The Republican governor of Utah, Gary Herbert, has said that he has "95%" federal approval for his modified Medicaid expansion plan, Healthy Utah. While a final agreement is still two or three weeks away, according to Herbert, Department of Health and Human Services secretary Sylvia Burwell has agreed in concept to a plan that includes some provision connecting enrollees with assistance finding work. It's not clear yet whether or not accepting that assistance would be a requirement, according to the Salt Lake Tribune.
Read that carefully: HHS has not agreed to any provision requiring recipients to either hold a job or be actively job hunting in order to be eligible for subsidies. Employment would be a goal, not a condition, of the program. Herbert had previously called that particular element of the proposed plan a "work requirement;" as of Tuesday, he was referring to as "work effort." He called it a benefit that the state would make available.
The practical scope of the "work effort" would be limited. According to census data, 66% of those in the coverage gap are already employed and another 10% are medically unable to work, leaving a little under a quarter of individuals impacted by the potential legislation.
Still, Herbert describes the results of the negotiations for the three-year pilot program as a "win, win, win all the way around."
Under the proposed Healthy Utah Plan, the state would use the $258 million it would have received from the federal government for Medicaid expansion to provide subsidies to Utahns who make too much for quality for Medicaid but too little to qualify for federal subsidies—somewhere between 54,000 and 75,000 individuals. The subsidies would then be used to buy private insurance on the market.
Here are the biggest stories in the healthcare industry this week:
Some industry members expected more functionality from the highly-anticipated tracking device.
CVS' goal is not to replace major healthcare providers, but to be chosen over current competitors and increase in-store sales.
Providers should expect added scrutiny when caring for people in the limelight.
...but not by CMS. Safety nets and academic medical centers fared the worst on readmission rates.
A new report casts doubt on HHS, claiming that the agency did not adequately ensure Arkansas' private option would be budget neutral.
And here's what we were reading:
- Adrianna McIntyre writes in the Incidental Economist about the recent Health Affairs study on the impact of coverage on ED usage by young adults.
- In light of the recent GAO report lambasting HHS for its alleged laxity in ensuring budget neutrality for the Arkansas waiver, we revisited this Healthcare Dive piece on how the private option impacts providers.
- Read the Salt Lake Tribune coverage of the "conceptual deal" on Healthy Utah.
- Read Dylan Scott in Talking Points Memo on Healthy Utah.