February 10, 2018
Trump Admin Chipping Away at Medicaid
The Trump administration and Republican governors are quietly but effectively chipping away at Medicaid, erecting both hard limits and practical barriers to coverage that will almost certainly cut the program’s rolls, and pulling it in a substantially more conservative direction.
Why it matters: Medicaid is the biggest insurance program in the country, covering more than 70 million people. It’s undergoing a substantial reinvention without any action from Congress, relying on a set of policy tools and legal authorities that have never before been used in quite the same way.
How it works: Medicaid is a joint state-federal program, and it’s long included a process that allows states to seek waivers from certain federal requirements. Republican governors, with an open invitation from the federal Centers for Medicare & Medicaid Services, have turned to that process to limit Medicaid in new ways.
One big difference: Past administrations — including the Obama administration — had used the same waiver process to let states attach some strings to their Medicaid programs, but always in tandem with some sort of coverage expansion.