Medicaid was established in 1965 by President Lyndon B. Johnson. It was designed as a federal and state program designed to give a safety net to those in the nation that are too poor to afford healthcare on their own. It also has benefits that other government programs like Medicare don't cover, like nursing home and in-house medical services.
Since 1965, it has done just that. Currently, it is the largest source of medical funding for low-income people in the country. As of 2017, Medicaid plans provided free health care to 74 million people.
The Affordable Care Act help expand the pool even more.
Every year, when Congress re-litigates it's yearly budget, Medicaid is subject to change. This is even truer in 2018.
Important Changes to Medicaid Plans in 2018
Because of its size, Medicaid is often the first thing to receive funding cuts when the government appropriates its budget. This is especially true now that we have a Republican president and Republican-dominated Congress that are philosophically opposed to the idea of government assistance.
They've introduced a lot of changes to Medicaid plans in 2018. Here are the biggest ones to look out for.
New Work Requirements
Under our current system, qualifications for Medicaid are based entirely on income, but now, the Trump administration has allowed states to introduce work requirements in order to be eligible for Medicaid.
The Trump administration has suggested that states introduce work requirements that follow similar guidelines as the existing work requirements for federal food stamps and other welfare programs. These programs generally require that someone has to work 20 to 30 hours a week in order to be eligible for food stamps.
But since states are responsible for actually running Medicaid, they get to decide how to ultimately implement the work requirements to receive Medicaid plans.
The Trump administration has suggested that states waive work requirements for the pregnant and disabled, or those undergoing drug treatment. However, it offers no actual legal requirement for the states to do so.
If you're already working, you have no reason to worry. But if you're currently pregnant, disabled or unemployed and rely on Medicaid, stay on top of your state's new Medicaid legislation.
Medicare Part B Cutbacks
Medicare Part B typically has caps on how much physical therapy one can receive on the plan. However, there have traditionally been exceptions to these caps. But this year, Congress did not extend those exceptions into 2018.
This means if you're someone in need of physical therapy you could potentially hit your cap pretty quickly and be forced to lose care or pay out of pocket.
There is some hope that these exceptions will be re-introduced but you might be at risk of hitting your caps in the meantime.
Less Penalties For Nursing Homes
According to CNN, 40% of the 6,500 nursing homes in America have received fines for care violations since 2013. Because of this, the Trump administration has eased the penalties for nursing homes in 2018 in the hopes of doing away with unneeded bureaucracy.
Critics of this plan, however, say that this will make it easier for nursing homes to abuse or neglect its Medicare and Medicaid patients.
Wisconsin Approves Drug Testing Medicaid Recipients
In a move that will increase government bureaucracy in regard to Medicaid, Scott Walker has proposed a drug test requirement for childless adults in the state of Wisconsin.
This plan affects 148,000 of the 1.2 million Wisconsinites on Medicaid plans. Since proposing this plan, Walker has exempted Medicaid recipients willing to enter themselves into a drug treatment program.
This plan also has an added requirement for Medicaid recipients. It now limits childless adults to four years of Medicaid benefits, unless they meet the program's work requirements.
Once an unemployed Medicaid recipient is either looking for a job or working for at least 80 hours a month, they can regain their benefits.
Maine Imposes New Medicaid Requirements
If you thought Wisconsin's Medicaid requirements went too far, Maine's requirements go even further.
The state's governor, Paul LePage wants to provide upfront assets test for Medicaid recipients, meaning that the government could require you to provide bank account information, property values and more.
LePage also wants to institute other work requirements that would limit Medicaid enrollment.
Medical Expense Tax Relief
In 2017, the federal tax plan allowed taxpayers to deduct medical expense that exceeded 10% of their taxable income. Many feared that once in power, the GOP would eliminate this tax benefit, which has proved to be helpful for low-income taxpayers.
Thankfully, the GOP actually lowered the threshold so that medical expenses that exceeded 7.5% of your taxable income could be deducted. This tax break will last until 2020 when the threshold will rise back to 10%.
Medicaid Referendums Across The Country
Voters in several different states have voted or are voting on referendums to increase Medicaid expansion in their states in 2018.
Maine actually successfully voted for Medicaid expansion but has been blocked by Gov. LePage until the government allocates funds for that expansions, so the fight is not over there.
On top of that, organizers in Utah, Idaho, and Nebraska have been working to put Medicaid expansion legislation on their general election ballots in November of 2018.
So if you live in either of these states and want to see Medicaid expansion, make sure to drum up support and get out the vote in late-2018.
Medicaid: Always A Battleground
Every year, the same battle is waged between Democrats and Republicans over Medicaid budgeting.
This year, with full control of the executive and legislative branches of governments, Republicans have made significant strides in reducing funding or imposing new restrictions for Medicaid recipients.
As a citizen who relies on Medicaid for healthcare, it is important to keep on top of the latest developments in Medicaid policy.
Hopefully, this rundown of Medicaid has helped you do just that.
If you happen to run a hospital and need help managing your patients' healthcare eligibility, consider contacting us.
Good luck out there! The American healthcare system can be a bureaucratic nightmare, but with the help of qualified, knowledgeable professionals it doesn't have to be.
Pete is the Vice President of Sales & Client Services at DECO Recovery Management. He covers the Mid Atlantic region and specializes in Medicaid related topics. It is DECO’s Mission to maximize reimbursement to our clients by leveraging innovative technology, processes and compassionate advocates to provide exemplary service.