Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-22T04:40:26.621Z Has data issue: false hasContentIssue false

Struggle for the Soul of Medicaid

Published online by Cambridge University Press:  01 January 2021

Abstract

Medicaid is uniquely equipped to serve low-income populations. We identify four features that form the “soul” of Medicaid, explain how the administration is testing them, and explore challenges in accountability contributing to this struggle. We highlight the work of watchdogs acting to protect Medicaid and conclude with considerations for future health reform.

Type
Symposium Articles
Copyright
Copyright © American Society of Law, Medicine and Ethics 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

42 U.S.C. § 12132 (2020); Olmstead v. L.C., 527 U.S. 581, 583 (1999).Google Scholar
42 C.F.R. §§ 4476.50 – 447.56 (2020).CrossRefGoogle Scholar
Centers for Medicare and Medicaid Services, “About Section 1115 Demonstrations,” available at <https://www.medicaid.gov/medicaid/section-1115-demo/about-1115/index.html> (last visited July 12, 2020).+(last+visited+July+12,+2020).>Google Scholar
Letter from Calder Lynch, Deputy Administrator and Director Center for Medicaid & CHIP Services to State Medicaid Directors, “Healthy Adult Opportunity,” January 30, 2020, available at <https://www.medicaid.gov/sites/default/files/Federal-Policy-Guidance/Downloads/smd20001.pdf> (last visited July 12, 2020).+(last+visited+July+12,+2020).>Google Scholar
Kaiser Family Foundation, “Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State,” March 10, 2020, available at <https://www.kff.org/medicaid/issue-brief/medicaid-waiver-tracker-approved-and-pendingsection-1115-waivers-by-state/#Table3> (last visited July 12, 2020).+(last+visited+July+12,+2020).>Google Scholar
Gresham v. Azar, 950 F.3d 93, 99 (D.C. Cir. 2020); Philbrick v. Azar, 397 F. Supp. 3d 11 (D.D.C. 2019) (New Hampshire); Stewart v. Azar II, 366 F. Supp. 3d 125 (D.D.C. 2019) (second Kentucky decision); Gresham v. Azar, 363 F. Supp. 3d 165, 169 (D.D.C. 2019) (Arkansas); Stewart v. Azar I, 313 F. Supp. 3d 237, 243 (D.D.C. 2018) (first Kentucky decision).Google Scholar
Gluck, A.R. and Huberfeld, N., “What Is Federalism in Healthcare For?What Is Federalism in Healthcare For? 70, no. 6 (2018): 16891803, at 1737, 1747.Google Scholar
CMCS Informational Bulletin, “Section 1115 Demonstration Process Improvements,” November 6, 2017, available at <https://www.medicaid.gov/sites/default/files/federal-policyguidance/downloads/cib110617.pdf> (last visited July 12, 2020).+(last+visited+July+12,+2020).>Google Scholar
Armstrong v. Exceptional Child Center, 575 U.S. 320, 347 (2015).Google Scholar
See Gresham, 950 F.3d 93 (Arkansas and Kentucky); See Philbrick, 397 F. Supp. 3d 11 (New Hampshire); Young v. Azar, Docket No. 1:19-cv-03526 (D.D.C. Mar. 4, 2020) (Minute Order granting summary judgment).Google Scholar
See Gresham, 950 F.3d at 103-104.Google Scholar
Department of Commerce v. New York, 139 S. Ct. 2551, 2575 (2019).Google Scholar
Letter from Penny Thompson, Chair of MACPAC to Alex Azar II, Secretary of the U.S. Department of Health and Human Services, November 8, 2018, available at <https://www.macpac.gov/wp-content/uploads/2018/11/MACPAC-letter-to-HHS-Secretary-Regarding-Work-Requirements-Implementation.pdf> (last visited July 12, 2020); Letter from Seema Verma, Administrator for Centers for Medicare and Medicaid Services to Penny Thompson, Chair of MACPAC, February 6, 2019, available at <https://ccf.georgetown.edu/wp-content/uploads/2019/02/2019_02_13_12_41_48.pdf> (last visited July 12, 2020); Government Accountability Office, “Medicaid Demonstrations: Approvals of Major Changes Need Increased Transparency,” April 2019, available at <https://www.gao.gov/assets/700/698608.pdf> (last visited July 12, 2020).+(last+visited+July+12,+2020);+Letter+from+Seema+Verma,+Administrator+for+Centers+for+Medicare+and+Medicaid+Services+to+Penny+Thompson,+Chair+of+MACPAC,+February+6,+2019,+available+at++(last+visited+July+12,+2020);+Government+Accountability+Office,+“Medicaid+Demonstrations:+Approvals+of+Major+Changes+Need+Increased+Transparency,”+April+2019,+available+at++(last+visited+July+12,+2020).>Google Scholar
Letter from Frank Pallone, Jr. and Ron Wyden to Christi A. Grimm, Principal Deputy Inspector General, January 14, 2020, available at <https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/TN.pdf> (last visited July 12, 2020).+(last+visited+July+12,+2020).>Google Scholar
L. Plank, “People with disabilities are staging protests in senators’ offices all over the country,” Vox, July 6, 2017, available at <https://www.vox.com/health-care/2017/7/6/15927940/people-with-disabilities-staging-protests-senators-offices> (last visited July 12, 2020).+(last+visited+July+12,+2020).>Google Scholar
Medicare for All Act of 2019, H.R. 1384, 116th Cong. § 1129 (2019); Medicare for America Act of 2019, H.R. 2452, 116th Cong. (2019).Google Scholar