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Archive: Medicaid

Capitol Connector
Your source for the latest updates from Capitol Hill. We translate policy into practice so you can learn how policy trends will affect your work and how best to prepare.

House Committee Sends Opioid Package to House Floor

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Thursday, the House Energy and Commerce Committee reviewed remaining opioid legislation to be included in a large package aimed at addressing the opioid crisis, an effort which began last week in the full Committee. The Committee approved 32 bills, a week after approving another 25 opioid measures, bringing the total up to 57. Bills that advanced this week include provisions to loosen both the Institution for Mental Disease (IMD) rule on residential substance use disorder (SUD) treatment and privacy rules governing SUD treatment records, promote best practices for recovery housing and to ensure mental health and SUD parity in the Children’s Health Insurance Program (CHIP).

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CBO Releases Economic Outlook, Future Health Care Spending Report

April 19, 2018 | Federal Budget | Medicaid | Medicare | Comments

Samantha Sears

Behavioral Health Policy and Practice Intern

The Congressional Budget Office (CBO) projects the country’s annual budget deficit will reach $1 trillion by 2020 in a new report released this week. The annual report was delayed this year to incorporate analysis on the impact of the Tax Cuts and Jobs Act passed in late 2017. The report highlights not only growing deficits but also growing health care spending for programs like Medicare, Medicaid and social safety net programs.

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Trump Orders Review of Medicaid, Other Safety-Net Programs

April 12, 2018 | Medicaid | Comments

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Tuesday, President Trump signed an executive order directing federal agencies to initiate a review of social safety-net programs, including Medicaid. The stated goal of the review is to have fewer individuals enrolled in Medicaid and other safety-net programs and increase their workforce participation. The order will likely provide momentum to Medicaid work requirement proposals from states and could expand to large-scale entitlement reform. The National Council strongly opposes work requirements and any other proposal that would seek to limit ability of individuals with mental illness and addiction to receive care through Medicaid.

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Advocacy Coalition Promotes Therapeutic Family Care on Capitol Hill

March 22, 2018 | Children and Youth | Medicaid | Comments

Samantha Sears

Policy and Practice Improvement Intern

Last week, a coalition of family and foster care organizations hosted a congressional staff briefing advocating for the inclusion of Therapeutic Family Care (TFC) as a reimbursable service through Medicaid nationwide. TFC provides standardized care in a community-based setting for children who would instead be treated in group homes or institutionalized care settings. TFC is currently only reimbursable as a distinct Medicaid service via a demonstration program in Utah, though many states offer access to TFC via the rehabilitation option in Medicaid.

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Trump Releases Budget Proposal, Seeks Medicaid Cuts and Opioid Funding

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

On Monday, President Trump unveiled his Fiscal Year (FY) 2019 budget request — detailing his Administration’s legislative and regulatory priorities for next year. The document revives last year’s failed attempts to block grant Medicaid, boosts spending to combat opioid addiction, and outlines other major health care priorities. As with most presidential budgets, this proposal stands little chance of being enacted into law as written. Instead, the President’s budget proposal will act more as a messaging tool to Congress, which just passed a major budget deal boosting defense and non-defense discretionary spending limits last week.

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Medicaid Work Requirements to be Enacted in Indiana

February 8, 2018 | Addictions | Medicaid | Waivers/SPAs | Comments

Katiri Zuluaga

Manager, State Initiatives

Indiana is now the second state to receive approval from the Centers for Medicare and Medicaid Services (CMS) for a waiver request that imposes work requirements on Medicaid beneficiaries to maintain coverage. Indiana’s Section 1115 waiver also enacts a Substance Use Disorder (SUD) Program which will include coverage for residential treatment in Institutions for Mental Disease (IMD) and will increase premiums for beneficiaries who use tobacco and are not engaged in tobacco cessation activities. The National Council for Behavioral Health strongly opposes work requirements and any attempts to restrict access to needed behavioral health services.

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Senate Approves Azar as HHS Secretary

January 25, 2018 | ACA | Medicaid | Medicare | Comments

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

The Senate voted to confirm former pharmaceutical executive Alex Azar as the new Secretary of Health and Human Services (HHS) on Wednesday. Six Democrats and Independent Sen. Angus King (I-ME) joined all but one Republican Senator in supporting Azar. As the nation’s top health official, Azar will oversee critical health programs like Medicaid and Medicare and take over the implementation of the Affordable Care Act (ACA). Azar’s confirmation gives HHS its first permanent leader since September, when former Secretary Tom Price resigned due to a scandal regarding his use of public funds for travel.

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CMS Approves First-Ever Medicaid Work Requirements in Kentucky

January 18, 2018 | Medicaid | Waivers/SPAs | Comments

Katiri Zuluaga

Manager, State Initiatives

In a historic first, the Centers for Medicare and Medicaid Services (CMS) approved Kentucky’s Section 1115 waiver request that imposes work requirements on Medicaid beneficiaries to maintain coverage. The National Council for Behavioral Health strongly opposes work requirements and believes that work requirements not only prevent individuals with mental health or substance use disorders from receiving the treatment they need, but are in opposition to the core mission of Medicaid. Nine other states have pending work requirement waivers; however, any approvals will likely be challenged in court delaying their implementation.

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CMS Issues Guidance Allowing Medicaid Work Requirements

January 11, 2018 | Medicaid | Waivers/SPAs | Comments

Stephanie Pellitt

Policy and Advocacy Associate

On Thursday, the Trump Administration released guidelines for states to create the first-ever work requirements for Medicaid recipients. The guidance targets “able-bodied adults” with some exemptions. While details are still emerging, the National Council has grave concerns that the policy’s exemptions will not be broad enough to protect all individuals with mental health and substance use disorders. Ten states have asked the federal government for approval to institute Medicaid work requirements. With this new guidance, the Administration is expected to begin approving these requests.

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HHS Nominee Appears Before Senate Finance Committee

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

The Senate Finance Committee held a confirmation hearing on Monday on the nomination of Alex Azar as Secretary of Health and Human Services (HHS). This is the second hearing on his nomination Mr. Azar has participated in. In late 2017, he appeared before the Senate Health, Education, Labor and Pensions Committee. The Finance Committee will vote on his nomination in the coming weeks.

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What to Watch for in Health Care in 2018

January 4, 2018 | ACA | Federal Budget | Medicaid | Medicare | Comments

Stephanie Pellitt

Policy and Advocacy Associate

Members of Congress returned to Capitol Hill this week following a holiday break. Neither chamber starts the new year with a clean slate, however, as Congress faces deadlines on government funding and a host of individual programs after voting to delay those decisions at the end of last month. Congress has less than three weeks to avert another government shutdown as well as sort through several competing health care priorities. Here is a preview of what to watch for in early 2018.

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Congressional Briefing Highlights Medicaid’s Role in Addiction Treatment

December 14, 2017 | Addictions | Medicaid | Comments

Stephanie Pellitt

Policy and Advocacy Associate

On Wednesday, the Partnership for Medicaid, a coalition that includes the National Council, hosted a Congressional briefing on the importance of Medicaid in supporting innovative addiction care. The day’s discussion focused on how Medicaid provides individuals with substance use disorders access to comprehensive care that not only addresses their addiction, but their physical and mental health needs. The briefing featured testimony from National Council member Mark Miller of Swope Health Services, who highlighted how Certified Community Behavioral Health Clinics (CCBHCs) are leading the way in behavioral health care innovation and expanding access to addiction treatment.

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Alex Azar Nominated to Lead HHS

November 16, 2017 | Medicaid | Medicare | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

President Trump, on Monday, nominated former pharmaceutical executive Alex Azar to be his next Secretary of Health and Human Services. Azar, who spent most of the last decade at Eli Lilly and Co., previously served for six years in the George W Bush administration – first as General Counsel for four years and then as Deputy Secretary for two years under President George W. Bush. The Senate will consider his nomination later this month.

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CMS Administrator Encourages Work Requirements in Medicaid’s New Direction

November 16, 2017 | Medicaid | Waivers/SPAs | Comments

Katiri Zuluaga

Manager, State Initiatives

Last week, the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma gave a speech that further elaborated on new guidelines and priorities for Medicaid waivers. The Administrator’s comments to State Medicaid Directors included encouraging states to submit Section 1115 waivers that include work requirements, using the term “community engagements” to describe work requirements for able-bodied adults.

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CMS Issues New Guidance on Waivers of IMD Rule

Stephanie Pellitt

Policy and Advocacy Associate

On Thursday, the Centers for Medicare and Medicaid Services (CMS) issued a letter to State Medicaid Directors outlining a new waiver process to allow Medicaid payment of a broad range of services for opioid and other substance use disorders (SUD), including residential treatment. The letter, issued in response to President Trump’s declaration of an opioid public health emergency, promises states a “more flexible, streamlined” 1115 Medicaid waiver approval process to accelerate state’s ability to respond to the opioid epidemic. While this move could present an opportunity for states to expand their continuum of care for addiction, strict budget neutrality requirements and heightened state reporting requirements may prove too burdensome for states to realistically pursue this option.

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Congress to Maintain Focus on Transforming Medicaid in FY2018

October 5, 2017 | Federal Budget | Medicaid | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

The new budget rules proposed in the House and Senate make clear that Congress will remain focused on passing sweeping, fundamental changes to the American health care system and Medicaid in FY2018. Though the narrative currently centers on tax reform, it is widely believed that if passed, immense cuts to Medicaid could help finance the Trump Administration’s tax reform plan. For mental health and addiction advocates, FY2018 is another year for advocacy, engagement and education.

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Senate Will Not Vote on Graham-Cassidy, Will Move to Tax Reform

September 28, 2017 | ACA | Medicaid | Comments

Shelley Starkey

Project Assistant

On Tuesday, Senate Majority Leader Mitch McConnell (KY) announced that the Senate would not be voting on the Graham-Cassidy health care bill before September 30. This news came after a GOP-only lunch where it was clear the bill did not have the 50 needed votes to secure passage. Senators Susan Collins (ME), John McCain (AZ) and Rand Paul (KY) all came out against the bill earlier this week. In a press conference following the announcement, Leader McConnell said the chamber will now shift its focus to tax reform.

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National Council to Co-Host Congressional Briefing on Opioid Epidemic and Medicaid

September 28, 2017 | Medicaid | Opioid and Heroin Epidemic | Comments

Katiri Zuluaga

Manager, State Initiatives

On Tuesday October 3rd, the National Council will co-host a congressional staff briefing in conjunction with Hill Day 2017. The briefing – sponsored by Senator Sheldon Whitehouse (D-RI) – will highlight the Thomas Scattergood Behavioral Health Foundation and Peg’s Foundation’s  Spring Paper Series: a series of research papers focusing on critical topics like the nation’s opioid epidemic, criminal justice reform and Medicaid behavioral health policies.

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GOP Health Care Bill Marches Forward in Senate

September 21, 2017 | ACA | Medicaid | Comments

Shelley Starkey

Project Assistant

The latest plan from the GOP to cap Medicaid and cut expansion is moving in the Senate with a committee hearing and a floor vote by the end of next week. The bill – authored by Senators Graham (R-SC), Cassidy (R-LA), Heller (R-NV) and Johnson (R-WI) – would turn critical federal funding for Medicaid into per capita caps or block grants for states, leaving cash-strapped states with fewer resources for critical care like mental health and addiction services.

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New GOP Health Care Plan Caps Medicaid, Cuts Expansion

September 14, 2017 | Medicaid | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

Four GOP Senators have introduced the latest iteration of health care legislation in the Senate. The bill, introduced by Sens. Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI) revives some of the most troubling elements of previous health care bills, including undermining the Medicaid expansion and imposing a per-capita cap on federal Medicaid funding. The National Council opposes this legislation as it harms Americans in need of comprehensive mental health and addiction treatment services.

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