.

Welcome to Obamacare.

This article originally appeared at Forbes on May 11, 2015.

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

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

Forbes: TN’s Obamacare Expansion Would Give ‘Free’ Cash To The Insured

By Nic Horton, Jonathan Ingram, and Josh Archambault   Mr. Horton is a Policy Impact Specialist, Mr. Ingram is Research Director, and Mr. Archambault a Senior Fellow at the Foundation for Government Accountability.

Gov. Bill Haslam (R-TN), who has previously stood strong against Obamacare expansion, announced just before Christmas that he will push the legislature to create a new entitlement for able-bodied adults in a fast-approaching special session. We’ve previously written on Gov. Haslam’s backroom deal to expand Obamacare and its questionable financing structure.

Legislators still have very little information on the plan, having only sketched out the “basic concepts” and leaving many details blank. The informational packet Haslam recently delivered to legislators, for example, noted that many “operational details will be finalized” at a later date. But what little is known leaves no room for excitement.

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Photo credit: Getty

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Forbes: Will The Real Mike Pence Please Stand Up?

By Nic Horton, Jonathan Ingram  and Josh Archambault  Mr. Horton is a Policy Impact Specialist, Mr. Ingram is Research Director, and Mr. Archambault a Senior Fellow at the Foundation for Government Accountability.

Over the last few weeks, various news reports have fueled speculation that Governor Mike Pence (R-Indiana) may be preparing to walk away from his Obamacare Medicaid expansion plan. This speculation was reignited over the weekend when Pence announced he would reject increased federal funding for the state’s pre-K program, citing the federal government’s “intrusion” as a key reason for his decision. Pence is demonstrating a prudent approach to pre-K funding, and this approach may very well tell us something about his next move on Obamacare expansion. Continue reading