With the uncertain future of healthcare reform, President Donald Trump's administration could reduce Medicaid enrollment by approving waiver applications from some states, reports Kaiser Health News.
Here are seven things to know.
1. Senate Republicans' recent efforts to overhaul the ACA have not been successful. The chamber's repeal and replace legislation, called the Better Care Reconciliation Act, failed earlier this month. Senate efforts for a straight repeal of major portions of the ACA without a replacement also failed, as did efforts for a "skinny" repeal bill. Legislation from the Senate, as well as the House-approved American Health Care Act to repeal and replace the ACA, included cutting funding for Medicaid expansion. Legislation put forth in the Senate also included capping federal Medicaid funding to states.
2. Now that various ACA repeal efforts have failed, the White House could use regulatory powers to reduce Medicaid enrollment, according to the report. This would entail approving waivers from a number of Republican-controlled states.
3. Indiana, Arkansas, Kentucky, Arizona and Wisconsin have all applied for waivers to adopt stricter Medicaid eligibility requirements, according to the report. All five states want to adopt work requirements. Wisconsin also seeks approval for a drug-testing requirement. Additionally, Indiana, Kentucky and Wisconsin want to require Medicaid beneficiaries to pay monthly premiums or get locked out of the program, the report states. Maine has not yet applied for a waiver, but also plans to pursue a premium requirement, as well as a work requirement.
4. Josh Archambault, senior fellow for the conservative Foundation for Government Accountability, told KHN the White House "may be even more proactive [now] in engaging with states on waivers outside of those that are already planning to do so." In his interview with the publication, he added the goal with the Medicaid eligibility requirements is to reduce Medicaid enrollment as states try to find ways "to transition able-bodied enrollees into new jobs, or higher-paying jobs."
5. Ultimately, states seeking waivers view the Medicaid eligibility requirements as a way to control their budget for the insurance program, according to the report.
6. However, the report states, those opposed to the waivers have expressed concerns the Medicaid eligibility requirements would be harmful to the needy. Jane Perkins, legal director of the National Health Law Program, told KHN her group "is assessing the legality of work requirements and drug testing and all avenues for challenging them, including litigation."
7. KHN reports the waivers could be approved "within weeks."
Read the full report here.