After Trump clears the way GOP states move to charge poor more for Medicaid
The  Trump  administration is giving states the green light to increase premiums on enrollees in Medicaid  the nation's health insurance program for the poor. (David Goldman/AP)
Indiana is at the leading edge of Republican efforts to shift Medicaid in a more conservative direction — with  the Trump administration  giving the green light to states to shift some of the burden for the program onto the poor.
Indiana began asking the destitute to pay a monthly premium for some Medicaid services in 2015  as part of a deal with  the Obama administration  to expand the program. But more recent moves by Kentucky  Maine and Wisconsin seeking to ramp up patients' payments do not include a goal of expanding the 53-year-old program.
Last month   the Trump administration  approved Kentucky’s petition to raise premiums and impose work requirements for Medicaid. Earlier this month   the administration  approved Indiana's plan to raise premiums for poor people who smoke tobacco.
The new Medicaid premiums come at a time when the Trump administration is seeking to overhaul the social safety net. Conservatives say the changes  which give poor people additional responsibilities for obtaining government benefits  will encourage them to join the workforce.
Critics say the requirements will push more people into poverty. The Trump administration also plans on unveiling legislation to create work requirements for public housing programs  and recently called for transforming the nation's food assistance program.
“A big part of the rationale behind what they're doing is the idea that these people are not intended to be beneficiaries of Medicaid  despite the law saying that they are ” said Judith Solomon  a health policy expert at the Center on Budget and Policy Priorities. “This is part of an overall agenda  as evidenced by the budget and elsewhere in the Trump administration  that would take away health care and food and rental assistance including for working families. All these pieces go together.”
[ Trump  wants to overhaul America’s safety net with giant cuts to housing  food stamps and health care]
In an email   Trump  officials said that allowing states to increase premiums for Medicaid enrollees would lead to more “responsible decision-making.”
But now some states are pursuing costlier premiums than what the Obama administration permitted  or introducing penalties for failing to pay those premiums  according to MaryBeth Musumeci  associate director at the Kaiser Family Foundation. And unlike prior administrations   Trump  is poised to permit states to enact premiums without also guaranteeing they expand coverage in exchange.
But after Republicans in Congress failed last year to repeal the Affordable Care Act   the Trump administration  dropped the requirement for expanding coverage when considering states' proposals for overhauling Medicaid.
“We will not just accept the hollow victory of numbers covered ” said Seema Verma  Trump's administrator of the Center for Medicare and Medicaid Services  at the time.
In North Dakota  meanwhile  lawmakers told The Washington Post they will consider adding new premiums in light of  the Trump administration 's recent approval of Kentucky's plan.
Conservative supporters of the policies say they encourage the poor to take responsibility for their health. “There needs to be some skin in the game ” said state Sen. Judy E. Lee (R)  chair of the North Dakota state senate's health services committee. “There’s a difference to how people respond when they might have to pay $2 to $3  and the flexibility we’re seeing from the  Trump  administration is very important.”
“This is a big part of the Trump administration’s war on Medicaid ” said Ari Ne'eman  who served on the National Council on Disability under President Obama. “We are talking about populations of people  many of whom are facing significant challenges associated with poverty  and adding an additional administrative burden is needlessly cruel and offers no meaningful policy rationale.”
[‘We would literally not survive’: How  Trump ’s plans for the social safety net would affect America’s poorest]
[TGT] is giving states the green light to increase premiums on enrollees in Medicaid  the nation's health insurance program for the poor. (David Goldman/AP)
Indiana is at the leading edge of Republican efforts to shift Medicaid in a more conservative direction — with  [TGT]giving the green light to states to shift some of the burden for the program onto the poor.
Indiana began asking the destitute to pay a monthly premium for some Medicaid services in 2015  as part of a deal with  the Obama administration  to expand the program. But more recent moves by Kentucky  Maine and Wisconsin seeking to ramp up patients' payments do not include a goal of expanding the 53-year-old program.
Last month   [TGT]approved Kentucky’s petition to raise premiums and impose work requirements for Medicaid. Earlier this month   [TGT]approved Indiana's plan to raise premiums for poor people who smoke tobacco.
The new Medicaid premiums come at a time when [TGT] is seeking to overhaul the social safety net. Conservatives say the changes  which give poor people additional responsibilities for obtaining government benefits  will encourage them to join the workforce.
Critics say the requirements will push more people into poverty. [TGT] also plans on unveiling legislation to create work requirements for public housing programs  and recently called for transforming the nation's food assistance program.
“A big part of the rationale behind what they're doing is the idea that these people are not intended to be beneficiaries of Medicaid  despite the law saying that they are ” said Judith Solomon  a health policy expert at the Center on Budget and Policy Priorities. “This is part of an overall agenda  as evidenced by the budget and elsewhere in [TGT]that would take away health care and food and rental assistance including for working families. All these pieces go together.”
[ [TGT]wants to overhaul [TGT] safety net with giant cuts to housing  food stamps and health care]
In an email   [TGT]  officials said that allowing states to increase premiums for Medicaid enrollees would lead to more “responsible decision-making.”
But now some states are pursuing costlier premiums than what [TGT] permitted  or introducing penalties for failing to pay those premiums  according to MaryBeth Musumeci  associate director at the Kaiser Family Foundation. And unlike prior administrations   [TGT]is poised to permit states to enact premiums without also guaranteeing they expand coverage in exchange.
But after Republicans in Congress failed last year to repeal the Affordable Care Act   [TGT]dropped the requirement for expanding coverage when considering states' proposals for overhauling Medicaid.
“We will not just accept the hollow victory of numbers covered ” said Seema Verma  Trump's administrator of the Center for Medicare and Medicaid Services  at the time.
In North Dakota  meanwhile  lawmakers told The Washington Post they will consider adding new premiums in light of  [TGT] 's recent approval of Kentucky's plan.
Conservative supporters of the policies say they encourage the poor to take responsibility for their health. “There needs to be some skin in the game ” said state Sen. Judy E. Lee (R)  chair of the North Dakota state senate's health services committee. “There’s a difference to how people respond when they might have to pay $2 to $3  and the flexibility we’re seeing from [TGT] is very important.”
“This is a big part of the Trump administration’s war on Medicaid ” said Ari Ne'eman  who served on the National Council on Disability under President Obama. “We are talking about populations of people  many of whom are facing significant challenges associated with poverty  and adding an additional administrative burden is needlessly cruel and offers no meaningful policy rationale.”
[‘We would literally not survive’: How  Trump ’s plans for the social safety net would affect America’s poorest]