While congressional Republicans and President Donald Trump have been searching for main cuts in federal funding of Medicaid, 26 states this 12 months expanded or enhanced advantages and at the least 17 plan to take action subsequent 12 months, based on a report launched Thursday.
The elevated advantages have been largely for psychological well being and substance abuse remedy, however states additionally added telemedicine and dental care, based on the report by the Kaiser Family Foundation and the National Association of Medicaid Directors. (Kaiser Health News is an editorially impartial program of the inspiration.)
The variety of states including advantages was the best in at the least a decade, based on the 50-state survey. Last 12 months, 21 states expanded advantages.
Just six states moved to chop Medicaid advantages in fiscal 2016.
Oregon final 12 months turned the primary state to supply protection for oral contraceptives prescribed by a pharmacist, relatively than a physician, with its Medicaid program, the report mentioned.
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Four states — Louisiana, Virginia, South Dakota and New York — added most cancers screening advantages akin to paying for genetic testing for the BRCA breast most cancers gene mutation.
Medicaid, the state-federal medical insurance program for the poor, covers nearly 75 million people and is without doubt one of the largest applications in state budgets. States typically add advantages to Medicaid throughout sturdy financial instances.
States added the advantages whereas Congress debated making important adjustments to this system, together with ending the open-ended federal spending that has been a staple of this system since its starting in 1966. The Republican efforts, together with payments to interchange the Affordable Care Act, have withered after stiff opposition from advocates and Democrats and three reasonable Republicans within the Senate.
Medicaid additionally faces uncertainty because the Trump administration weighs whether or not to permit states for the primary time to require non-disabled, grownup enrollees to work with a view to qualify for advantages. At least six states have such a request pending with the Centers for Medicare & Medicaid Services, and a choice is anticipated earlier than finish of the 12 months.
Robin Rudowitz, affiliate director for the Kaiser Family Foundation’s Program on Medicaid and the Uninsured, mentioned states are including advantages to answer the nationwide opioid abuse drawback in addition to to proceed the development to offer enrollees who’re aged or have critical well being issues the power to stay of their properties longer as an alternative of going to nursing properties. She mentioned extra states have been increasing advantages for a number of years popping out of the Great Recession, which resulted in 2009.
“We are seeing the delayed effects of the improving economy — enrollment growth is going down … and states are increasing provider [reimbursement] rates and restoring and adding benefits,” she mentioned.
Even whereas Maine, Indiana, Kentucky and different states want to add an adult work requirement to Medicaid, which is able to make it more durable for some folks to qualify, a few of these identical states and others are enhancing advantages, she mentioned.
“All of this is happening against a backdrop of major uncertainty about what is going to happen at the federal level,” Rudowitz mentioned.
After three years of supersized enrollment progress that peaked in 2015 on account of most states increasing protection underneath the ACA, Medicaid enrollment progress slowed to 2.7 p.c nationally in fiscal 12 months 2017, which ended Sept. 30, down from three.9 p.c the 12 months earlier than, based on a second Kaiser report additionally launched Thursday.
Overall Medicaid spending elevated three.9 p.c in 2017, up from three.5 p.c in 2016. States reported that enhance mirrored larger spending on things like prescribed drugs and long-term care companies.
The states’ share of Medicaid spending grew by three.5 p.c additionally in 2017 however is anticipated to go up 6 p.c in 2018. That enhance is generally a results of states beginning to pay 5 p.c of the price of new enrollees lined underneath the ACA growth. The federal authorities paid the complete prices for these enrollees by way of 2016.
The survey was carried out by analysts on the Kaiser Family Foundation and Health Management Associates.
Correction: This story was up to date on Oct. 19 to right an enhancing error. The survey was carried out by analysts from each the Kaiser Family Foundation and Health Management Associates, not simply Health Management Associates.